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Centre for otorhinolaryngology and head and neck surgery, Shrimann hospital

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Centre for otorhinolaryngology and head and neck surgery, Shrimann hospital

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centre for otorhinolaryngology and head and neck surgery is one of the most prolific and well equipped centre for ENT and head and neck surgery in the region, it caters to a plethora of cases from the speciality from the simplest to the most complex

24/04/2021

Case report #2 :
A 72 year old male presented with tracheostomy done at outside centre for respiratory distress. Pt. Had earlier history of loss of voice and aspiration of food. A CT scan was also done at outside centre which showed a transglottic growth with erosion of thyroid cartilage with extra laryngeal spread.No significant cervical lymphadenopathy was noted. The histopathology showed squamous cell carcinoma. Patient was prepped for a total laryngectomy with bilateral selective neck dissection. Pulmonary function tests were performed which were normal. Patient was counseled extensively regarding voice rehabilitation with both a prosthesis and electrolarynx and advantages and disadvantages of both. Pt. Chose not to go with primary TEP. Pt. Was taken up for a total laryngectomy. A Gluck Sorenson incision was given encompassing the tracheostomy site. Flaps raised. B/l 2 through 4 neck dissection was done. A total laryngectomy was done. Cricopharyngeal myotomy was done. Pharynx was closed in a t shaped manner. Final histopathology revealed a T4 lesion. 60 lymph nodes were also recovered out of which 2 were positive for metastasis. After 4 weeks patient is on oral diet and doing well. Now being prepared for postoperative radiotherapy.

21/04/2021

Re : previous post

20/04/2021

Carotid body tumours are very rare entities. They arise from the paragangliomic cells at the bifurcation of CCA into ICA and ECA. These are highly vascular tumours deriving their blood supply mostly from the ECA. Presenting a recently done case of carotid body tumour in a young female, 18 years of age. The presenting complaint was that of a neck swelling. The patient had an outside ct scan which showed a lesion in the region of carotid bifurcation. A fresh MRI and ct angio were obtained which showed the lesion at the bifurcation of carotid with characteristic splaying of carotid vessels. The lesion was seen to be completely encircling the ECA with more than 270 degree involvement of ICA and hence was classified as shamblin 3. 24 hr urinary metanephrines were also obtained which were normal. A complete preoperative workup was done. After which patient was taken up for surgery. A transverse incision was given and flaps were raised. The tumour was seen to be involving the ICA almost circumfrentially with some involvement of tunica media which made subadventitial resection difficult. Intraoperatively decision was made to resect the tumour along with the carotid bifurcation and reconstruct ICA with a saphenous graft. The help of cardiothoracic team was taken. After excision of the tumour, the ICA was reconstructed by the CTVS team. Blood flow was established. At all points all major neural structures including the hypoglossal nerve were preserved. After 4 weeks of surgery the patient is doing well with no neural deficits. Blood flow was also established post operatively with a colour doppler. Pictures coming in next post
P.s A special thanks to Dr. Rakesh Sudan (CTVS) without whose expertise this case would not have been possible

25/03/2021

Hello friends this is a academic page that is being created to discuss interesting cases in otorhinolaryngology and head and neck surgery. We will try and post weekly cases and create a forum for discussing these cases

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Pathankot Road
Jalandhar
144012

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