Biomedical subjects
Publications and source records attributed to R C Nayar.
A case of left pyriform sinus fistula in a 20-year-old male is presented. The surgical management of this uncommon condition is discussed. Its embryological and clinical aspects are reviewed.
The clinical records of 26, predominantly male, adults with rhabdomyosarcomas in the head and neck were analyzed. Patients' ages ranged from 18 to 74 years (mean: 24.5 years). According to the retrospective clinical group classification, 18 (69%) of 26 were advanced tumors at initial presentation belonging to group III or IV. The ethmoids were the most common primary site of origin in 12 (46%) of 26 patients. Nodal and systemic metastases were noted in 12 (46%) and 6 (23%) patients, respectively. Bone metastases were noted in 4 patients. Heterogeneous treatment protocols were used with a variety of chemotherapy combinations in most cases, with surgery and radiotherapy. Overall results were poor, with a survival rate of 7.6% at 5 years. Neither histopathology nor response to chemotherapy was found to influence survival. All long-term survivors belonged to the early-stage groups (clinical groups I and II) for which complete surgical excision was possible. In spite of a poor prognosis after relapse, the use of aggressive chemotherapy appeared to prolong life in some patients.
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A case of malakoplakia, of the temporal bone in a nine-month-old male child is reported. The lesion presented as an aural polyp, associated with a lower motor neuron facial palsy. On exploration, the granuloma was noted to involve the temporal bone, eroding the bony labyrinth. It was successfully treated with surgical debridement, and antibiotics. A review of the relevant literature is presented.
Conventional external ear swab cultures were compared with cultures obtained from the middle ear, in 25 cases of tubotympanic type ('safe'), chronic suppurative otitis media. These cultures were identical in 22 of the 25 cases. Anaerobic organisms were isolated in only one case. Mixed infections of both gram-positive and gram-negative organisms were seen in nine cases (36 per cent). Staphylococcus aureus was the commonest single agent isolated (16 cases). Multidrug resistance was seen in 12 of these isolates.
Deviated nasal septum (DNS) is believed to occur in neonates following the trauma of birth processes. The present prospective study was undertaken to evaluate the relationship of intrauterine and parturition processes with neonatal septal dislocations. The neonates were subjected to a series of tests to assess presence and extent of deviated septum within the first 48 hours. A statistically significant correlation was demonstrable between the incidences of septal deviations with intra uterine fetal positions and mode of delivery.
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A case of Rhinoscleroma of the left maxilla and ethmoid with involvement of the orbital apex, in a female diabetic, is reported. The significance of the associated diabetes is discussed.
The hypopharyngeal anatomy of 20 post-laryngectomy patients was studied both with endoscopy and radiological contrast medium examination. The pharynx was found to be essentially a featureless tube with mucosal rugosities running along its axis. No correlation was found between the endoscopic and radiological appearance of the pseudoepiglottis, or between its presence and post-operative complications or the acquisition of oesophageal speech. A low incidence of post-operative dysphagia was noted. The RPS ratio for normal patients was calculated.