Surgical treatment of preauricular sinus:Standard Approach



A preauricular pit may mark the entrance to a sinus tract, which can vary in length, follow a tortuous course, and branch extensively. Preauricular sinuses and cysts have a component of close association with the auricular perichondrium. For this reason, some argue that complete removal of a sinus tract or cyst should also include a portion of the auricular perichondrium at the base of the lesion.

Preauricular sinuses or cysts are found lateral and superior to the facial nerve and parotid gland, whereas first branchial cleft malformations are found in close association with these structures, as well as with the external auditory canal.

Surgical treatment of preauricular sinus: supra-auricular approach

Click Image to Enlarge

Clock wise:Preop Pic/Skin incision./Temporalis fascia dissection/
Under perichondral dissection (medial-lateral vision)/
Excision concluded/Result

In 1990, Prasad et al. for the first time, described a new surgical approach defined supra-auricular which was based upon the theory that a fistula is, almost always, included in subcutaneous tissues between the temporalis fascia and perichondrium of the helix cartilage. Therefore, these Authors proposed that the elliptical incision of the standard technique be extended higher upward to the pre- and supra-auricular temporal region . This allows better surgical vision without adverse aesthetic consequences. Dissection proceeds identifying the temporalis fascia medially to the sinus area. It is only this fascia that represents a medial and deep limit of dissection that continues in a medium lateral direction until reaching the helix cartilage . At this level, dissection is made below the perichondral layer and, at the point of maximum adherence of the fistula, excision of a small portion of the cartilage is advisable . The surgeon, during dissection, does not follow the fistula but, being aware of the space in which it develops, removes all subcutaneous tissue comprised between thetemporalis fascia and the helix perichondrium . In this tissue, the sinus is certainly present with its ramifications and the eventual cyst.

Flower of the Day

AOI Archives:AOI Karnataka State Branch 1989

AOI Karnataka State Branch :16th Annual Conference was held at Dev Raj Urs Medical College,Kolar on April 1- 2,1989
Orations : 30 years beyond Mast ( Dr S Kameswaram,Chennai )
Evolution of Neuro-Otology (Dr R M Verma,Ex Director NIMHANS Bangalore)
Role of Cryo Surgery in Head and Neck Tumours(Dr Prem Kakar,New Delhi)
Best PG Presentaion : Dr Bharati (Bangaloe Medical College )
Best Local Branch : Mysore Branch
Hon Secretary :Dr S B Medikeri

Imaging in a case of croup (laryngo-tracheo-bronchitis)


The usual diagnosis of croup does not require imaging. The diagnosis can very well be made only by history and the sound of ‘barking seal’ cough. However, on certain occasions the child is exhausted by the respiratory distress and the cough may not be heard because of the poor effort. Radiology helps in ascertaining the diagnosis in these cases. In AP view of x-ray soft tissue neck, a ‘pencil tip’ appearance of subglottis is seen. In lateral view of x-ray soft tissue neck the usual demarcation of ventricle can’t be made and the area of glottis and subglottis has a hazy appearance, suggesting mucosal edema.
http://emedicine.medscape.com/article/407964-imaging
--
Dr Harpreet S Kochar
MBBS (AIIMS), MS (AIIMS)
Consultant
Dept of ENT and Head Neck Surgery
Kailash Hospital (Greater Noida) and Delhi ENT hospital (Jasola, New Delhi)
India
Ph: 09873898361
Web: www.entgreaternoida.com
*Viral croup, also known as acute laryngotracheobronchitis, is an age-specific viral syndrome characterized by acute laryngeal and subglottic swelling, resulting in:
Hoarseness
Cough
Respiratory distress
Inspiratory stridor

Acute Sinusitis & Complications


Acute Maxillary Sinusitis(Centre)
Subperiosteal Orbital Abscess(Left Top/Right Bottom))
Acute otomastoiditis(Left Bottom)
Pott's puffy tumour(Right Top)

Tension pneumocephalus:A rare complication of FESS


There is a bone defect at the fovea ethmoidalis (red arrow).
Also there are post-operative changes indicating that the patient had undergone FESS.
The intracranial air is a complication of FESS.

With this complication, usually the patient goes home feeling fine, and then shows up approximately two weeks later with CSF leak and meningitis, due to the defect in the bone and dura.
Tension pneumocephalus occurs when air in the head acts like a mass: there is a bony defect which lets air in but not out (valve-like function).
Every time the patient sneezes, air is forced through the defect into the intra-cranial space, and remains trapped there.
At a certain moment the amount of air is sufficient to cause mass effect on the surrounding intra-cranial structures.

Palliative Care in Otolaryngology

Palliative Care AAO-HNS Crse

Flower of the Day

33rd Annual Delhi State AOI Conference March 6-7,2010



Conference Website http://aoiconf.blogspot.com/

THE ASSOCIATION OF OTOLARYNGOLOGISTS OF INDIA
DELHI STATE BRANCH
Contact
Dr L M Parasher
09811154220

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Safety Pin Ingestion :Dr.Talangara Nooruddin,Ohud hospital,Madinah,Saudi Arabia


Dear Sir,
I am reporting this case from Ohud hospital,Madinah,Saudi Arabia.As you can see when the resident called me to see a 2 months old baby with H/O FB ingestion I never expected to see this interesting FB.It was a dilemma in the OR as we did not have small enough instrument that can be manipulated through a size 4 scope.We managed to extract the FB by locating the sharp edge which was struck to left side of the oesophagus and holding on to it with an alligator forceps and removing it with great care.It took us a lot of time and patience and it was quite satisfying.I think it was the handiwork of an elder sibling even though his intentions were good.
regards,
Dr.Talangara Nooruddin,
ENT Consultant.

READERS ARE REQUESTED TO SHARE THEIR CLINICAL CASES
Comments at update@entindia.net

Safety-pin ingestion in children: a cultural fact

Journal Pediatric Surgery International
Publisher Springer Berlin / Heidelberg
ISSN 0179-0358 (Print) 1437-9813 (Online)
Issue Volume 19, Number 6 / August, 2003
Category Original Article
Abstract

Pediatric foreign-body (FB) ingestion is a common problem. Many of these FBs are sharp objects such as needles, toothpicks and safety pins (SP). This report reviews the management of SP ingestion in children. During a 16-year period, we recorded 49 pediatric cases of witnessed SP ingestion. In all children, SPs were used to attach the blue beads to the child's suits with the belief of averting the evil eye. The mean age was 8 months ranging from 4 months to 2 years, and 30 patients were males and 19 were females. SPs were most commonly sited in esophagus (37%) and stomach (37%). In the remainder, the SPs have already reached the duodenum and intestine. In this series, 20 (41%) children passed SPs spontaneously, 14 (28.5%) required endoscopic removal and 15 (30.5%) underwent surgery. The outcome of all patients was uneventful. All of the esophageal SPs require endoscopic intervention, however, after passing into stomach the patients can be observed with keeping the surgical intervention in mind if the SP displays a fixed position for more than three days.

An FB Collage


CLICK IMAGE TO ENLARGE

Flower of the Day

ENDO ORL &HNS 2010 30th APRIL 1st &2nd MAY 2010,Chennai


The benefits of participating are:
· Quite a lot of surgeries on all 21/2 days will be demonstrated, distinct from international conferences. The 2 way discussion will cover practically important points.
· Parotid and thyroid surgeries will be emphasized this time in addition to earsurgeris, FESS etc.,
· By expert Indian faculty appropriate for our Indian patients and disease scenario
· Quiz in a special way.
The budding ENT surgeons as well as the post graduates eager to learn will profit.
The banquets are free of cost.

DOWNLOAD BROCHURE HERE

With regards,
Dr. G. Sundhar Krishnan MS, DLO
PhD – Endoscopic Skull Base Surgery
www.keeh.org
Last date for registration at least cost is 15th March 2010

Transanasal Endoscopic Anterior Skullbase surgery on 7th March-2010,Ahmedabad, Gujarat. India.


The Department of ENT & Neurosurgery at Sterling Hospitals has organized a
Live Workshop on Transnasal Endoscopic Anterior Skull base Surgery
Date:7Th March 2010, Sunday
Time:9 am - 6 pm
Venue:Auditorium, Sterling Hospitals, Ahmedabad.
Faculty
Dr. Nishit Shah, M.S. (ENT).
Dr. K.L.Meghnadh, M.S. (ENT).
Dr. C.E.Deopujari, M.ch. (Neuro Surgery).
Live surgical display of transnasal endoscopic pituitary surgery, CSF rhinorrhoea repair,Anterior skull base tumour surgery with interactive session planned.
Kindly registrar with Medha (+91 99244-49887) (Between 10 am - 05 pm)
For more information contact
Dr. Ruchir Shah (ENT surgeon) + 91 98250-22640
Dr. Monrak Shah (ENT surgeon) + 91 98244-44338

Telephone Screening for Hearing Loss Questioned by ASHA

Test signals are limited to frequencies below 3000 Hz (cycles per second) so that hearing at higher frequencies is not screened. Also, the physical nature of the signal that is actually heard depends on factors, such as the telephone answering machine used to conduct the tests, the telephone transmission lines, the model of telephone used by the caller, background noise, the response of the telephone for that particular call, and even the position of the telephone receiver relative to the listener's ear.
Because of these factors, two persons calling the same telephone screening number from different telephones may receive somewhat different tests. In fact, the same person using the same telephone may not receive exactly the same test each time he or she calls.
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Blister-Wrapped Tablet Struck in esophagus


A 23 year old male presented with acute and absolute dysphaia for 3 hours. He said that he had taken few pills for GI disturbance which led to this problem. Considering the fact that tablets are radioluscent, and not yield anything on imaging, an X ray soft tissue neck was nonetheless requisitioned. The xray on initial evaluation seemed just fine. However closer scrutiny revealed an interesting foreign body in upper esophagus. A tablet only, but in its blister pack. The air around the tablet in the blister pack was seen as tram track sign around the radioluscent tablet itself. Removing it was a tough task too as the sharp edges of the tough blister pack would'we torn the esophageal wall upon withdrawing. The edges were rolled up and guided into the esophageal speculum for removal. The patient had infact taken the tablets in a small envelope from the chemist and drained the pills down his throat directly from the envelope without realising that one was still in its pack.
Dr Harpreet S Kochar
MBBS (AIIMS), MS (AIIMS)
Consultant
Dept of ENT and Head Neck Surgery
Kailash Hospital (Greater Noida) and Delhi ENT hospital (Jasola, New Delhi)
India
Ph: 09873898361
Web: www.entgreaternoida.com

Esophageal Perforation Caused by a Blister-Wrapped Tablet

Sachin Tendulkar: The Joy of India


Master blaster Sachin Tendulkar became the first batsman ever to score 200 runs in the history of the 50-over game.

How to read Sinus CT Scan:Dr Kevin Soh


TURN THE SOUND ON

Conference Report: 3rd International Live Ear surgery and Temporal Bone Dissection course for ENT surgeons


Pushpanjali Crosslay hospital, Vaishali, NCR Delhi in association with Claros Foundation, Barcelona , Spain organized the 3rd International Live Ear surgery and Hands-on Temporal bone dissection course for ENT surgeons at the hospital premises on the 14th and 15th of January, 2010.

READ FULL REPORT

Flower of the Day



Location :Garden of Five Senses,Delhi

Management of Unknown Primary



Site:Neck Metastases - Unknown Primary
Histology:Squamous Cell Carcinoma
Adenocarcinoma
Poorly Differentiated Malignancy
Stage:T0 N1-3 M0-1
READ MANAGEMENT

Guest lectures with QA session on Pediatric Otolaryngology by Cincinnati Group (USA),Delhi, 15th March, 2010


3 Guest lectures with QA session on Pediatric Otolaryngology by Cincinnati Group (USA)
Dr. J. Paul Willging
Dr. Ravindhra G. Elluru
Dr. Alessandro de Alarcon
Date: 15th March (Monday) 3-5 PM
Venue:
Vardhman Mahavir Medical College and SJ Hospital-
Lecture theatre I in College Building

Topic: "Management approaches to children with upper aerodigestive tract anaomalies"

For details: Dr N N Mathur, Professor ENT, VMMC & SJH.
Mobile: 9811109637

FACTS ABOUT HEARING IMPAIRMENT AND DEAFNESS

According to 2005 estimates by the World Health Organization (WHO), 278 million people worldwide have moderate to profound hearing loss in both ears.
80% of deaf and hearing-impaired people live in low- and middle-income countries.
The number of people worldwide with all levels of hearing impairment is rising mainly due to a growing global population and longer life expectancies.
Chronic middle ear infection is the main cause of mild to moderate hearing impairment in children.
The impact of hearing impairment on a child's speech, language, education and social integration depends on the level and type of hearing impairment, and the age of onset, especially if it begins before the age when speech normally develops.
In developing countries, fewer than 1 in 40 people who would benefit from a hearing aid have one.
Current annual production of hearing aids is estimated to meet less than 10% of global need.
50% of deafness and hearing impairment is avoidable through prevention, early diagnosis, and management.

GO TO LINK

Coping with Cancer:

Dr.Kumaresh
I am happy that my suffering is becoming an eye opener for others and that their lives are changing for the better.
This is also inspiring me to write about my life, which was equally as traumatic as my journey to cancer.
In fact I always used to wonder why I need to undergo these sufferings and now I realise there has been a higher calling to my trauma.

GO TO THE BLOG

Flower of the Day

Dr.D.Anand Karthikeyan compilation on E books in Otolaryngology


Atlas of Otology
Basic Otorhinolaryngology
Middle Ear Surgery

Dr.D.Anand Karthikeyan M.S(stud)
Kanpur, Uttar Pradesh, India
http://anandkarthikeyan.blogspot.com/

“3rd International Spring Course on Functional an Aesthetic Surgery of the Nose”, 10-12,May 2010,Final Programme



Website
Final Scientific Prgramme
Registration


Dear Friends and Colleagues
Here we are with our biannual appointment, the “3rd International Spring Course on Functional an Aesthetic Surgery of the Nose”, which will be held in Castel San Pietro Terme (Bologna) ITALY, between 10th and 12th of May, 2010.

The official languages will be Italian and English, with possibility of simultaneous translation.

We truly hope you will join us in Castel San Pietro Terme during the sunny spring of 2010.

Ignazio Tasca

____________________________

Ignazio Tasca M.D.
Director E.N.T Department
Castel San Pietro Hospital
Bologna- Italy-
Tel. +390516955111 Hospital
+39051941930 Home
+393356663460 Mobile
E.mail igntasc@tin.it home
i.tasca@ausl.imola.bo.it hospital

“SKULL BASE ENDOSCOPIC SURGERY” FROM PITUITARY FOSSA TO CRANIO - CERVICAL JUNCTION PARIS (France) 16TH – 19TH JUNE 2010




CLICK HERE TO VIEW BROCHURE

SCIENTIFIC SECRETARIAT
Dr. Salvatore Chibbaro
Service de Neurochirurgie-Hopital Lariboisiere Paris (France)
Phone:(+33) 1 49958146
Fax (+33) 1 49958155
E.mail: schibbaro@hotmail.com

ORGANIZING SECRETARIAT
Dr. Giuseppe Garo
SIACH
Phone: (+39) 340 3785028
E.mail: giuseppe.garo@siach.eu
For informations and inscriptions visit:
http://www.siach.eu

Computed tomography (CT) in chronic suppurative otitis media : Correlation between CT and surgical findings

(This article on CT in CSOM was published in IJLO way back in 1988)
S. P. Dubey1 , Y. N. Mehra1 , S. B. S. Mann1 and S. Suri2

(1) Deptt. of Otolaryngology, Postgraduate Institute of Medical Education & Research, (PGIMER), Chandigarh, India
(2) Deptt. of Radiodiagnosis, Postgraduate Institute of Medical Education & Research, Chandigarh, India
Abstract Chronic suppurative otitis media (CSOM) is one of the commonest causes of deafness. Moreover, CSOM may lead to fatal intracranial complications, when medical and/or surgical management is delayed. 31 patients of CSOM were preoperatively evaluated with high-resolution computed tomography (CT). Subsequent operative findings were correlated with CT scan findings. Cholesteatoma was seen in 15 cases, granulation tissue in 5 cases, combined cholesteatoma and granulation tissue in 4 cases and other findings in 7 cases. Excellent correlation between CT and surgical findings obtained with respect to extent of soft tissue masses, pneumatisation, bony boundaries of the tympanum, and ossicular complex. Occasionally CT gave erroneous impression of dehiscence of dural and sinus plate. CT scan play a major role in preoperative evaluation and post operative follow-up of the patients with CSOM.
>Preview Page

FILLERS IN SECONDARY RHINOPLASTY

CLICK HERE TO SEE VIDEO
Easy Filler is a pure transparent natural resorbable Gel totally Biocompatible to be injected into the skin defects. EASY FILLER applications are for Rhinoplasty, Kissing Wrinkles – Lip Augmentation – Scar Reduction – Naso-Labial Correction – Cheek Correction, Pits, Hands, etc.

DR. ADRIANO BARTOLI FROM UNIVERSITY OF ROME WILL BE CONDUCTING 4 WORKSHOPS IN INDIA
Lecture & Hands-on fee for 2 days workshop is Rs. 25,000/-
Contact : tracom@tracom.in

Don't Get Burned: Stay Away From Ear Candles

A lit "candle" that can drip hot wax into your ear, usually as you lie on your side.
Sound dangerous? The Food and Drug Administration (FDA) thinks so, and is warning consumers to steer clear of products being sold as ear candles.
These "candles"—hollow cones that are about 10 inches long and made from a fabric tube soaked in beeswax, paraffin, or a mixture of the two—are being marketed as treatments for a variety of conditions. These conditions include ear wax buildup, sinus infections, hearing loss, headaches, colds, flu, and sore throats.

READ MORE

Info: American Academy of Otolaryngology—Head and Neck Surgery

Delhi AOI Live Surgery Pre Conference Workshop: UCMS & GTB Hospital ,March 5, 2010



CLICK IMAGE TO ENLAGE

X-rays in otolaryngolgoy :Dr Balu

CLICK FULL SCREEN TO VIEW
Role of X-rays in otolaryngolgoy

Dr Dukhan Ram (1899-1990)


Dr Dukhan Ram passed both D.L.O. and DOMS of Royal College of Surgeons, London in 1934 and returned to join as lecturer in Eye and ENT Dept., Patna Medical College. In 1944, he was elevated to the post of Prof. of Eye and ENT Dept. which was a combined department at Patna. During this professorship, D.O. and D.L.O courses were started in addition to M.S. (Eye) and M.S. (E.N.T.)
He was equally involved in the activities of the associations of Eye and ENT Surgeons both at the State and All India level. The state unit of A.O.I. was formed under his Presidentship in 1952. He was the Chairman, organising committee of the annual conferences of A.O.I. held at Patna in 1952 and at Jamshedpur in 1956. He presided over the all India annual conferences of ENT and also Eye held at Hyderabad in the year 1953 and 1961 respectively.
In recognition of his services to the speciality, he was awarded Padma Bhushan in 1967. He was also elected to the state assembling from Sasaram the same year.
Read More

Bilateral accessory tragi on the suprasternal region


Bilateral accessory tragi on the suprasternal region. J Dermatol. 1997 Aug;24(8):543-5.

We report a 25-year-old man who had two protruding firm masses on his suprasternal region. These lesions were present at birth without any family history. He had no other subjective symptoms. In a histological specimen, there were numerous unevenly distributed telogen follicles that contained vellus hairs. Beneath a relatively narrow zone of fibrovascular tissue, lobules of fat with a central core of cartilage were seen. The mass was totally excised; during the follow-up period, there was no evidence of recurrence. The tragus derives from the first branchial arch. The accessory tragus can be found along the entire course of embryonic migration. It is usually located unilaterally in the preauricular region. To our knowledge, bilateral development on the suprasternal region has not been previously reported.

History of World Voice Day ,April 16 th

The World Voice Day was established on April 16th
with the main goals of increasing public awareness of the
importance of the voice and alertness to voice problems.
The event started in Brazil in 1999 as the Brazilian National
Voice Day.
It was the result of a mixed initiative of
physicians, speech-language pathologists and singing
teachers that belonged to the former association ‘Sociedade
Brasileira de Laringologia e Voz – SBLV’ (Brazilian
Society of Laryngology and Voice).
This initiative was followed by other countries, such as Argentina and Portugal,
and the Brazilian National Voice Day became the
International Voice Day.
In the United States, the American
Academy of Otolaryngology – Head and Neck Surgery
officially recognized this celebration in 2002 and in
that year the event obtained the name ‘World Voice Day’
The voice is a topic of interest
to otolaryngologists/phoniatricians, logopedists/speech
pathologists, singing teachers, vocologists, acousticians,
biomechanical engineers and many other specialists.

Video : Endoscopic Removal of Salivary Stone



source :Sialendoscopy CHU Montpellier France

Salivary gland stone removaL
When the diameter of the stone is 5mm or less, it can be removed purely by an endoscopic technique, particularly when the stone is located above the muscles that comprise the floor of the mouth. The four common techniques used to remove the salivary gland stones are:
The grasping technique
Using a small wire basket retrieval system
Mechanical Fragmentation
Laser fragmentation
When the diameter is larger than 5 mm, a twofold (endoscopic assisted) approach can be utilized. The endoscope is introduced and the stone localized, and then dissected and removed in an intraoral approach. After a sialolith is removed from an affected gland, a sialastic stent is inserted into the duct for two to four weeks for the duration of the healing process of the oral region and until normal function of the gland is restored. This prevents scar formation which can develop overlying the ductal opening into the mouth.

"Say Ahh!" GE Commercial Acknowledging What ENTs Do Best



For those curious, the music was taken from Beethoven's 9th Symphony, 4th movement, otherwise known as "Ode to Joy."

Courtesy : FAUQUIER ENT CONSULTANTS
WARRENTON, VA, UNITED STATES

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Joseph Toynbee


Pic : Water fountain at the top of Wimbledon Hill in memory of Joseph Toynbee
Joseph Toynbee
Born December 30, 1815
Died July 7, 1866
Nationality: United Kingdom
Fields otologist
Known for pathological and anatomical studies of the ear

Joseph Toynbee, born in 1815, was the son of a Lincoln farmer and one of fifteen children. He studied medicine in London and was well known for his works amongst the poor, championing issues of sanitation and public health. In 1855 he set up the first ENT unit in the United Kingdom at St Mary's Hospital, Paddington. The unit comprised three beds and was set up with the purpose of treating diseases of the ear, nose and throat.

A pioneer of many revolutions in ENT, including the artificial tympanic membrane as well as the modern otoscope. His contribution to the understanding and treatment of diseases of the ear cannot be overestimated.

A long time sufferer of tinnitus, Toynbee died after inhaling the vapours of hydrocyanic acid and chloroform in an attempt at a cure.

FESSCON 2010,Guwahati,-Conference Report by Dr George Varghese


Click Image to Enlarge
Click here to view Album

FESSCON 2010 @ Guwahati, 29th to 31st January 2010 ( www.fesscon.com), was a grand success under Dr.Miklu Senapati.
The course included live demonstrations of FESS ( including revision FESS) by Prof.Gerald Wolf( Graz,Austria),Live demonstration of Endoscopic Trans- Sphenoid Hypophysectomy of Pituitary Adenoma by Dr.George Varghese( Kochi,India),& Endoscopic DCR by Dr.Janakiram( Trichi,India).
There were lectures by Prof.Gerald Wolf, Dr.Amusa( Nigeria), Dr.Ashwamedsing Dinassing( Mauritius), Dr.George Varghese,Dr.PP Devan( Mangalore),Dr.Hetal Patel( Mumbai),& Dr.Janakiram,& by the local faculty.'

Dr.George Varghese

The Cape Temporal Bone Dissection Manual


CLICK HERE TO DOWNLOAD

FESS Cadavaric Dissection Guide: Dr Reda Kamel(Egypt)



Click here to download

charity in ENT

Claros Foundation (Spain) conducts charity camps in India every year .Donates one cochlear implant each year to the needy.Today on February 14, a free cochlear implant surgery was done at Pushpanjali Crosslay Hospital,Delhi.
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16th Annual Conference on the Diseases of the Nose and Paranasal Sinuses & 1st Conference of the Pan Arab Rhinology Society February 24-26, 2010, Cai



Website http://rhinologyegypt.org/index.php
Contact
Reda Kamel
Professor of Rhinology
Cairo University
Egypt
61 Canal Street
Maadi - Cairo - 11431
Egypt
Mobile: 002-012-2137172
Fax: 002-02-7530124
email: rhinology@redakamel.com
rkamel55@hotmail.com
web site: www.redakamel.com

Surgeon/Physician Burnout: Readers Comments Welcome


Burnout self Test


Comments

Dr Santosh Kacker (Delhi): Define Burnout

Blog Author:burnout is defined as the index of the dislocation between what people are doing vs what they are expected to do.

Dr Sunil Kathuria(Delhi):
Surgeon's burnout is a major problem. Human body can take limited amount of cumulative stress. More mental stress you have more long term problems you face.
Body's ability to heal itself is more in the younger age but as a person grows old risk of burnout / mental and physical problems increases.
Best way to avoid this is
1.Do limited work after a certain age.
2.Have a team. Distribute your work and stress among your team members.
3.Learn to say no.
4.Have a break as often as required and possible.
Basic mantra is you can not do every thing in this lifespan.So make realistic targets and have friends from non medical group and develop a hobby.

ADMIRAL[DR] VK SINGH(Agra):

Why USA Only, in India a medical practitioner is under stress from the day he/she decide to become Doctor,:
[1] Preparation to clear PMT/CPMT where 50% seats are already reserved for academically substandard material, [2] Stress of passing MBBS with limited
faculty, [3] Forced rural posting after internship when he is not prepared mentally& professionally. [4] selection for post graduation for limited seats(again reservation??) [5] job insecurity ? [6] As a surgeon STRESS IS severe already described by you ,in addition CONSUMER FORUM/LITIGATIONS AGAIANST SURGEONS Due to ill Motivation From All concerned.
[7]In one Survey it was Obseved That Doctor!s Life Span is 5 years less then general population in Metro Cities. .[8] NO WONDER YOUNGESTERS ARE OPTING FOR MORE LUCRATIVE JOBS WITH MUCH LESS EFFORTS.


More comments welcome on update@entindia.net OR PUT COMMENTS BELOW

Ear and Rhinoplasty workshop,Nashik, 25 - 28 February 2010



click here to view details

Conference Secretariat
Dr. S. T. Indorewala
Indorewala ENT hospital,
Behind Mahamarg bus stand,
Nashik- 422001.
Ph. +91-253-2580690 Mob. +91-9423173972

Interdomal Ligament in Rhinoplasty : short Video



The interdomal ligament (red arrow) separates the deep and superficial medial layers of the nasal superficial musculoaponeurotic system. The deep medial layer (black arrow) runs immediately anterior to the anterior septal angle and cranial to the interdomal ligament. The superficial medial layer runs into the columella in the subdermal plane.


CLICK HERE to View Video

Introduction of Labels in this Blog



Dear Readers
The blog is now Label enabled.
You can easily click on label of your choice to view similar Posts.
Like if you click on conference announcement,you will get all the conference posts only.
Few more labels will be added in future

SINOCON 2010,20-21 February ,Bangalore


SINOCON 2010
CME ON SINONASAL DISEASE
20 – 21 FEBRUARY 2010

CLICK HERE to View Scientific Programme

DEPARTMENT OF ENT
COMMAND HOSPITAL AIR FORCE, BANGALORE
BANGALORE 560007

Tel : 9341007780, 9916040312
E Mail : sinocon2010@gmail.com

Lt Col (Dr) Satish

Announcing AAO-HNSF 2010 Call for Papers: Scientific Program

A Message from Gregory W. Randolph, MD,AAO-HNSF Coordinator for International Affairs:

Call for Papers
On February 8, 2010, the American Academy of Otolaryngology—Head and Neck Surgery Foundation (AAO-HNSF) started accepting abstract submissions online for its Scientific Program for the Annual Meeting & OTO EXPO to be held September 26-29, Boston, Massachusetts, USA.

The Scientific Program includes oral and poster submissions for Scientific (Clinical Research) and Translational & Basic Science Programs. Submit your abstract now

Mark Your Calendar to Register in May
For complete meeting and program information or to register and reserve your hotel online, please visit our website www.entnet.org/annual_meeting from May 3 on.

We hope you will join us at our 2010 Annual Meeting & OTO EXPO, the largest meeting and exhibit of its kind! The conference offers otolaryngologists and other health care professionals a series of unique and dynamic educational experiences designed to broaden and enrich their understanding of otolaryngology-head and neck surgery and to provide a foundation for continued learning.

We look forward to seeing you in Boston, Massachusetts!

Gregory W. Randolph, MD
Harvard University—Massachusetts Eye and Ear Infirmary
Coordinator for International Affairs and International Editor, Otolaryngology—Head and Neck Surgery

PS: Forward this email reminder to your colleagues so they can share in this unique program
American Academy of Otolaryngology—Head and Neck Surgery Foundation
1650 Diagonal Road Alexandria VA 22314-2857
Phone - 1-703-836-4444 | Fax - 1-703-683-5100

Pneumoparotid


Pneumoparotid is the presence of gas in the parotid gland or salivary ducts. It is the result of an increase in intraoral pressure and the subsequent forced entry of air through Stensen's duct. Pneumoparotid can be caused by dental instrumentation, positive-pressure ventilation during anesthesia, chronic cough, and playing a wind instrument and other physical activities that involve forceful exhalation The clinical examination can reveal unilateral or bilateral parotid swelling, subcutaneous emphysema, or frothy salivary secretions. Computed tomography (CT) and standard sialography confirm the diagnosis. Treatment is aimed at the elimination of precipitating factors. Two treatments have been considered for sialadenitis
secondary to recurrent or chronic episodes of pneumoparotid: transposition of Stensen's duct and parotidectomy
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The Association of Otolaryngologists of India (Delhi State Branch) Annual Pre Conference Live Surgical Workshop ,Friday, 5th March 2010

Friday, 5th March 2010
The Association of Otolaryngologists of India (Delhi State Branch) Annual
Pre Conference Live Surgical Workshop
Theme: Basic E.N.T. Surgery
Live surgical workshop through CCTV
8.30 am to 5 pm
Venue: Department Of Otorhinolaryngology
University College of Medical Sciences and Associated G.T.B.Hospital,
Dilshad Garden,
New Delhi-110095
Workshop Chairman
Dr. P. P. Singh
Professor and Head of the department,
Department Of Otorhinolaryngology
University College of Medical Sciences and associated G.T.B.Hospital,
Workshop Coordinator:
Dr. Arun Goyal (Contact: 9810812813)
Reader, Department Of Otorhinolaryngology
University College of Medical Sciences and Associated G.T.B.Hospital,
The workshop will cover the basic steps, skills, pearls and guidelines in the various ENT surgeries during live operative demonstrations. The focus will be on the use and methods of use of the various instruments and equipment. It will be a learning bonanza for the young ENT surgeons and a practical update on the skills for the rest of us.
All the Pre- registered delegates of the Annual conference of 33rd Annual Conference of the Association of Otolaryngologists of India Delhi State Branch will be registered complimentary for this workshop. Please retain your registration fee receipt of the conference for the complimentary registration which will be mandatory for attending the workshop.

‘Deviation from normal practice not medical negligence’

New Delhi: As long as doctors have performed their duties and exercised an ordinary degree of professional skill and competence they cannot be held guilty of negligence, the Supreme Court held on Wednesday. Laying down a set of principles, a Bench said, “Mere deviation from normal professional practice is not necessarily evidence of negligence.”
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OTC Nasal Drops and Addiction: Dr Samit Bali (Nagpur)

A leading MNC has just started intensive media campaign for there OTC(over the counter)nasal spray/drops on TV channels. The general public in India, which is very easy to be influenced by these advertisement campaign, are purchasing these products without the consent of a registered doctor.
In a recent study conducted by a online website (www.entindia.net) on these intensive advertisement, 93% were strongly against the media campaign, while 4% supported it , while the rest were neutral.
In western developed countries like USA about 10 million people annually have fallen prey to the addiction of these nasal sprays containing active metabolite oxymetazoline and xylometazoline. Presently no similar data is available in India.
Read More ...

Rhinitis medicamentosa: electron microscopic changes of human nasal mucosa.http://is.gd/87O2j

How will you treat Rhinitis Medicamentosa?

1.STOP the nasal decongestant spray use immediately
2.High dose prednisone starting at 60mg tapered slowly over ~3 weeks
3.Start steroid nasal spray use
4.Start hypertonic saline flushes to the nose

Read More..

Readers comments are welcome

Dr Samit Bali (Nagpu
r)

Throw the culprit medicine out, thus the urge is thrown with it.
Counseling to patient & relatives
Identify and treat the underlying pathology
Nasal saline flushes
Tapered steroid spray followed by nasal steroid spray.

National Laryngotracheal Surgery Workshop,Nair Hospital, Mumbai ,26-28 March 2010

The Department of Oncosurgery, Prince Aly Khan Hospital and Department of ENT, Nair Hospital, Mumbai are jointly hosting the Nationsal Workshop on LaryngoTracheal Surgery (including Lasers) at Mumbai. Internationally renowned LaryngoTracheal Surgeon Prof. Monnier, Switzerland is the International Faculty and Prof. Sultan Pradhan is the National faculty. There will be interactive live surgical demonstration in addition to Cadaveric Dissection demonstration.
Venue- Dept. of ENT, T.N.Medical College and B.Y.L. Nair Ch. Hospital, Mumbai

Dates 26th,27th and 28th March 2010

Registration: Consultants-Rs.2000/-
Residents-Rs. 1000/-

There will be a special focus on "Decision-making" in these cases with interaction between delegates and faculty.
Delegates can also bring their patients for Prof. Monnier's opinion and management by him, if he feels so.The range will incluse all cases of airway obstruction including subglottic stenosis, tracheal stensis, VC palsy etc.
For the first time we have also involved Paediatric Surgeons in the workshop as, many of thhe patients seen by us are in the paediatric age group, hence we will be happy if you could spread the word to your Paediatric Surgery colleagus too.
For details and any assistance please contact:

Dr. Bachi T. Hathiram, Prof and Head of Dept of ENT-09323699192
Dr. Sanjay Chhabria, Asst. Professor ENT-09819744720
Dr. Vicky S. Khattar, Asst Professor ENT-09324655600

AOI Archives:1989 MALABAR Branch

AOI Malabar Branch was formed on 18th June 1989 at Calicut.It incuded ENT Surgeons from six North Districts of Indian State of Kerala.
The Office bearers elected that year were:
President : Dr K G Vijayrahavana
President Elect : Dr A K Gangadharan
Secretary: Dr G.Vijaykumar
Associate Secretary:Dr P.Murleedharan Nampoothiri
Treasurer : Dr V Kriahna Das

READERS ARE REQUESTED TO SEND US AOI BRANCH NEWS TO update@entindia.net
Malabar (Malayalam: മലബാര്‍) is a region of southern India, lying between the Western Ghats and the Arabian Sea. The name is thought to be derived from the Malayalam word Mala (Hill) and Puram (region) derived or westernised into bar.

Cancer “fertilizers”

Here are some dietary substances that create a fertile soil for cancers:

Refined sugars (drive up proinflammatory insulin and insulin-like growth factor, or IGF)
Insufficient omega-3s/excess omega-6s (favor inflammation)
Growth hormones in meat and non-organic dairy products (stimulate IGF)

Okay, what diet does this sound like? Lots of sugar, bad fats, and meat – the typical Western diet.

Cancer inhibitors

So, what should we eat? In addition to avoiding saturated fat, sugar, meat and non-organic stuff, a good cancer-fighting diet would include some/all of the following:

Catechins (in green tea) – inhibit angiogenesis

Phytoestrogens (in soy products) – block overstimulation of tumors by estrogen; prevent angiogenesis

Curcumin (in turmeric) – inhibits inflammation, inhibits angiogenesis, promotes apoptosis in tumor cells

Ellagic acid (in berries) – inhibits angiogenesis, blocks transformation of environmental carcinogens into toxic substances

Anthocyanidins (in blueberries, cranberries, cinnamon, dark chocolate) – promote apoptosis in tumor cells

Terpenes (in mint, thyme, marjoram, oregano, basil, rosemary) – inhibit tumor cell invasion, promote apoptosis in tumor cells, inhibit angiogenesis

Gingerol (in ginger) – inhibits inflammation and angiogenesis

Sulforaphane, indole-3-carbinol (in cruciform veggies) – prevent precancerous cells from becoming malignant; promote apoptosis of tumor cells, inhibit angiogenesis

Sulfur compounds (in garlic and onions) – reduce carcinogenic effects of nitrosamines (created in overgrilled meat and present in tobacco); promote apoptosis in tumor cells; help regulate blood sugar levels.

Lycopene (in carrots, yams, other bright colored veggies and fruits) – stimulates NK cells to become more aggressive; inhibits tumor cell growth

Long-chain omega-3 fatty acids (in fatty fish) – reduce cancer cell growth, prevent metastasis

Vitamin D (sun, cod liver oil, milk (tiny amount), vitamins) – dramatically reduces risk of several cancers

Polyphenols (red wine, chocolate) – block NF-kappa B (important in all three stages of cancer development: initiation, promotion, progression), limit angiogenesis

Abstract:Fine needle aspiration cytology in childhood TB lymphadenitis

J. Balaji1, 2 , S. Shanmuga Sundaram1, S. Nataraja Rathinam1, P. Amutha Rajeswari1 and M. L. Vasantha Kumari1

(1) Institute of Child Health and Research Centre, Government Rajaji Hospital and Madurai Medical College, Madurai, Tamil Nadu, India
(2) ADE / TNEB, Mullai Nagar, Periyampatty Post, Dharmapuri Dt Tamil Nadu., 635205, India
Received: 26 November 2008 Accepted: 28 May 2009 Published online: 20 November 2009

Abstract
Objective To evaluate the efficacy of Fine Needle Aspiration Cytology (FNAC) to diagnose Tuberculous (TB) lymphadenitis with compare to excision biopsy and to correlate TB lymphadenitis with clinical, cytological, radiological and mantoux test features.
Methods This was a prospective correlational study. FNAC was done by a pediatrician for 135 children with persisting lymphadenitis after two weeks of antibiotic therapy in the period of January 2005 to June 2006 and compared with excision biopsy in a tertiary care hospital.
Results Forty Six cases (34.07%) were TB lymphadenitis diagnosed by FNAC. Excision biopsy and cytological correlation was done in 100 cases. Sensitivity, specificity and diagnostic accuracy for TB lymphadenitis were found to be 98%, 100% and 99% respectively. Positive and negative predictive values were 100 and 98 respectively. Large (>2cm) (86.9%), multiple (52.1%), matted (47.8%), posterior cervical and submandibular group nodes with history of contact (P=0.0016), positive mantoux test (P=0.0001) and Grade III and IV Protein Energy Malnutrition (PEM) (P=0.0041) were significantly seen in TB lymphadenitis. Ziehl Neelson staining for Acid Fast Bacilli (AFB) was positive in 32.5% cases of TB Lymphadenitis.
Conclusion Pediatrician himself can do FNAC which is an excellent first line method to diagnose TB lymphadenitis and it has equal accuracy to excision biopsy.

Head & Neck Cadever Dissection Course For PG students-AFMC, Pune, 25 to 27 March 10

Head & Neck Cadever Dissection Course For PG students-AFMC, Pune

Contact Brig PS Sukthankar
E mail pinni_ss@yahoo.co.in
AFMC Pune
The history of an institution portends the future & directs its destiny. The Armed Forces Medical College was formed at Pune on 01 May 1948 by the amalgamation of Army Medical Training Centre, the Army School of Hygiene, the Central Military Pathology Laboratory, the School of Blood Transfusion and Army School of Radiology. The college was initially housed in Eve’s Estate and later shifted to Connaught Barracks, the present location.Read more http://is.gd/7UpYF
Department of Otorhinolaryngology in the Armed Forces Medical College was established in the year 1965 for training Medical Officers of the Armed Forces in the specialty of ENT. The department over the years has shown tremendous growth to emerge as one of the pioneering centres of Otorhinolaryngology in the country.Dr PS Sukhtankar is presently the Head of Department.

ISOCON Conferences


The ISOCON 2010 will be held in Nagpur in November 2010
The ISOCON 2011 will be held in Kochi in November 2011
Watch this blog for details

1st Airway Course & Hands on Laser Training on 23rd, 24th & 25th April 2010,Pune

Deenanath Mangeshkar Hospital, Pune has organized its 1st Airway Course & Hands on Laser Training on 23rd, 24th & 25th April 2010. This would be 1st airway course with hands on training in the country.
The course includes Lectures, Live Surgical Demonstration by National & International Faculty, Case Discussion, Multipoint Video Conferencing, as well as hands-on cadaveric dissection, hands on laser course and hands on training on Simulators.
Kindly be part of it and help us to make it a grant success . Looking forward for active participation from your colleagues and students.

Thanking you,
Dr. Sachin Gandhi - Course Director
Consultant ENT Surgeon & Director Department of Laryngology

Hospital :
Deenanath Mangeshkar Hospital & Research Centre
Erandwane, Pune 411004 , India

Contact details :
Telephone: +91 (0)20 66023511 / 9595123008
Mobile - +91 9822040961
Email:- voiceclinic@gmail.com voicelaser@dmhospital.org
Website - www.voicelaser.com

Dr Namita Narahari
Deenanath mangeshkar Hospital
Erandwane
Pune
9373072737

CLICK HERE FOR PRO GRAMME AND REGISTRATION

Advance FESS Worochop,Raipur ,February 20-12-,2010



CLICK IMAGES TO VIEW BROCHURE

DR RAKESH GUPTA ,MS[ENT]
EYE &ENT HOSPITAL
OPP NEW BUS STAND
RAIPUR[CG]
PH 0771-2430288, 2426559,094242-23860

World Cancer Day:4 February 2010

Cancer is a leading cause of death around the world. WHO estimates that 84 million people will die of cancer between 2005 and 2015 without intervention.
Each year on 4 February, WHO supports International Union Against Cancer to promote ways to ease the global burden of cancer. Preventing cancer and raising quality of life for cancer patients are recurring themes.
This year's theme, “Cancer can be prevented too”, focusses on simple measures to prevent cancer such as:

*no tobacco use
*a healthy diet and regular exercise
*limited alcohol use
protection against cancer-causing infections.

WHO LINK


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Poll:Do you approve Otrivin Nasal drops TV Advertisement

Yes 5 (4%)

No 95 (93%)

Could not care less 2 (1%)

Votes so far: 102
Poll closed
Dr Saumitra Kumar said...
No I am absolutely against the advertisement.It is going to ruin many more noses and breed a lot of rhinitis medicamentosa patients.It should be immediately taken off air.
January 29, 2010 11:25 PM
Mann said...
no, I m totally against advertising these drugs.
these drugs are to b prescribed by a doctor and only then used in the recommended dosage, otherwise there can be side effects also.
February 1, 2010 1:17 PM

More Comments
No.
Dr. Narottam Puri
President - Medical Strategy & Quality
Fortis Healthcare Limited

To prevent rebound congestion, use over-the-counter decongestant nasal sprays for no more than three days in a row. Prescription nasal sprays containing steroids don't cause this rebound effect, so they can be used on a daily basis for years
James T. Li, M.D. MAYO CLINIC

Auditory Brain Stem Implant (ABI) : Dr J M Hans


Dear Dr Rajesh Kalra,

This is to inform all, thru your Blog, that we, at the Primus super Speciality Hospital, New Delhi, (Chairperson : Mrs. Achla Dewan) have successfully performed our 1st Auditory Brain Stem Implant on a 2.5 yrs old child with B/L Cochlear Nerve aplasia. The child is from LEH, Ladhakh, J & K. This is the 1st ABI in North India & 2nd in the country for a congenitally deaf child.

With deepest regards,
Prof. Dr. J.M.Hans
Director, Dept. of ENT & Cochlear Implant Centre,
Primus Super Speciality Hospital, New Delhi
(M) +91 9718126565
&
Ms Meenakshi Wadhera,
Assoc. Meenakshi Speech & Hearing Clinic,
New Delhi.
An Auditory Brain Stem Implant (ABI) is a surgically implanted electronic device that provides a sense of sound to a person who is profoundly deaf, due to sensorineural hearing impairment (due to illness or injury damaging the cochlea or auditory nerve, and so precluding the use of a cochlear implant).

The auditory brain stem implant uses similar technology as the cochlear implant, but instead of electrical stimulation being used to stimulate the cochlea, it is instead used to stimulate the brain stem of the recipient.

DR HANS RECEIVED MANY CONGRATULATORY MESSAGE WHICH MAY BE READ BELOW

Coimbatore, Tamil Nadu: 18th Annual Conference of Indian Society of Otology,February 5-7,2010

Emblem of the State Government of Tamilnadu.Image via Wikipedia

It is referred as Manchester of South India in business circles, and has textile mills, factories, engineering firms, automobile parts manufacturers, health care facilities, and educational institutions. The hill stations of Ooty, Coonnor and Valparai are close to the city making it a good tourist attraction throughout the year. The city is situated on the banks of the Noyyal River and is close to the Siruvani Waterfalls.

BEST WISHES TO DELEGATES AND ORGANIZERS
8th Annual Conference of Indian Society of Otology

February 5 to 7 2010 at Coimbatore.

Contact:- Dr NJ Rajan,Org.Secretary, ENT Clinic,Main Bazar,Ooty-643001.

Email:-dr.njrajan@rediffmail.com, Mob:09443095756



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Foreign Body Instructional Materials. Test your skills on 15 aerodigestive foreign body cases.



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