Surgical approach to Parapharyngeal Tumours - Our Experience

Introduction The complex anatomy of the parapharyngeal space, the surrounding vital structures and late presentation of the tumours affecting this space pose difficult surgical challenge to every otolaryngologist. The study gives an overview of the experience in managing parapharyngeal tumours in a tertiary care setting. Materials And Methods Fifteen patients with parapharyngeal tumours were treated surgically in a medical college hospital in Kolkata in the three year study period. Surgical approaches were chosen, considering the size, site, extent and histology of the tumours. Results Most of the patients (33.33%) were from 20-30 years age group. 60% were females. The most common presenting feature was neck swelling. 80% of the cases were benign.The most common histologic variant was Schwannoma. The tumours were accessed through Trans-cervical, Trans-cervical Trans-parotid or Trans-cervical with Midline Mandibulotomy approaches. The most common post-operative complication was wound dehiscence. Discussion The most common presentation of a parapharyngeal mass was neck swelling mainly behind the angle of mandible (86.67%). Younger patients in their third decade of life were found to be affected more. Gadolinium enhanced MRI was found to be the most important investigation in parapharyngeal tumours. Complications were minimal. Conclusion A conservative trans-cervical approach was found to be feasible and effective in majority of the cases over radical ones, which may be required in malignancies and skull-base involvement

Myxoid Chondrosarcoma of the Hyoid Bone

Introduction Chondrosarcoma of hyoid bone is very rare with only 19 cases still reported. We, therefore, present this case report for the interest of medical literature to make clinicians aware of the disease. Case Report They usually present as a slow growing upper neck mass. Computed tomography (CT) and magnetic resonance imaging (MRI) are useful radiologic investigations. The tumour was resected through a trans-cervical approach. Definite diagnosis was made by postoperative histopathology and immunohistochemistry. Discussion Surgical excision is the treatment of choice for local control. Incomplete removal is a risk factor for recurrence and possible dedifferentiation. Long term follow up is necessary

Myxoid Chondrosarcoma of the Hyoid Bone

Introduction Chondrosarcoma of hyoid bone is very rare with only 19 cases still reported. We, therefore, present this case report for the interest of medical literature to make clinicians aware of the disease. Case Report They usually present as a slow growing upper neck mass. Computed tomography (CT) and magnetic resonance imaging (MRI) are useful radiologic investigations. The tumour was resected through a trans-cervical approach. Definite diagnosis was made by postoperative histopathology and immunohistochemistry. Discussion Surgical excision is the treatment of choice for local control. Incomplete removal is a risk factor for recurrence and possible dedifferentiation. Long term follow up is necessary

Present Scenario of Childhood Deafness: A Tertiary Level Health Care Study

Abstract Introduction Hearing loss is the most common sensory deficit in humans today. Approximately 63 million people in India suffer from significant auditory impairment. Materials and Methods Fifty children of 0-7 years age group, presented to a tertiary level center in Kolkata were assessed by objective and behavioural audiological tests. Result Mean age of presentation was found to be 40.5 months. No risk factor could be identified in 72% of the cases. 47% fell into the profoundly deaf category. Discussion Numerous studies agree that half of the infants with sensorineural hearing loss have no risk factors at birth and thus would be missed by a targeted hearing screening.  Conclusion India certainly faces a worse situation regarding childhood deafness. Implementation of universal neonatal hearing screening along with pre-school hearing assessment can certainly change the scenario