Botox dosages in spasmodic dysphonia

Botox dosages are practioner dependent.

To start with, use low dosage. 1 U for women and 1.5 Unit for man. 

Average dose 3 units per side. 

This maximize benefits (fluency) 

And minimize side effects (breath voice) 

Basal cell carcoma (Atrophic Variant)

Paediatric auditory brainstem implant

Implant is placed in the lateral recess of the 4tb ventricle close to foramen of Luschka and stimulates dorsal and ventral nuclei. 

The cochlear nucleus has tonotopicity. 

Flocculus of cerebellum is variable in size and hides the entry into lateral recess.

Switch on of cochlear Auditory brainstem implant is done after 3-4 months.

Vestibular dysfunction is seen I. Few patients.

Indication of cochlear implant

(From lecture of Dr. Mohan Kameshwaran)


It take 2-3 year for child to learn after implant and it varies. This is unlike Cochlear implant where it takes less than 1 year.

Fasting guidelines prior to Anaesthesia

Latest guidelines on Fasting prior to Anaesthesia.

Clear liquids allowed upto 2 hours prior to Anaesthesia.

Other liquids allowed upto 4 hours prior to Anaesthesia

Light diet allowed upto 6 hours prior to Anaesthesia.

If a patient has taken a heavy meal,then 10 hours must elapse prior to Anaesthesia.

Endoscopic excision of right maxillary sinus Odontogenic cyst having a tooth within it. 

Nose pack with airway is best

in laying down of fears of suffocation. 

Did Total thyroidectomy with modified neck dissection for a papillary carcinoma of thyroid patient. 

50 year female presented with foul smell in nose for 2 months. 

Nasal endoscopy showed purulent discharge coming form left middle meatus and going to Naso pharynx. 

After uncinectomy, fungal muck seen on floor of left maxillary sinus causing purulent postnatal drip. 

Congenital Cholesteatoma as seen behind intact ear drum causing facial palsy and complete hearing loss

A small thornwaldt cyst detected incidentally on MRI