Central giant cell lesion is a non-neoplastic proliferation, usually asymptomatic, of unknown aetiology. This case report describes the diagnosis and treatment for a maxillary central giant cell lesion. We report a case of a 30-year-old lady with a central giant cell granuloma (CGCG) who presented with a history of right-side nasal blockage, swelling and pain in the right side of the cheek, proptosis of the right eye, occasional blurred vision for one month. Images and histopathology examinations confirmed the diagnosis. The patient underwent tumour resection through the endoscopic endonasal approach successfully without any postoperative complication, there was no recurrence within a year of follow up and its histopathological analysis was consistent with a CGCG. Histopathological examination of the mass confirmed as CGCG. Complete excision of right sinonasal mass achieved by right endoscopic sinus surgery through modified Denker’s approach. As CGCG is a non-neoplastic lesion of unknown aetiology, histopathology is necessary for definitive diagnosis. Treatment can vary depending on the extension of the tumour.

Hemangiomas of the nose are very rare lesions.They may be found in both paediatric and adult population.The various modalities of treatment may range from medical management to surgical management.We are reporting a benign vascular lesion near the nasal tip at the soft triangle aesthetic subunit in a 64 year old male which was treated by simple surgical excision using electrocautery and primary closure. Histopathological examination of excised specimen confirmed the diagnosis as hemangioma.

Background: Tonsillectomy is one of the most common surgeries performed by an otolaryngologist, with post operative pain during the initial 24 hours being one of the most common challenging concerns. This makes it a need to find a suitable mode for managing the post operative pain imperative. This study aims to: assess the post operative pain control with ropivacaine 0.25% and bupivacaine 0.25% and to assess which among these two drugs are better in controlling the post operative pain and safer. Methods: The 70 patients were selected, randomized, double blinded into group 1 and group 2 and given intraoperative infiltration of either 0.25% ropivacaine or 0.25% ropivacaine respectively into the tonsillar bed after tonsillectomy. The surgeries were done by the same surgeon by cold steel method of tonsillectomy. Post operative pain was evaluated using VAS (visual analogue scale) at regular intervals. Other parameters like hemodynamic status, surgical duration, any adverse reactions to the medications are also recorded. Results: There was a statistically significant difference seen in the post operative pain scores between the two groups at all time intervals, with group 1 having a lower score compared to group 2. Conclusions: Intraoperative infiltration of local anesthetics into the tonsillar bed was effective in controlling the post operative pain, with ropivacaine suitable anesthetic agent as compared to bupivacaine due to its higher efficacy and safety.

Background: The presence of pathologies of vocal folds cause significant changes in their normal vibratory patterns, which impact the resulting voice. Accurate and early diagnosis is needed for proper and timely management of the underlying vocal cord pathology. Diagnostic assessment in dysphonic patients should comprise both clinical aspects and voice-related problems experienced by the patients in their daily life. A combination of video-stroboscopy, acoustic analysis and Voice handicap index (VHI) helps in detailed evaluation of vocal cord abnormalities. Methods: This was a prospective, observational study. A total of 134 patients with voice disorders were included in the study. The VHI-10 questionnaire was filled by the patients. Acoustic analysis of their voice samples and Video-stroboscopic evaluation of their larynx was done. Results: A VHI-10 score of >11 was noted in 102 patients. Fundamental frequency, jitter and shimmer were significantly related to the type of lesion. All the video-stroboscopic parameters were significantly related with the vocal cord lesions. Conclusions: Acoustic analysis along with video-stroboscopy serve as a better diagnostic tool for quantification and categorisation of vocal cord pathologies. VHI-10 helps in assessing the limitations/the impact on quality of life (QOL) (caused by the various vocal cord pathology).

Patients having inferior turbinate hypertrophy causing intractable sneezing, rhinnorhoea which is non-responsive to conventional medication require alternative therapies. Aim of the study was to compare medical management vs chemical cautery with medical management in treatment of inferior turbinate hypertrophy since both these treatments are easily accessible, cost effective to the patients as well as not associated with major complications. The complaints sneezing, rhinorrhoea, nasal blockage, headache, eye irritation and redness of patients are reduced and quality of life of patients improved after chemical cautery with medical management as compared to medical management alone. 50 patients of age group 15-75 years with c/o Sneezing, rhinorrhoea, nasal blockage and headache were included in our study. Inferior turbinate hypertrophy was diagnosed on the basis of anterior rhinoscopy and diagnostic nasal endoscopy. Patients were divided randomly in 2 group-group A (medical management), group B (chemical cautery with medical management). The 22 question sino-nasal outcome test (SNOTT22) score and rhinomanometry was done before and after treatment to compare the efficacy and detect symptom free period in both groups. Percentage of relief was more among group B patients as compared to group A patients. Symptom free period was more in group B patients as compared to group A patients and both of them were analysed on the basis of SNOTT22 score and rhinomanometry. Chemical cautery with topical application of silver nitrate coupled with medical management is more effective in treatment of inferior turbinate hypertrophy as compared to medical management alone.

Facial nerve neurofibromas (FNN) are a rare benign tumor of facial nerve can arise from anywhere along the course of the facial nerve from the cerebellopontine angle (CPA) to the extracranial branches within the parotid. They are most commonly located in the parotid gland, and FNN in temporal bone are rarely reported. Intratemporal facial neurofibroma arise from facial nerve in internal auditory canal or in Fallopian canal. It usually manifests as progressive facial palsy, but also can present as sudden or repetitive facial palsy mimicking Bell’s palsy. We reported a case of intratemporal facial neurofibroma arising mainly from mastoid segment in 17-year-old female who presented with progressive facial palsy for 3 years. We briefly reviewed previous cases of intratemporal facial neurofibroma reported in the literature to provide a comprehensive understanding of this rare entity.

Langerhans cell histiocytosis (LCH) is characterised by multisystem disorder with various entities grouped together under same name. Oral cavity manifestations of this disease is yet to be explored. In oral cavity it can present with ulceration, swelling or osteolysis of underlying bone. Oral cavity involvement due to LCH might confuse the examining doctor resulting in misdiagnosis of such dreadful disease. So here we are reporting a case of LCH in a 4 years old female presented to us with ulceration over hard palate mucosa. Biopsy was taken from the ulcer site which was positive for LCH. On further examination and evaluation of the patient multisystem involvement was found with involvement of skull bone.

Seborrheic keratosis is a benign cutaneous tumour. The most common sites include head, neck, trunk and extremities except palms and soles. Pinna is a very rare site for such a lesion. They mostly present as multiple small lesions and solitary large lesion is very rare. Ultraviolet light exposure and human papilloma virus infection are possible etiologies. The differential diagnosis may include various benign lesions along with malignancy. The treatment options include removal of the tumour by simple surgical excision or by other means such as laser ablation. The confirmation of the diagnosis is by histopathological examination of excised specimen. There may be chances of recurrence of the lesion and so close follow up is required. We are reporting a brownish lesion at the cavum concha of left ear pinna appreciated since 1 year following thermal injury sustained during the welding work. The lesion was surgically excised and histopathology confirmed it as seborrheic keratosis. Patient has been followed up for 6 months and no recurrence noted.

Background: The sino-nasal unit, although anatomically a very small space, is quite exceptional in the sense that an eclectic mix of neoplastic tumors originate from here. The diverse nature of the neoplastic pathologies and their unique natural histories prompted for this study. Methods: In this prospective study of two years, done in a rural tertiary care hospital of India, 46 patients with benign neoplastic tumors of nasal cavity, sinuses and nasopharynx were analyzed for their clinic-pathological and radiological profile and surgical management. Results: The incidence of benign tumor was predominant in second decade (34.8%) with significant male preponderance (M:F ratio 2.28:1). Unilateral nasal obstruction (100%) and epistaxis (84.8%) were the two most common presenting complaints. Almost half (48%) of the patients presented as late as more than one year after the onset of the symptoms. Nasal cavity was the commonest site of the tumors (50%). The most common benign tumor in present study was capillary hemangioma (41.31%) followed by angiofibroma (26.09%). All tumors were removed by a standard functional endoscopic sinus surgery or combined approach. Except a single case of inverted papilloma, all the other cases showed no recurrence at the end of one year follow up period. Conclusions: It can be concluded from present study that conjoint application of radiology, endoscopy and histopathology is of utmost importance in dealing with benign neoplastic pathology of sino-nasal region. There is significant success in managing benign sino-nasal tumors with functional endoscopic sinus surgery or by combined approach.

Preauricular sinuses and pits are congenital anomalies located in or just in front of the ascending limb of the helix. Even though excising a sinus is a relatively minor surgical procedure, recurrence is not uncommon if an adequate resection is not done. Surgery is only indicated when it is complicated by recurrent infection or abscesses. Simple closure may not be possible when there is large tissue defect. In those circumstances local flaps will be required to cover the defect. In this article we report 2 cases which had large tissue defect after excision and closed with local rotational flaps. This provided good cosmetic outlook and no recurrences so far. There are not enough articles published so far with such kind of reconstruction techniques for preauricular sinus excision tissue defects.