Annals of Indian Academy of Otorhinolaryngology Head and Neck Surgery

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Background: Thyroid swellings are commonly encountered in the surgical practice and accurate preoperative evaluation of thyroid disorder becomes mandatory for proper management of the patient. Aims and Objectives: To evaluate the clinical and radiological features of thyroid nodule with thyroid surgery. Materials and Methods: A total of 60 patients were included with more than 15 years of age presented with thyroid nodule. Results: Fifty three patients were females and seven were males with goitre duration of 6-60 months and presented with progressive increase in the size of the goitre. After clinical evaluation majority of patients were diagnosed as STN. According to ultrasonography, 58 patients were diagnosed as benign lesions while 2 patients were diagnosed with malignant lesions. According to FNAC, maximum number of patients i.e., 37 were diagnosed with colloid goitre while 2 patients had malignant lesions. On histopathological examination, 58 patients were diagnosed with benign lesions while 2 were diagnosed with malignant lesions. USG findings were correlated with thyroid surgery, Among 60 patients of thyroid nodule. 56 patients underwent hemi thyroidectomy.in which 34 were right thyroidectomy and 22 were left thyroidectomy and 4 patients underwent total thyroidectomy. One patient of total thyroidectomy was develop recurrent laryngeal nerve palsy. Conclusion: USG and FNAC has been shown to be more sensitive, specific and accurate than either technique alone but high resolution USG has important and cost effective investigation to decide the extent and type of surgery of thyroid nodules.

Aims: To test the validation of the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaires (QLQs), the core module QLQ-C30, and the head and neck module QLQ-H and N35 in a tertiary care center. Materials and Methods: Forty head-and-neck cancer patients completed the QLQ-C30 and the QLQ-H and N35 during their treatment. Questionnaires given to them were translated into their regional language Kannada. Evaluation of the responsiveness, reliability, and validity of the questionnaire was undertaken. Results: The data support the reliability of the scales. Validity cannot be assessed. The questionnaire was responsive to change over a period of time; however, the applicability of the European questionnaire in Indian clinical setup is debatable. Summary: This data suggest that the EORTC QLQ-C30 and the QLQ-H and N35 are reliable and responsive when applied to a sample of head-and-neck cancer patients in India. Hence, it can be used as a platform to test validity at a multicentric level. Conclusion: Both the questionnaires are equally effective, the newer one providing more insight however few items maybe irrelevant in Indian context.

Malignancy of temporal bone is a rare entity with an incidence of <0.2% of all head-and-neck cancer with an average age of occurrence at 60 years. We present here a case of a 21-year-old boy with temporal bone cancer who presented with clinical features of complicated chronic suppurative otitis media, radiologically as chronic osteomyelitis creating a diagnostic dilemma as there was no predisposing factor for osteomyelitis. The diagnosis was confirmed by open biopsy which revealed squamous cell carcinoma. The best survival rate is obtained with total temporal bone resection and post-operative radiotherapy.

There are a number of complications after thyroid surgery such as compressing hematoma, tracheomalacia, wound infection, damage to the recurrent laryngeal nerve or superior laryngeal nerve, hypothyroidism, hypocalcemia, scar formation, and thyroid storm, but discharging skin sinus of the neck is a rare complication. We report a case of discharging pus sinus of the neck after hemithyroidectomy for 1 year; pus culture was positive for Pseudomonas aeruginosa. Thyroid function test was normal. Ultrasonography disclosed branching sinus tracts and right lobe thyroid nodule and the left lobe not visualized. Sinus tracts' excision surgery was done. Histopathology report revealed fibrocollagenous stroma with clusters of epithelioid cells, histiocytes, Langhans giant cells, and chronic inflammatory cells with foci of caseous necrosis. The diagnosis of thyroid tuberculosis (TB) was therefore made. Patient was put on isoniazid, rifampicin, ethambutol, and pyrazinamide. She responds well. Although seldom observed, TB should be kept in mind in the differential diagnosis of discharging sinus of neck.

Online since 12^th Sep, 2016