Cholesteatoma protruding through previous cortical mastoid cavity

 

Well lined cholesteatoma sac seen protruding through Mastoid bone. He underwent cortical Mastoidectomy 10 years back and was almost symptom free except for once annual ear discharge for last 3 years which used to respond to antibiotics. This ear discharge was from postaural fistula. This time, his ear discharge responded partly and it came from ear canal as well with typical fishy smell of Cholesteatoma.

Memorial Sloan Kettering Cancer Hospital, New York

 

Dr. Jatin P Shah, Chief of Head & Neck Surgery (middle) with Dr. Apostoles (Italy) and Dr. Ajay  Jain (India) at his 10th floor Office at MSKCH

 

With Fellows  of Head & Neck Surgery at MSKCH, New York

 

Tympanic Membrane perforation following blast injury.

This is a case of blast injury and this patient has been following for last 4 weeks. Margins of the perforation are healing slowly. Clot has retracted. Stapedius tendon, Round window and Incudostapedial joint is clearly visible.

Question: How long do you wait for these perforation to heal before taking up for surgery?
(I Plan to wait for at least 3 months)

Isolated fracture of lamina papyracea.

Note fracture of medial wall of right orbit wall (known as Lamina payracea because this bone is as thin as paper).

Same case as above in different axial cuts of CT Scan. Fortunately this patient does not have any diplopia.

Low grade adenocarcinoma of Parotid

This was a very large tumour which was abutting the external auditory canal. The whole EAC cartilage became bare and so fascia was kept over the bare cartilage while closing the wound. A radical parotidectomy was done for full clearance of tumour. The patient received Radiotherapy after.

Submandibular duct calculus

A 60-year Female presented with uncontrolled diabetes mellitus with cellulitis of floor of mouth. She responded to oral clindamycin. When the swelling subsided, a left side submandibular calculus was discovered which was confirmed with CT Scans. Despite insulin treatment, her sugar levels remains highly uncontrolled. Her stone was removed under local anesthesia and the duct was marsupialized.

Here is a view of marsupialized submandibular duct few months after surgery. Clear saliva can bee seen coming from it.

 

Tongue tie