Neocord formation after Type III cordectomy is insufficient for complete glottic closure due to scarring and soft tissue deficit. This study evaluates the role of autologous fat injection (AFI) in phonosurgical management of patients who have previously undergone Type III cordectomy for early glottic cancer. Data was collected from hospital records of patients who underwent AFI after previously undergoing Type III cordectomy. A minimum duration of 6 months post-cordectomy was maintained before fat injection. Trans-oral injection was performed at a single site. Pre-operative voice evaluation was done using VHI, GRBAS scale and MDVP software. Post-operative evaluation was done at 6 weeks. 21 out of 62 post-Type III cordectomy patients chose to undergo fat augmentation and were included in the study. A comparison of pre-operative and 6 months post-operative AFI voice analysis showed a significant improvement in VHI, all parameters of GRBAS scale, and improvement in Jitter, Shimmer, SPI and NHR. There was a decrease in fundamental frequency but this was not statistically significant. AFI is an effective procedure for surgical voice rehabilitation of patients who have undergone Type III cordectomy for early laryngeal cancer.

Background and objectives Allergic rhinitis affects up to 20% of the general population and is one of the most common reasons for presentations to the outpatient department. We hereby present a case series which attempts to have a correlation between tissue eosinophilia (inferior turbinate) and increased eosinophil count in blood (>440 cells/mm3). Materials and methods Thirty-six patients presented to the Outpatient Department of Bapuji Hospital and Chigateri General Hospital (Teaching Hospitals attached to JJM Medical College), Davangere, with nasal obstruction and symptoms suggestive of allergic rhinitis with turbinate hypertrophy who were posted for elective bilateral partial inferior turbinectomy with/without submucous resection/septoplasty. These patients had increased absolute eosinophil count in blood. Formalin fixed inferior turbinectomy specimens were routinely processed for histopathology. Eosinophils in the mucosa and submucosal region were counted by method of Shioda and Mishima. Results Ten patients out of 36 showing increased eosinophil count in blood show ‘significant eosinophilia’ in turbinates (27.7%). Conclusion Peripheral eosinophilia does not always correlate with tissue eosinophilia which opens up a possibility of using nasal mucosa biopsy for confirmation of presence of eosinophils. Further studies are needed to explore the demonstration of ‘activated’ tissue eosinophils in the diagnosis of allergic rhinitis.

Kimuras disease is a chronic inflammatory disorder mostly affecting subcutaneous tissue, lymph nodes and salivary glands which has affinity for the Asian population. Histopathologically characterised by a lymphofolliculoid granuloma with infiltration of surrounding tissues by eosinophils, often with concomitant peripheral blood eosinophilia and elevated serum immunoglobulin E. TH2 cells are suspected to play an important role with increased levels of IL-5 and IgE. We hereby present a case of left parotid swelling in paediatric age group which was gradually increasing in size. Radiological investigations showed heterogenous parenchyma with multiple hypoechoeic lesions in parotid. Peripheral blood picture gave normal eosinophil count. Superficial parotidectomy was carried out and final histopathology suggestive of Kimuras disease was made.

No abstract

Paralysis of the facial nerve (cranial nerve VII) is a relatively uncommon entity in children. It not only results in weakness of the facial musculature affecting the facial expressions, eye closure, and oral competence, but also causes psychological and emotional trauma to the child and parents. Unilateral palsy is usually idiopathic, whereas bilateral palsy usually has an underlying cause. We report a case of a 4-year-old girl who presented to us with simultaneous facial nerve paralysis where the second side was involved within 7 days of the first, before its complete resolution. Evaluation of the patient and the possible etiologies of bilateral facial palsy have been discussed further.