A 26-year-old man, presented to our department with history of a metallic foreign body in the neck. On wound exploration under local anaesthesia, the foreign body was not readily palpable. It was removed with the help of a magnet.

Introduction Ophthalmological symptoms are common in ear, nose and throat conditions. Orbital involvement and ophthalmological presentations may be indicative of the extensive and aggressive nature of the pathology. This study evaluated the causes of various ophthalmological presentations in relation to primary ENT diseases in patients attending the ENT Department of a government tertiary referral teaching hospital. Material and Methods Sixty patients with ophthalmological presentations arising out of primary ENT diseases were assessed in detail. Comprehensive physical, ophthalmological and ENT examinations were done. Ophthalmological and ENT diagnoses, treatment details, outcome and complications if any were also noted. Results Most number of patients were in the age group 51 to 60 years (14; 23.4%). Most common ophthalmological symptom was periorbital oedema (51.6%) followed by epiphora (48.3%); the most common ENT symptom was headache (50%) followed by nasal discharge (48.3%). Most common diagnosis among patients was sinusitis (46.7%) followed by mucocele (21.7%). Most common (47%) otorhinological diagnosis associated with proptosis in this study was infections in the form of orbital cellulitis or abscess associated with sinusitis. Majority (43, 71.7%) of the study sample had surgical management.   Conclusion This study reiterates the need for a high index of suspicion from the part of the ophthalmologist to look beyond eye diseases as causes for ophthalmological presentations and from the part of otorhinolaryngologist to be aware of various non-ENT symptoms secondary to ear, throat and nose diseases. A close collaboration between the ophthalmology and ENT departments is essential in successful management of such patients.

Granular cell tumors are benign relatively rare lesions that can occur in any organ in the body. Tongue is the most predilected site. Granular cell tumor vocal cord is even rarer and typically occurs in the third decade of life. It generally presents as a single lesion, but multiple lesions can also occur. Patients present with hoarseness and\or airway obstruction. Granular cell tumors are resistant to radiotherapy, and therefore surgical excision is the treatment of choice. We report the case of granular cell tumor vocal cord in a 13-year-old male child in whom direct laryngoscopic excision of the tumor was advocated. A 13-year-old boy presented to Department of ENT medical college Kottayam, with history of change in voice and frequent clearing of throat of 5 months duration. He was subjected to detailed ENT evaluation and indirect laryngoscopic examination showed a smooth reddish mass involving the entire length of right vocal cord with normal vocal cord mobility. Neck and other ENT areas were within normal limits. General examination did not reveal any abnormalities. He was investigated and subjected to Direct Laryngoscopy under General Anaesthesia. The laryngoscopic finding was a firm reddish mass involving the entire length of membranous part of right vocal cord which was completely excised and the specimen sent for histopathological examination. Post operative period was uneventful. KeywordsThe histopathology (Photo 1, 2 and 3 ) report came as Granular cell tumour. During the first postoperative review clinical examination showed a normal larynx with normal vocal cord and the patient was absolutely free of symptoms. He is under regular follow up now. DiscussionGranular cell tumour is a benign mesenchymal neoplasm of schwann cell origin. Previously it was named as Granular cell myoblastoma and also called as Abrikossoff tumour. Current etiological data suggest that granular cell tumour is the consequence of degradation and is not a specific neoplastic entity. The granular cell tumour usually affects middle aged individuals of range 30 to 50 years and there is slight female predilection. The oral cavity, specifically the tongue is the most common site of its occurrence. Other sites include the anterior and posterior chest wall, upper limbs, larynx, stomach, vulva and anogenital region. Most common location in larynx is the true vocal cords-middle and posterior 1\3 rd.