Reversible cardio-pulmonary changes due to adeno-tonsilar hypertrophy.

Adeno-tonsillar hypertrophy, with signs of upper airway obstruction is a common presentation in ENT clinics. Recently it is identified as a major cause of sleep apnea syndrome. Several isolated case reports of pulmonary hypertension and corpulmonale appeared in the literature. The authors report two such children aged less than 2 years with cardio-pulmonary changes occurring secondary to chronic adeno-tonsillar hypertrophy that were successfully treated with the surgical removal.

Treacher Collins syndrome with acute airway obstruction.

Treacher Collins syndrome presents with cranio-facial deformities of variable expressions and severity, but rarely is it associated with acute airway obstruction of such severity that it necessitates surgical intervention. The authors describe their experience with such a neonate, who presented with acute airway obstruction successfully managed with a tracheostomy. The relevant English literature is reviewed.

Endoscopic sphenopalatine ganglion block for pain relief.

The anaesthetic effect of the sphenopalatine (SPG) block has been well utilized for intranasal topical anaesthesia but the analgesic efficacy of (SPG) block, though well documented in literature, has not been put into practice. The methods available for SPG block till date were blind as they do not visualize the foramen. Nasal endoscopies have been used to visualize the foramen for an effective block. The authors present their experience with the endoscopic sphenopalatine ganglion block for pain relief in head and neck malignancies and neuralgias.

The indications and complications of pectoralis major myocutaneous flap reconstruction in head and neck surgery-our experience.

Most of the head and neck cancer patients in India present to the Otolaryngologist, Head and Neck surgeon in the advanced stages of their disease. Extensive resection followed by acceptable morphological & functional reconstruction is the goal for the surgeon. Use of the pectoralis major myocutaneous (PMMC) flap enables extensive ablative procedures to be carried out followed by immediate and reliable reconstruction. Thirty consecutive cases of biopsy proven squamous cell carcinoma of the head and neck region were studied. All underwent extensive resection of the tumour with pectoralis major myocutaneous flap reconstruction, with preor post-operative external irradiation. This study concentrates on the indications for and complications encountered with the use of the pectoralis major myocutaneous flap. Also included is an extensive review of the literature relating to the complications encountered with the use of this method of reconstruction.

Familial Treacher-Collins syndrome.

The major congenital malformations of the first and second branchial arch derivatives such as mandibulofacial dysostosis have a genetic basis. Treacher-Collins syndrome is transmitted as an autosomal dominant trait, although many cases occur as spontaneous mutations. The characteristics are hypoplasia of the malar, mandibular and maxillary bones, antimongoloid slanting of the palpebral fissures and a receding chin. The aural findings include malpositioning or maldevelopment of the pinna or external auditory meatus, an atretic bony plate instead of tympanic membrane, or ossicular malformations. Five members of a Hindu family affected by Treacher-Collins syndrome spanning three generations are examined in detail, with special reference to their hearing.