Elongated styloid process causing Eagle's Syndrome is a rare clinical entity and the diagnosis is often difficult as a result of its vague symptomatology. However, palpation of tonsillar fossa with radiological demonstration of the elongated styloid process confirms the diagnosis. This is a report of a retrospective study conducted at the KVG Medical College, Hospital, Sullia, Karnataka, India where 15 patients who were surgically treated for Eagle's syndrome in the ENT department were retrospectively studied. Fourteen patients became symptom free after surgery within three months of follow up. Tonsillo-styloidectomy is the treatment of choice for Eagle's syndrome with a high success rate.
Multiple oculo-cutaneous malignancies are a common manifestation on sun-exposed facial areas in patients with Xeroderma pigmentosum (XP). Commonly seen are the basal cell carcinoma and the squamous cell carcinomas which manifest in the early first decade in contrast to fifth and sixth decade in the general population. XP manifests as photosensitivity, hyperpigmentation, premature skin aging and malignant changes like squamous cell carcinoma, basal cell carcinoma, fibrosarcoma and rarely malignant melanoma as well as internal malignancies. We report 11 cases of Xeroderma pigmentosa managed in our institute which included sex males and five females. All had photosensitivity, hyperpigmentation and consanguinity with facial malignant lesions like SCC and BCC. Ocular signs of photophobia and excessive lacrimation was seen in all the cases while blurring of vision due to corneal clouding, corneal injection, pterygium and limbal SCC were seen in 5 cases. SCC of the lids were seen in 7 cases while BCC seen in 8 cases and limbal and conjunctival SCC seen in one case. All were managed with excision while one case of melanoma with neck secondaries needed radical neck dissection while the other orbital exenteration. Oculo-cutaneous malignancies occur in the sun exposed areas so patients are advised regular follow up with speciality care. Awareness about the rare condition and importance of early detection and prevention of UV rays induced skin damage should be propagated. The disease is ultimately fatal, life can be prolonged by simple preventive measures to minimize sun exposure and early detection of the skin lesions and management.
Paraganglioma is a rare neoplasm arising from carotid body usually benign and constitute 0.5 % of all total body tumors. They constitute 60-70 % of head and neck paraganglioma and resemble other paragangliomas of the body like glomus jugulare, glomus tympanicum, and pheochromocytoma. This is a retrospective analysis of the medical records of carotid body paraganglioma cases. Nine patients operated during the study period and the follow up traced were included in the study. Seven females and 2 males were analysed. Six had tumor on the left side and 3 had on the right side. All the cases surgical excision was done by a tranverse incision as 2 patients had Shamblin I, 5 patients had Shamblin II, and 1 patients Shamblin IIIa. All the Shamblin I had tumor away from the carotids and were easily dissected without vessel damage, a sub adventitial tumor excision was performed in all the 5 cases of Shamblin II, 1 case of Shamblin IIIa was dissected with difficulty without sacrificing or vessel reconstruction. Paraganglioma of the carotid body should be considered as a differential diagnosis for painless lateral neck masses. Larger tumors need a multidisciplinary team of head and neck with vascular surgeons for better results.
Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ) is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT) has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT) in diagnosing the bony changes in the early phase of the disease.
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