Dermoid Cyst of the Parotid Gland: A Rare Entity

Abstract

Dermoid cysts of the head and neck are a rare entity. These cysts are benign cystic malformations and histologically composed of tissues originating from ectoderm and mesoderm. Dermoid cysts usually presents as midline neck mass and rarely appear in lateral region. These are extremely rare in parotid gland, however should be considered as a differential in the list of parotid mass. There are a few cases published till date. Superficial parotidectomy is suggested as surgical treatment, however sometimes enucleation is also sufficient. There are only very few case reports published on dermoid cysts in parotid glands. We present a rare case of this entity and the challenges faced in making diagnosis with a short review of the literature.

http://bit.ly/2QRnJpq

A Survival Analysis of Hypopharyngeal Cancer Patients: A Hospital-Cancer registry Based Study

Abstract

To study the survival in patients affected with hypopharyngeal cancer among treatment groups and different stages. Data of hypopharyngeal cancer patients diagnosed from 1st January 2010 to 31st December 2010 was used in the present study. The cases were analyzed for gender, age group distribution, sub-sites at presentation, stage at diagnosis and the type of treatments. Survival from the date of first diagnosis was estimated and hazard ratios were calculated. Survival probability and hazards ratios (HR) were calculated by Kaplan–Meier method and Cox-proportional regression analysis respectively. Censoring of patient who survived longer than 5 years was done. Active follow-up was done for the survival analysis. The study cohort included 217 patients and treatment compliance was observed in 46.9% of cases. The median age at diagnosis was 57 years (range 24–90), 86.2% of cases were locally advanced cases (stage III and IV), pyriform sinus was major sub-site (96%), radiotherapy was main treatment modality alone in 84.8% of cases, median survival was 31 months and 5-year overall survival was 36.9%, and HR for stage IV was 1.9 (P = 0.03, 95% CI − 1.04 to 3.7). In developing setting of North East India, radiotherapy was the main modality of treatment for hypopharyngeal cancer patients, and understanding the clinical parameters and survival of this group of cancers is crucial for its control.

http://bit.ly/2BEiVt4

Feasibility of Parotid Duct Transposition for the Treatment of Dry Eye: A Cadaveric Study

Abstract

Total dry eye is encountered less frequently, but it may lead to blindness. Transposition of parotid duct to the conjunctival cul-de-sac is a method of treatment for advanced cases of xerophthalmia to prevent blindness. Tears and parotid secretions have similar composition; therefore saliva provides an excellent replacement for tears. Limitation of this procedure is that the length of the parotid duct may not be adequate to reach the conjunctival cul-de-sac. This study was conducted in 30 fresh cadavers to assess the length of parotid duct and technical feasibility of parotid duct transposition for the treatment of dry eye. The parotid duct was dissected and resting length of parotid duct was measured on both sides without stretching. The distance between ear lobule to lateral canthus was also measured on both sides in each cadaver. The length of parotid duct ranges from 4.5 to 7 cm with average length was 5.8 cm. The majority of the cadavers had parotid duct length of 6 cm. Length of the right and left parotid duct was found to be equal in all cadavers. Parotid duct reached comfortably in 24 cadavers (80%) while it was short in 6 cadavers (20%) by 1–1.50 cm in length. Parotid duct can be transposed easily to the lower conjunctival cul-de-sac in majority of the cases. If the parotid duct is falling short than a cuff of the buccal mucosa can be taken in order to gain length.

http://bit.ly/2QVkFJ1

Adult convulsive status epilepticus(CSE)

Determinants of outcome in convulsive status epilepticus in adults: An ambispective study from central India

p. 84

Raunak Dani, Ajoy Sodani, Kapil Telang, Richa Nigam DOI:10.4103/aian.AIAN_466_17   Background: The determinants of the outcome in adult convulsive status epilepticus(CSE), also the implication of the value of mean arterial blood pressure (MAP), and random blood sugar at admission on the outcome are not clear. Objectives: The objective of this study is to look for the determinants of unfavorable outcome in CSE. Materials and Methods: Ambispectively gathered data from 55 patients, treated consecutively with identical protocol during January 2010–December 2016, were analyzed. The demographic and clinical variables were identified and correlated with outcome in each individual. Results: There were 65.45% males and 34.55% females. Favorable outcome (conscious and discharged) was seen in 63.6%, unfavorable (death 14.5%, absent cortical functions 10.9%, and inability to wean-off anesthetic agents 10.9%). The parameters associated with unfavorable outcome were female gender (odds ratio [OR]: 1.45), MAP ≤80 mmHg (OR: 2.57), time to first medical attention >5 h (OR: 127.8), and time to control clinical seizures >3.5 h (OR: 7.87). Almost 44.2% of patients with SE severity score >2 had unfavorable outcome (sensitivity 75% and specificity 45.7%). New scoring system, the CSE outcome score (CSEOS, developed by combining the predictors associated with higher odds of poor outcome), predicted the poor outcome with the sensitivity and specificity of 90% and 54.29%, respectively. Discussion and Conclusion: Low MAP and delay of >3.5 h in treatment initiation or seizure control are the key determinants of poor outcome in CSE. With the incorporation of CSEOS, we believe that our findings can be helpful in the process of clinical decision-making and prognostication of patients with CSE.

Dermoid Cyst of the Parotid Gland: A Rare Entity

Abstract

Dermoid cysts of the head and neck are a rare entity. These cysts are benign cystic malformations and histologically composed of tissues originating from ectoderm and mesoderm. Dermoid cysts usually presents as midline neck mass and rarely appear in lateral region. These are extremely rare in parotid gland, however should be considered as a differential in the list of parotid mass. There are a few cases published till date. Superficial parotidectomy is suggested as surgical treatment, however sometimes enucleation is also sufficient. There are only very few case reports published on dermoid cysts in parotid glands. We present a rare case of this entity and the challenges faced in making diagnosis with a short review of the literature.

http://bit.ly/2QRnJpq

A Survival Analysis of Hypopharyngeal Cancer Patients: A Hospital-Cancer registry Based Study

Abstract

To study the survival in patients affected with hypopharyngeal cancer among treatment groups and different stages. Data of hypopharyngeal cancer patients diagnosed from 1st January 2010 to 31st December 2010 was used in the present study. The cases were analyzed for gender, age group distribution, sub-sites at presentation, stage at diagnosis and the type of treatments. Survival from the date of first diagnosis was estimated and hazard ratios were calculated. Survival probability and hazards ratios (HR) were calculated by Kaplan–Meier method and Cox-proportional regression analysis respectively. Censoring of patient who survived longer than 5 years was done. Active follow-up was done for the survival analysis. The study cohort included 217 patients and treatment compliance was observed in 46.9% of cases. The median age at diagnosis was 57 years (range 24–90), 86.2% of cases were locally advanced cases (stage III and IV), pyriform sinus was major sub-site (96%), radiotherapy was main treatment modality alone in 84.8% of cases, median survival was 31 months and 5-year overall survival was 36.9%, and HR for stage IV was 1.9 (P = 0.03, 95% CI − 1.04 to 3.7). In developing setting of North East India, radiotherapy was the main modality of treatment for hypopharyngeal cancer patients, and understanding the clinical parameters and survival of this group of cancers is crucial for its control.

http://bit.ly/2BEiVt4

Feasibility of Parotid Duct Transposition for the Treatment of Dry Eye: A Cadaveric Study

Abstract

Total dry eye is encountered less frequently, but it may lead to blindness. Transposition of parotid duct to the conjunctival cul-de-sac is a method of treatment for advanced cases of xerophthalmia to prevent blindness. Tears and parotid secretions have similar composition; therefore saliva provides an excellent replacement for tears. Limitation of this procedure is that the length of the parotid duct may not be adequate to reach the conjunctival cul-de-sac. This study was conducted in 30 fresh cadavers to assess the length of parotid duct and technical feasibility of parotid duct transposition for the treatment of dry eye. The parotid duct was dissected and resting length of parotid duct was measured on both sides without stretching. The distance between ear lobule to lateral canthus was also measured on both sides in each cadaver. The length of parotid duct ranges from 4.5 to 7 cm with average length was 5.8 cm. The majority of the cadavers had parotid duct length of 6 cm. Length of the right and left parotid duct was found to be equal in all cadavers. Parotid duct reached comfortably in 24 cadavers (80%) while it was short in 6 cadavers (20%) by 1–1.50 cm in length. Parotid duct can be transposed easily to the lower conjunctival cul-de-sac in majority of the cases. If the parotid duct is falling short than a cuff of the buccal mucosa can be taken in order to gain length.

http://bit.ly/2QVkFJ1