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Biomedical subjects

D A Tandon

Publications and source records attributed to D A Tandon.

At least 19 recordsLinked to original sources
PubMed1996

Results of definitive radiotherapy in T1 and T2 glottic carcinoma: Institute of Rotary Cancer Hospital experience.

Early glottic carcinomas (T1 and T2) constitute only 2% of all laryngeal cancers in our data. Seventy patients were seen between 1985 and 1992. All patients were treated by cobalt-60 small field radiotherapy using a beam directed shell. The total dose delivered was 60-65 Gy in 31 patients and 66-70 Gy in 39 patients. The follow-up period ranged from 5 to 126 months, with a mean follow up of 37 months overall and 55 months in the surgical salvage group. Radiation therapy controlled disease in 71% (50 of 70) of patients overall; 75% with T1 and 67% with T2 lesions. Total laryngectomy as salvage surgery was performed in 70% (14 of 20) of patients whose disease recurred. Ultimate control including surgical salvage occurred in 64 (91%) of 70 patients in the present study. The actuarial 5 year survival was 83 and 80% in T1 and T2 tumours, respectively (statistically insignificant). This report supports the policy of definitive irradiation, reserving surgical salvage for radiation failures in early laryngeal cancers.

Adult↗
PubMed1995

Hyoid bone and atlas vertebra in established mouth breathers: a cephalometric study.

The position of hyoid bone and atlas vertebra in 29 established mouth breathers (17 boys and 12 girls) in the age group of 10-14 years were cephalometrically evaluated and compared with 23 nose breathers (11 boys and 12 girls). The children of both the groups were selected on the basis of history and clinical examination. The comparisons were made using univariate analysis for male and female groups separately as well as combined. It was observed that mouth breathers do maintain an extended head posture, which was evident from a decrease in distance between the occiput and dorsal arch of atlas vertebra. However the results of the present study did not reveal any distinct characteristics of hyoid bone and atlas vertebra that can be used to predict or associate the craniofacial pattern of mouth breathers.

Adolescent↗
PubMed1994

Trans-ethmoidal optic nerve decompression.

Blunt head injury frequently results in visual impairment, the optimal treatment of which is still debated. Over a 5-year-period (1987-1991) 111 patients with indirect optic nerve injury resulting from closed head trauma have been treated. In each case loss of vision was the only neurological deficit. In group A, 66 patients were initially treated with large doses of prednisolone (80 mg/day) for 3 weeks. Twenty-seven patients improved on steroids alone. In the remaining 39 patients in whom either unsatisfactory or no improvement occurred a transethmoidal optic nerve decompression was performed. Twenty-two patients in the latter group improved, thus yielding an overall improvement rate of 74.2% in group A. Group B (control), in which 45 patients were treated with prednisolone only (80 mg/day for 3 weeks), had an overall improvement rate of 51% (23 patients). The study reveals that while nearly half of such patients can improve on steroids alone, optic nerve decompression significantly improves recovery rates in patients where conservative treatment is unsatisfactory (P < 0.05). Total loss of vision not responding to steroids, absence of waveform on visual evoked response, and presence of an optic canal fracture indicate a poor prognosis.

Adult↗
PubMed1994

One year outcome of babies with severe neonatal hyperbilirubinemia and reversible abnormality in brainstem auditory evoked responses.

Brainstem auditory evoked responses (BAER) were longitudinally recorded prospectively in 18 term infants with neonatal hyperbilirubinemia (NHB) (total serum bilirubin > 15 mg/dl). Seven neonates had abnormal BAER. Wave complex IV-V was absent in eight recordings in NHB group while they were normal in the control group (p < 0.001). Prolongation of latency of waves I and V and interwave conduction time (wave I-V) occurred in jaundiced infants especially when unconjugated serum bilirubin level rose above 22 mg/dl. The abnormalities in BAER reversed to normal in all seven neonates after exchange blood transfusion indicating transient nature of bilirubin toxicity to the brain. All seven neonates in the study and control group had normal hearing, development quotient and were free of neurological sequelae on follow up for one year.

Audiometry, Evoked Response↗
PubMed1994

Olfactory neuroblastoma: results of combined therapy.

Olfactory neuroblastomas are seldom encountered in otolaryngologic practice. Eleven such patients were treated by combined therapy over a nine year period. Two cases who initially underwent surgery only required salvage for a local recurrence by a combined modality. Nine patients were disease-free at the end of two years, with four of them being so for five years. Adjuvant chemotherapy was used in four cases, one of whom developed distant cutaneous metastasis after two years. Craniofacial resection was performed on three patients. A combined therapy is recommended for all stages of olfactory neuroblastoma.

Adolescent↗
PubMed1993

Anterior mandibulotomy for oral and oropharyngeal tumours.

In the last six years, anterior mandibulotomy was used to approach tumours of the oropharynx and oral cavity in 39 cases. Twenty-six of these had primary lesions in the anterior two-thirds of the tongue. Eight cases had lesions in the base tongue, three in the cheek, and two in the tonsil. Twenty-six cases had T3 tumours, nine had T2 lesions, and four had T4 tumours. Twenty-five patients received post-operative radiotherapy. In 16 cases the mandibulotomy was combined with a marginal mandibulectomy. In 23 cases reconstruction was carried out using a pectoralis major myocutaneous flap. Adequate margins on histopathology obtained in all but eight patients. Bone-related complications occurred in only three patients, all of whom were previously irradiated. Thus the anterior mandibulotomy provides excellent exposure for oral and oropharyngeal tumours, with low complication rate, and avoidance of segmental mandibulectomy.

Combined Modality Therapy↗
PubMed1993

Traumatic optic neuropathy in children: a prospective study.

Fifty children with indirect optic nerve injury were prospectively studied over an 8-year period. They constituted 20% of all patients with optic nerve injury managed on a slightly different protocol. Half of these children were injured due to fall from a height, followed by road traffic accidents in 40% of the cases. Forty-three children had unilateral and 7 children had bilateral visual impairment. Five children had definite history of delayed-onset visual involvement, which ranged from 12 to 72 h following injury. Fifty percent of these children had fractured skulls and 14% had optic canal fracture. Visual evoked potentials were performed in 43 patients of which wave formation was normal in 7 and abnormal in 14 patients. The remaining 22 patients had no wave formation. All the patients were managed conservatively and received corticosteroids for a period of 3 weeks. In 7 children an optic nerve decompression was performed between 4 and 6 weeks following injury. Spontaneous visual improvement was observed in 20 (40%) children. In all the patients onset of visual recovery was noticed within 3 weeks. Of the 7 children who had optic nerve decompression, 4 had minimal spontaneous recovery and their vision remained static. All these 4 children benefited by surgery and the vision improved further following the decompression. Three children had no perception of light prior to surgery and none of these patients showed visual improvement following surgery. The present study brings out the clinical profile of children with optic nerve injury and the indications of surgery in these patients.

Adolescent↗
PubMed1993

Mucosal melanomas of the upper aerodigestive tract.

Mucosal melanoma of the upper aerodigestive tract is a rare disease with a relentless inexorable course. This lesion involved the nasal cavity, maxillary sinus and palate in two cases each all of whom underwent a radical excision. The disease did not respond to radiotherapy in two patients with nasopharyngeal involvement. One other patient died of distant metastasis within five weeks of diagnosis. Despite surgery offering variable disease free periods, the prognosis remains guarded.

Adult↗
PubMed1992

Carcinoma of the soft palate.

During a 10 year period 30 patients with carcinoma of the soft palate were treated. There were 22 cases in stages I and II. A curative dose of irradiation was used in 25 cases, four of whom required surgical salvage. Another five cases were treated by a combined modality of surgery and postoperative radiation. Seven cases had nodal metastases. A mean two-year disease-free survival of 83 per cent was obtained. The probability of five-year disease free survival was 65 per cent.

Carcinoma, Squamous Cell↗
PubMed1992

Parapharyngeal neurofibromas.

This paper is a retrospective study of 15 patients with parapharyngeal neurofibromas operated over a six year period. No patient presented with a neurological deficit. CT scans revealed a well encapsulated moderately enhancing mass in ten cases. The tumour was removed by a transcervical approach in ten cases while in five a cervical-transpharyngeal route with mandibulotomy was used; in three of the latter group the tumour was retropharyngeal. In two cases a recurrence was successfully excised. It was realized that a mandibulotomy was required when the internal carotid was displaced medially, or if the tumour extended to the base of skull or when its vertical diameter exceeded 8 cm.

Adolescent↗
PubMed1992

Parapharyngeal lipoma.

Lipomatous tumours of the parapharyngeal space are rare. A case of lipoma of the parapharyngeal space is reported for its rarity, characteristic radiological findings, and effect on growth of the facial bones.

Child↗
PubMed1992

Combined therapy in advanced head and neck cancers.

The results of single modality treatment using surgery or radiotherapy alone in advanced head and neck cancers are known to be unsatisfactory. The present study analyses 252 cases with stage III and IV resectable cancers of the head and neck region selected to be treated by a combined regime of pre- or post-operative radiation and radical surgery. Only 193 patients completed the treatment protocol. There were 58 cases (33.5 per cent) who failed either at primary or regional sites or both. Nine cases (five per cent) developed distant metastasis. Absolute and determinate four year disease-free survival was 55 per cent and 61 per cent respectively. Early lesions (stage I and II) have been excluded from the study. The study indicates that a reduction in primary and regional failures correlates well with a combined therapy, though prolonged treatment may affect patients' compliance to some extent.

Adult↗
PubMed1992

Role of prophylactic antibiotics in surgery for advanced head and neck cancer.

Four regimens of prophylactic antibiotics were utilized in 122 consecutive patients of stages III and IV carcinoma of the upper aero-digestive tract undergoing major resections in a randomized single-blind study. Ampicillin, gentamicin, cephalexin and metronidazole were used in different combinations for periods of 5 or 10 days. A cephalexin-metronidazole protocol for 10 days was associated with lowest post-operative infection rate. Oral-oropharyngeal resection and use of pectoralis major myocutaneous flap were the most important factors contributing to infection.

Adult↗
PubMed1992

Primary subglottic carcinoma.

Primary subglottic carcinoma is rare with a uniformly poor prognosis. We present our experience of eight such cases treated over a period of ten years. One patient had a mucoepidermoid carcinoma while the rest had a squamous cell carcinoma. A combination of surgery and radiotherapy was employed in five cases, while one case each underwent radiotherapy only, surgery only and salvage surgery following radical irradiation. Three cases died of locoregional failure within a year. The remaining five patients have been disease-free for six months to 3.5 years.

Adult↗
PubMed1991

Carcinoma of the hypopharynx: results of combined therapy.

Hypopharyngeal carcinoma is an aggressive cancer with a guarded prognosis. Results of 64 patients with-hypopharyngeal cancer, 59 of whom were in stage III or IV, undergoing curative therapy during a six-year period were analysed. A combined modality resulted in a 62% and 38.4% 2-year disease free survival incases with pyriform sinus and postcricoid tumours respectively. Results of radiotherapy failed salvage surgery were much poorer for either site.

Carcinoma↗
PubMed1988

Giant cell tumour of the temporosphenoidal region.

A case of giant cell tumour of the temporo-sphenoidal region and superior part of infratemporal fossa is presented along with a brief review of the literature. The tumour mass was removed by curettage using a Weber-Fergusson incision with transection of the zygoma. There was no recurrence at three-year follow up.

Adult↗
PubMed1988

Nasopharyngeal angiofibroma: (a nine-year experience).

In a nine-year period 50 nasopharyngeal angiofibromas, of whom 13 had recurrent tumour, were treated surgically at the All India Institute of Medical Sciences, New Delhi. A new staging system according to the regions involved was used; 31 patients in whom the tumour was limited to the nasopharynx (Stage I) and those with superior spread into the ethmoid or sphenoid sinuses (Stage IIA) had their tumours removed by a transpalatal route, alone or in combination with other approaches. Tumours with lateral extensions into the pterygopalatine or infratemporal fossae or the cheek (Stage IIB), and those with simultaneous superior and lateral spread (Stage III) underwent a transmaxillary excision (19 cases). In two of the three cases with intracranial extension (Stage IV), the tumour was removed successfully from below. There was no mortality. The usefulness of the transmaxillary approach, especially in recurrent cases, is emphasized. No adjuvant modalities were employed in this series and blood loss was acceptable.

Adolescent↗