Faculty of Medicine

This study shares our experiences in managing patients with thyroglossal cysts. These are common midline tumors of neck. Characteristically these masses move on protrusion of tongue due to their intimate relationship with hyoid bone. Adults commonly presented with this lesion eventhough literature review suggests it to be common in children. All these patients underwent surgery because of the presence of mass rather than any symptoms. All 30 patients taken up in this study had a normal functioning thyroid in the normal position in addition to the cystic lesion.

Proximity of orbit to nose and paranasal sinuses makes it rather vulnerable to insults due to otolaryngological causes. The medial wall of orbit (Lamina papyracea) is rather paper thin and it
happens to form the lateral wall of anterior ethmoid air cells. Infections / tumors involving paranasal sinuses can involve orbit also causing proptosis. The aim of the article is to study the
common otolaryngological causes of proptosis in our Institution during 2009 – 2012.

Malignant tumors involving maxilla is rather rare. This comprises about 1% of all malignant tumors seen in humans. This tumor constitutes roughly 3% of all head and neck malignancies. This article discusses our experience in managing patients with malignant tumors of maxilla. All our patients underwent total maxillectomy followed by post operative irradiation. Mean survival rates of our patients ranged from 2.5 years to 3 years. Survival rates were also dependent on the histology of the tumor. This is a retrospective study of patients who presented to our Institution between 2006-2010.
In our study we found that surgery had a definitive role despite the staging. Even advanced cases had a definite improvement in the quality of life. All our patients received post operative irradiation
(full course) following total maxillectomy.

Malignant tumors involving maxilla is rather rare. This comprises about 1% of all malignant tumors seen in humans. This tumor constitutes roughly 3% of all head and neck malignancies. This article discusses our experience in managing patients with malignant tumors of maxilla. All our patients underwent total maxillectomy followed by post operative irradiation. Mean survival rates of our patients ranged from 2.5 years to 3 years. Survival rates were also dependent on the histology of the tumor. This is a retrospective study of patients who presented to our Institution between 2006-2010.
In our study we found that surgery had a definitive role despite the staging. Even advanced cases had a definite improvement in the quality of life. All our patients received post operative irradiation
(full course) following total maxillectomy.

Nose is the most prominent part of the face, hence it is likely to be the most common structure to be injured in the face. Although fractures involving the nasal bones are very common, it is often ignored by the patient. Patients with fractures of nasal bone will have deformity, tenderness, haemorrhage, edema, ecchymosis, instability, and crepitation. These features may be present in varying combinations. This article discusses the pathophysiology of these fractures, role of radiography and ultrasound in their diagnosis and their management.

Zygoma is a very crucial component which maintains facial contour. Fractures involving zygoma is very common, in fact it is the second most common facial bone to the fractured following facial trauma (next only to nasal bones). Fractures involving maxilla not only creates cosmetic deformities, it also causes disruption of ocular and mandibular functions too. This article attempts to discuss in detail the etiopathogenesis and the various management options available. It also includes our 3 years experience in treating these patients at Stanley Medical College Chennai.
During the period of 3 years between 2010 - 2012 about 82 patients got treated in our institution for faciomaxillary trauma.

Blow out fracture of orbit involves fracture of orbital floor without fracture of infraorbital rim. This injury is common from frontal blow to orbit. Frontal blow to orbit causes increased intraorbital
tension causing fracture of floor of the orbit (weak point) with prolapse of orbital content into the maxillary sinus cavity. This causes enophthalmos and diplopia. Infraorbital rim is not involved in pure blow out fracture, it is also involved then it should be considered as an impure blow out fracture [3]. Entrapment of inferior rectus muscle between the fracture fragments will cause
diplopia in these patients. This article discusses a novel endoscopic internal reduction of fractured fragments. Main advantage of endoscopic approach is the lack of facial skin incision. It is cosmetically acceptable.

Fractures involving frontal bone are rather uncommon. Injuries to this bone is rather critical because of its proximity to brain. This article attempts to discuss this topic with focus its prevalence, its causes and various treatment modalities available. Three crucial areas need to be addressed. They include anterior table, posterior table and frontal sinus outflow tract. Posterior table fractures are usually associated with anterior table fractures and CSF leak. Hence these patients should be treated as head injury cases

This is a case report of a rather rare disorder i.e. Ramsay Hunt syndrome. This is caused by Varicella zoster infections involving geniculate ganglion of facial nerve. This syndrome is
manifested by the presence of blebs in the external auditory canal, ear ache, and lower motor neurone type of facial paralysis. This patient had excellent recovery following administration of
oral steroids and acyclovir.

This paper summarises the effectiveness of tissue adhesives in otorhinolaryngology. Although the adhesion system cannot and should not replace surgical suture, it provides valuable assistance in tissue synthesis and in local haemostasis, particularly in cases where conventional suture methods are especially difficult to apply. In addition to good adhesion, an elastic consistency, and good tissue compatibility, the adhesive is completely absorbed.
The system has been used successfully in myringoplasty, laryngectomy during pharyngeal closure, repair of CSF leak, laryngocele, and ossiculoplasty.

Being a left-handed surgeon, more specifically a left-handed ENT surgeon, presents a unique pattern of difficulties.
This article is an overview of left-handedness and a personal account of the specific difficulties a left-handed ENT surgeon faces.

Grisel syndrome is defined as atlantoaxial subluxation following infections of upper airway. These patients present with torticollis which is persistent. Radiology is normal in these patients. This is
actually a sinister problem which should always be kept in mind before taking up a patient for adenotonsillectomy. Subclinical subluxation of atlantoaxial joint may become overt causing brain
stem compression following adenotonsillectomy surgery. This actually occurs because the paraspinal muscles are relaxed (due to the use of muscle relaxants) during the procedure. The actual position of tonsillectomy (Rose position) aggravates this condition. This article attempts to explore this problem
with a review of 10 year published literature on this subject

Pleomorphic adenoma is the common salivary gland tumour encountered. Most of these tumours occur in major salivary glands; Parotid gland happens to be the commonly involved one. This case report discusses a case of intraoral salivary gland tumour (in the hard palate). This case report discusses a case of pleomorphic adenoma of hard palate with a review of corresponding world literature. Even though these tumours are painless and slow growing ones, it is important to identify
these cases rather early and extirpate them totally.

Anatomy of the lateral nasal wall is highly complex and variable. With the popularity of endoscopic sinus surgery a through knowledge of this complex anatomy is very vital. Highly variable anatomy and paucity of standard landmark makes this region vulnerable for complications during endoscopic sinus
surgery. The learning curve for endoscopic sinus surgery is made rather steep by this highly variable
anatomy . Study of anatomy of lateral nasal wall dates back to Galen (AD 130201).
He described the porosity of bones in the head. Davinci in his classical anatomical drawings has illustrated maxillary
sinus antrum. He also described maxillary sinus as cavities in the bone that supports the cheek .
Highmore (1651) described maxillary sinus anatomy. Hence it is also known as antrum of Highmore .
It was during the 19th century that Zuckerkandl came out with the first detailed description of maxillary sinus and its surrounding anatomy. Paranasal sinuses are four air filled cavities situated at
the entrance of the upper airway. Each of these sinuses are named after the skull bone in which it is located

This article attempts to analyze all cases of odontogenic cysts involving upper jaw who presented at Stanley Medical college during 2007 – 2012. This article analyzes the incidence of these cysts during the above said period, age of occurrence, sex predilection if any, clinical presentations and optimal treatment modality. Common complaints with which patients presented to our Institution was swelling over jaw, next was loosening of dentition, paresthesia. 30 patients had presented with cysts involving upper jaw out of which 29 were females and one was male. All these patients underwent surgical removal of the cystic lesion.

Mucoceles are gradually expanding lesion involving paranasal sinuses. This is usually caused due to obstruction to the normal drainage channels of paranasal sinuses leading on to pent up secretions within it. These patients classically don't present with symptoms pertaining to nose and sinuses but with
ophthalmological signs and symptoms. They invariably present to the opthalmologist before finding their way to an otolaryngologist.

Atrophic rhinitis is a chronic embarrassing debilitating disease involving nasal cavity and paranasal sinuses. It is characterized by foul smelling crusts (greenish) inside the nasal cavity. Nasal mucosa tends to bleed when these crusts are removed. Nasal cavity appears to be excessively roomy. Foul
stench emanates from the patient. Patient is mercifully unaware of this stench because of the presence of anosmia. This article discusses the various features of this disease and the various
management modalities available.

This manuscript discusses the importance of clinical examination in the diagnosis of otological
disorders. The art of clinical examination combined with accurate history taking by the surgeon
invariably points to the correct diagnosis in otology. It is worth while spending time examining the
patient in a systematic manner. This article describes the clinical examination techniques used in
examining an otological patient.

Malignant otitis externa is a severe debilitating disorder that involves the external auditory canal. The
term “Malignant Otitis Externa” is actually a misnomer. It has been coined to indicate the destructive
capabilities of this disorder. This article discusses etiopathogenesis, diagnostic problems and various
management modalities available to manage the same.

Gingival hyperplasia / hypertrophy is a rather common condition. This article reviews literature pertaining only to gingival overgrowth following drug ingestion. A wide range of causes have been
attributed to gingival overgrowth. Drug induced overgrowth commonly occurs following medications prescribed for non dental causes. Pathogenesis of gingival overgrowth following ingestion of certain drugs is still unsure. Certain high risk co existent factors like presence of gingivitis has been implicated. Management of this condition should take into consideration the condition for which the offending drug has been prescribed. Physicians should be aware of drugs that could cause gingival overgrowth in order to identify and manage this problem.