Sunday, July 27, 2014

Superior laryngeal nerve palsy

This patient presented with four day history of hoarseness of voice.  He was being treated for acute laryngitis by a physician.  He was prescribed voice rest, antibiotics and antacids.  He did not have any relief.

His laryngoscopy showed that his leafy vocal cord was bowing on adduction and did not have full tension.  It was moving well but didn't close fully producing a significant vocal gap.  A working diagnosis of left superior laryngeal nerve palsy was made and treatment started.  

Left superior laryngeal nerve palsy

Same patient showing vocal cords in full abduction

Friday, July 18, 2014

X ray Mastoids

X Ray Mastoid air cells. Rt side x rays shows hazy mastoid air cells with some sclerosis while on left shows a very well pneumatized mastoid air cell system.

Contact Granuloma of the vocal cords

These are the two pictures of before and after giving steroids in a case of Contact granuloma of the vocal cord. Blue arrow shows an active granuloma. the paler counter part is shown in next photo after treatment. This patient does not have any significant history of trauma or intubation.

Blue arrow shows an active contact granuloma

Monday, July 14, 2014

How common are symptomatic adenoids causing otitis media witheffusionin adult patients. ?

This 39 year gentleman presented with recurrent right side otitis media with effusion. Nasal endoscopy showed a mass in Nasopharynx blocking right side Eustachian tube. A MRI was done which suggested it to be Adenoids.a biopsy was also done which showed it to be reactive hyperplasia of lymphoid tissue.  
Right side Grommet was put.  

Cervical tuberculosis in a 8 year girl.

this 8 year girl presented with a mass just above hyoid bone. Pus was drained using a small incision and the mass become very firm with antibiotics treatment and did not disappear. the mass was excised under general anesthesia. It was very adherent to surrounding structures and bleeding a lot. Cheesy material was present in the core of the mass. It was thought to be a sebaceous cyst or thyroglossal cyst during surgery. Histopathological study report came as tuberculosis.


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