A simple way of managing auricular hematomas

Auricular hematomas are sometimes difficult to manage by the conventional technique of aspiration and pressure bandages. Moreover with bulky bandages it is difficult for the patient to return to work early despite it being a small problem.
I have started using a simple way of managing it effectively and with the added advantage that the patient can return to work the next day.
Tiny bits of a nasogastric tube, about 3 mm in length are cut to make small splinters, which are then cut in midline to halve them. The hematoma is simply aspirated and these tiny bolsters are secured on medial and lateral aspect of the pinna with convexity to the skin, using a 4-0 prolene mattress suture. The application is done at multiple spots depending upon the dimension of hematoma. These are removed at tenth day with good results and no recurrences.

--
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

A novel technique for treating auricular hematomas in mixed martial artists (ultimate fighters).

Am J Otolaryngol. 2010 Jan-Feb;31(1):21-4. Epub 2009 Mar 26.

Roy S, Smith LP.

Department of Otolaryngology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA. sohamroy0@gmail.com
Abstract
PURPOSE: This study aimed to describe a "bolsterless" technique for managing auricular hematomas in professional fighters. METHODS: Eight auricular hematomas were drained under local anesthesia by incising along an anatomical auricular crease. After evacuation of the hematoma and copious irrigation, the resultant skin flap was replaced in anatomical position, and through-and-through absorbable mattress sutures were used to secure the flap in place. Incision sites were left open and dressed with antimicrobial ointment. No bolsters were placed. The patients were given 1 week of oral antibiotic therapy. RESULTS: All 8 hematomas resolved without further intervention. All 8 ears returned to their preinjury cosmetic state. Fighters were able to return to training within a week of the initial injury. No postoperative infections or other complications were noted. CONCLUSIONS: In contrast to wrestlers, mixed martial artists (also called "ultimate fighters") do not routinely wear protective head gear. As a result, they are at increased risk of recurrent auricular hematomas, often resulting in severe auricular deformities (cauliflower ear). These patients are anxious to return to training and fighting, and are reluctant to wear a bolster after repair. At their urging, we agreed to attempt this bolsterless technique. Although 2 patients in this series already had a significant cauliflower ear before being treated for the current hematoma, in all cases the auricle returned to its preinjury condition. Bolsterless treatment using mattress sutures and cosmetically placed incisions represents a successful technique for management of auricular hematomas in this population.

Diagnostic contributions of videolaryngostroboscopy in the pediatric population.

Arch Otolaryngol Head Neck Surg. 2010 Jan;136(1):75-9.

Mortensen M, Schaberg M, Woo P.

Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, PO Box 800713, Charlottesville, VA 22903, USA. mm6nj@virginia.edu

Abstract

OBJECTIVE: Videolaryngostroboscopy (VLS) is a standard technique used for evaluating adult patients with dysphonia. However, while pediatric dysphonia affects 5% of children, children with dysphonia are traditionally examined with a flexible nasal endoscope. The purpose of this study was to determine whether VLS provides additional diagnostic yield in children. DESIGN: A retrospective medical chart review was conducted from 2001 to 2006. SETTING: Tertiary care center. PATIENTS: Pediatric patients aged 3 to 17 years (mean age, 11 years) who presented with prolonged dysphonia. All patients were previously examined by flexible laryngoscopy and treated with speech therapy for a presumed diagnosis of vocal cord nodules. INTERVENTIONS: Flexible or rigid VLS was performed. MAIN OUTCOME MEASURE: The diagnosis per patient established after VLS. RESULTS: Eighty patients were included in the study: 50 underwent rigid VLS; 28 underwent flexible VLS; and 2 did not tolerate either procedure. A total of 132 diagnoses were made, including 68 benign mucosal diseases (41 nodules, 15 polyps, 8 cysts, and 4 sulci), 41 inflammatory disorders, 11 functional disorders, 6 congenital disorders, 4 traumatic injuries, and 2 neurologic disorders. Many patients received more than 1 intervention for their dysphonia, including antireflux medication and speech therapy, but 16 patients also underwent phonomicrosurgery. CONCLUSIONS: Patients with a history of prolonged dysphonia for whom treatment has failed should be referred for evaluation by VLS. Videolaryngostroboscopy elucidates subtle features of different disease processes; clarifies the differences between benign mucosal disorders that might require surgical intervention; and helps identify inflammatory processes that contribute to dysphonia. To our knowledge, these findings have not previously been reported in the pediatric population. Although most pediatric dysphonia can be attributed to benign nodules, our results show that inflammatory conditions and benign lesions other than nodules contribute to dysphonia and are often overlooked and undertreated.

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World No Tobacco Day, 31 May 2010

The World Health Organization (WHO) selects "Gender and tobacco with an emphasis on marketing to women" as the theme for the next World No Tobacco Day, which will take place on 31 May 2010.

Controlling the epidemic of tobacco among women is an important part of any comprehensive tobacco control strategy. World No Tobacco Day 2010 will draw particular attention to the need to protect women and girls from the harmful effects of tobacco marketing and smoke in accordance with WHO Framework Convention on Tobacco Control.

World Voice Congress (VOICE 2010),September 6-9,2010,Seoul

Website www.voice2010.org

Dear Colleagues,

On behalf of the Organizing Committee of the 4th World Voice Congress (VOICE 2010), it is my great honor and pleasure to announce that VOICE 2010 will be held in Seoul from September 6-9. The Congress will bring together a diverse community of clinicians, therapists and scientists of the voice science and therapeutic fields from all over the world to share their cutting-edge expertise and knowledge.

The scientific program on voice disorders, motor speech disorders, dysphagia, craniofacial disorders, speech and hearing disorders, fluency disorders and many others will give the most comprehensive and global view of research and issues challenging the professions, research and science today.

Seoul, the capital of Korea, is a lively metropolitan city teeming with modern and traditional Korean culture. Its historical and cultural background makes Seoul the ideal city to hold the 4th World Voice Congress. The organizing committee is planning many attractive social programs to help you enjoy Seoul and is taking the utmost care to pay attention to every small detail.

I would like to extend to you my warmest welcome to Korea, and look forward to seeing you at the 4th World Voice Congress in Seoul, Korea in 2010.

Sincerely yours,

Hong-Shik Choi, MD
President
The 4th World Voice Congress

MRI and MR sialography of juvenile recurrent parotitis.

Pediatr Radiol. 2010 May 14. [Epub ahead of print]

Gadodia A, Seith A, Sharma R, Thakar A.

Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India, 110029.

Abstract

BACKGROUND: Juvenile recurrent parotitis (JRP) is the second most common inflammatory salivary gland disease of childhood, after mumps. Diagnosis of JRP is usually based on clinical history of recurrent unilateral or bilateral parotid swelling and demonstration of sialectasis. Conventional sialography, digital sialography, US, MRI and sialoendoscopy have been used as investigative tools for the diagnosis of JRP. MR sialography is increasingly recognized as a useful supplement to sialography in salivary duct disorders. OBJECTIVE: To describe the MRI and MR sialographic findings in children with JRP. MATERIALS AND METHODS: MR Sialography was performed using T2-weighted three-dimensional constructive interference in steady-state (CISS) and half fourier acquisition single-shot turbo spin-echo (HASTE) sequences in 62 children with inflammatory salivary gland disease. Out of these 62 children, 6 had JRP. Axial T1- and T2-W images were also performed. RESULTS: The main parotid duct was normal in all six children with JRP. High signal intensity focal lesions suggestive of sialectasis were seen involving both parotid glands in all six children. CISS sequence demonstrated the intraglandular ducts and sialectasis better than HASTE images. CONCLUSION: MRI and MR sialography can non-invasively delineate the parenchymal and ductal system abnormalities of the parotid glands in children with JRP. Although MR and MR sialography cannot substitute US, they can accurately depict findings such as sialectasis and signal intensity changes in the parotid gland depending upon the phase of the disease (acute vs. chronic inflammation). The radiologist should be familiar with MR findings of JRP.

PMID: 20467735 [PubMed - as supplied by publisher]

Applied Middle Ear & Cochlear Implant Live Surgery Workshop,13-14,2010 November,Agra

EAR SURGERY by Dr G K Narayana

Dr G KNarayana,MBBS,MS. professor and HOD, otolaryngology

Dept, SDUMC, Kolar.Honourary ENT Surgeon,

Srisathyasai general hospital.bangalore.

Email:	gknarayana@yahoo.com
Address:	anugrha ENT care
Website:	http://in.youtube.com/user/gknarayana

House Institute Histopathology

Cochlear reconstruction to show surviving hair cells (dots), supporting cells (hillocks), and missing elements (M) in partially deafened individual.

ENT Pateint Information Blog:Dr Prateek Nayak

I am an ENT and Head and Neck surgeon practising in Bangalore,India
This blog is for anyone seeking information in various conditions in the ear ,nose ,throat, voice or head and neck.
Keep visiting for all such interesting medical info
Cheers!

CLICK HERE TO VISIT

Brain tumour risk in relation to mobile telephone use:After decade-long study on brain tumor risk, findings are still inconclusive

This is the largest study of the risk of brain tumours in relation to mobile phone use conducted to date and it included substantial numbers of subjects who had used mobile phones for 10 years.Overall, no increase in risk of either glioma or meningioma was observed in association with use of mobile phones. There were suggestions of an increased risk of glioma, and much less so meningioma, at the highest exposure levels, for ipsilateral exposures and, for glioma, for tumours in the temporal lobe. However, biases and errors limit the strength of the conclusions we can draw from these analyses and prevent a causal interpretation.

LINK

Perioperative medication errors in otolaryngology

Perioperative medication errors in otolaryngology
Rebecca Rosenwasser 1, Almut G. Winterstein, PhD 1 2, Amy F. Rosenberg, PharmD, BCPS 5, Eric I. Rosenberg, MD, MSPH 3, Patrick J. Antonelli, MD 4 *
Laryngoscope

The authors have no funding, financial relationships, or conflicts of interest to disclose.
KEYWORDS
Medication • error • patient safety • perioperative • Level of Evidence: 4
ABSTRACT

Objectives/Hypothesis:
Medication errors are a common cause of poor clinical outcomes. Information on perioperative medication errors is scarce. This study was aimed at identifying the nature, cause, and potential remedies for medication errors in otolaryngologic surgery.

Study Design:
Prospective and descriptive.

Methods:
Clinicians were incentivized for reporting possible medication errors that occurred from the preoperative through the first postoperative clinic visit over a 2-month period. Each report was investigated by an expert panel to determine validity, preventability, contributing factors, and potential preventative measures. A random sample of procedures and clinic visits were monitored for compliance with safe medication practices and information flow.

Results:
From 589 surgeries, 20 medication errors were reported (two preoperative, four operative, five during hospital admission, two in transition between services, four during discharge, and three postoperative). Errors included wrong dose (seven), omitted dose (six), wrong drug (five), wrong site (two), and unnecessary drug (one). Causes included failure to consider weight-based dosing, use accurate drug references, calculate the total medication supply needed, verify the administration site, consider pertinent patient information (e.g., allergies), reconcile medications upon transfers, and document medication histories. Use of preprinted order forms was flawed, and discharge instructions were insufficient to guide patients postoperatively.

Conclusions:
Failure to adhere to safe medication-use practices occurred throughout perioperative care. Improvement in medication documentation, following established safe practices, integration of patient information in prescribing decisions, and use of clinical decision support systems appear necessary to prevent perioperative medication errors in otolaryngology.
Received: 25 January 2010; Revised: 20 February 2010; Accepted: 25 February 2010

XX IFOS World Congress,Korea,June 1-5,2013

The host city, Seoul, has a first-rate convention center with state-of-the-art facilities in the heart of the city surrounded by all categories of accommodations. Seoul has been the capital city since the beginning of the Joseon Dynasty (1392-1910) until now. It offers numerous interesting historical and cultural sights for the visitors from all over the world.
The primary host organization, the KORL-HNS, has 3,500 members including 400 in-training resident members working at the 87 resident training centers including 40 universities in Korea.

VISIT WEBSITE
Conference Website

AAO-HNSF Meetings

Future AAO-HNSF Annual Meeting Destinations

2011 San Francisco, CA* September 11-14

2010 Boston, MA* September 26-29

Past AAO-HNSF Annual Meeting Destinations

2009 San Diego, CA October 4-7

2008 Chicago, IL September 21-24

2007 Washington, DC September 16-19

2006 Toronto, Ontario, Canada September 17-20

2005 Los Angeles, CA September 25-28

2004 New York, NY September 19-22

2003 Orlando, FL September 21-24

2002 San Diego, CA September 22-25

2001 Denver, CO September 9-12

2000 Washington, DC September 24-27

1999 New Orleans, LA September 26-29

1998 San Antonio, TX September 13-16

1997 San Francisco, CA September 7-10

1996 Washington, DC September 29-October 2

1995 New Orleans, LA September 17-20

1994 San Diego, CA September 18-21

1993 Minneapolis, MN October 2-6

1992 Washington, DC September 13-17

1991 Kansas City, MO September 22-26

Diagnosis and treatment of small follicular thyroid carcinomas

Br J Surg. 2010 Jun;97(6):839-44.
Diagnosis and treatment of small follicular thyroid carcinomas.
Clerici T, Kolb W, Beutner U, Bareck E, Dotzenrath C, Kull C, Niederle B; German Association of Endocrine Surgeons.

Collaborators (35)
Department of Surgery, Kantonsspital St Gallen, St Gallen, Switzerland.
Abstract
BACKGROUND: Follicular thyroid microcarcinomas (mFTCs) of 10 mm or less in size rarely manifest clinically and their clinical significance is controversial. This study assessed their characteristics and incidence, and analysed treatment modalities used for mFTC. METHODS: Members of the German Association of Endocrine Surgeons were asked to review patients with mFTC operated on between 1990 and 2005. RESULTS: Data for 90 patients from 26 institutions were reported. Histopathological slides were available for re-evaluation in 35 patients. Most initial diagnoses had to be revised because of incorrect size assessment or incorrect diagnosis (benign adenoma, papillary thyroid carcinoma (PTC), follicular variant of PTC). The diagnosis of mFTC was confirmed in only four patients. As a result of the incorrect histopathological diagnosis, unnecessary completion thyroidectomy and radioiodine ablation were performed in 17 and 20 patients respectively. The incidence of mFTC was calculated to be 0.12 per million population per year. CONCLUSION: mFTC is exceptionally rare. Such tumours are overdiagnosed, resulting in unnecessary treatment associated with avoidable morbidity. Histopathological re-evaluation by an experienced pathologist is recommended before embarking on further treatments when a diagnosis of mFTC is made.

PMID: 20473996 [PubMed - in process]

Pic of Day

Location : Disneyland {HK)

Retained gauze swabs in the neck

Cases J. 2009 Jul 27;2:6413.
A submandibular gossypiboma mimicking a salivary fistula: a case report.
Amr AE.

Department of Surgery Sahel Educational Hospital, Cairo Egypt.
Abstract
Retained gauze swabs in the neck have seldom been reported. We present the case of a 27-years-old man who suffered a persistent discharging sinus for 8 years following excision of a right submandibular gland. Computed tomography fistulography was done showing a Blind track ending into a cavity just beneath the floor of mouth. Neck exploration eventually revealed 2 gauze swabs that were tightly packed in the area of submandibular duct. This article further emphasizes the importance of sound operative room practice to avoid this serious problem.

Endoscopic resection of the submandibular gland via a hairline incision

Laryngoscope. 2010 May;120(5):970-4.
Endoscopic resection of the submandibular gland via a hairline incision: a new surgical approach.
Song CM, Jung YH, Sung MW, Kim KH.

Department of Otolaryngology-Head and Neck Surgery, Seoul National University Boramae Hospital, 39, Boramae-Gil, Dongjak-Gu, Seoul 156-707, South Korea.
Abstract
OBJECTIVES/HYPOTHESIS: Submandibular gland excision is traditionally performed by the transcervical approach. To avoid or reduce visible scarring and nerve injury, diverse innovative surgical trials have been reported. Here we report a patient who had an endoscopic submandibular gland resection via a hairline incision. METHODS: A 36-year-old woman presented with a right submandibular gland tumor that was found on a routine check-up. The submandibular gland was resected under endoscopic assistance via a posterior hairline incision using an ultrasonic scalpel. RESULTS: The resection was successful, causing no acute complications, such as neural injury, hematoma, or seroma formation. The incision scar healed with an excellent cosmetic result. CONCLUSIONS: Endoscopic submandibular gland resection via a hairline incision was feasible and resulted in an excellent surgical and cosmetic outcome. Laryngoscope, 2010.

"VERTIGO 2010, STATE OF ART WORKSHOP ON DIZZINESS"June 27, 2010,Hyderabad

Image Guided Endoscopic Sinus Surgery Live Surgical Workshop cum Hands-on Cadaver Dissection Workshop on FESS 5th & 6th June, 2010 Shillong

Image Guided Endoscopic Sinus Surgery Live Surgical Workshop cum Hands-on Cadaver Dissection Workshop on FESS

5th & 6th June, 2010

Department of E.N.T.
North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences (NEIGRIHMS), Shillong (Meghalaya) - 793018

Contact: Dr. Amit Goyal 9436766200 meetugoyal@yahoo.com
Dr. N. Brian Shunyu 9774028155 drnbshunyu@yahoo.com



Thanks & Regards,


DR. AMIT AK GOYAL
MS, DNB, MNAMS
Assistant Professor
Department of Otorhinolaryngology and Head & Neck Surgery
North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences (NEIGRIHMS)
(An Autonomous Institute under Ministry of Health & Family Welfare, Government of India)
Mawdiangdiang, Shillong (Meghalaya) - 793 018 INDIA.
Phone Nos.: +91 364 2538025 (Hosp) Extn. 1406, +91 364 2538055 (Res)

Mobile No.: +91 94367 66200
Alternate E-mail id: dramitgoyal@gmail.com
Res.: B-10-D, NEIGRIHMS, Shillong.
Permanent Address: 81, LIC Cly, ASC Road, Ajmer - 305 006
Phone No. +91 145 2431954

Web Page on Halitosis-Fauqueir

Halitosis (also known as bad breath) most often is caused by volatile sulfur compound producing bacteria in the oral cavity (85%). Such bacteria exist on the gums, teeth, tonsils, adenoids, and tongue. Other (less common) causes of bad breath also include reflux, sinus infections, pneumonia, bronchitis, kidney failure, metabolic dysfunction, cancer, etc. The most recalcitrant cause of halitosis (in people with excellent oral hygiene) is due to bacterial overgrowth in the back part of the tongue (lingual tonsils). Adenoids is another location often neglected as a cause of halitosis.
LINK

Onset of subcutaneous emphysema and pneumomediastinum after tonsillectomy:

Several complications can be related to surgical approaches of head and neck regions. Among those, there are rare conditions such as pneumomediastinum, pneumothorax and subcutaneous cervical emphysema. This study reports a case of a patient that developed pneumomediastinum, pneumothorax and subcutaneous emphysema after undergoing tonsillectomy. In order to reduce these complications in surgical approaches such as tonsillectomy, care should be taken with intubation, use of oxygen mask for positive pressure ventilation during anesthesia recovery, aggressive surgical maneuvers and use of surgical instruments that may cause deep tonsillar injuries.
Read...
Read more

Spot Diagnosis posted on MAY 2:answer to the pic question

Malerupted upper molar. Open mouth NCCT PNS clinched the diagnosis. There is no plan for any intervention till the time symptoms are not there.
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

12th Asia-Oceania ORL-HNS Congress, Auckland, NZ,1-4,March 2011

Dear Rajesh ,

The Organising Committee of Asia-Oceania 2011 joins me in extending a warm invitation to you to register for the 12th Asia-Oceania Otolaryngology Head and Neck Congress which will be held from 1 – 4 March 2011 at the Aotea Centre, Auckland, New Zealand.

Asia-Oceania 2011 promises to be an outstanding Otolaryngology Conference. The Invited Faculty includes speakers from the very top tier of each of our Sub-Specialty streams: Otology, Rhinology, Head and Neck, Paediatric, Laryngology, Facial Plastic and Sleep Medicine. Bracketed with this is the outstanding Audiology/Audiological Medicine program.

The content of this Congress is truly exceptional in its breadth, depth, and quality; add to this the unique setting of New Zealand (“100% Pure”) and we have what could be considered an “Otolaryngological Experience of a Lifetime”

The Organising Committee hopes you will take advantage of this opportunity to come to Auckland and embrace the theme of our conference (“Ethical Outcomes”).

Once here, you can also experience the outstanding adventure tourism and spectacular scenery that New Zealand provides, as well as the “clean and green” image that other countries strive to emulate.

The Organising Committee welcomes you to Auckland for the collabaration between
New Zealand Society of Otolaryngology-Head and Neck Surgery
New Zealand Audiology Society
International Academy of Oral Oncology
International Federation of Head and Neck Oncological Societies
This joint venture is unique in the history of Asia - Oceania Congresses and presents "Ethical Outcomes" as a theme, with speakers addressing Quality and Cost Effectiveness as major issues.
VISIT CONFERENCE WEBSITE

Children's liquid cold, allergy medicine recalled

Fri Apr 30, 11:25 pm ET
WASHINGTON – More than 40 over-the-counter infant's and children's liquid medications are being recalled in the United States and 11 other countries because they don't meet quality standards.
McNeil Consumer Healthcare issued the recall for children's versions of Tylenol, Tylenol Plus, Motrin, Zyrtec and Benadryl after consulting with the Food and Drug Administration.
The company is recalling the products because some did not meet required quality standards, the company said in a statement Friday. Some of the products recalled may have a higher concentration of active ingredient than is specified on the bottle. Others may contain particles, while still others may contain inactive ingredients that do not meet internal testing requirements.
The company is advising consumers to stop giving the products to their children as a precautionary measure. The recall was not undertaken because of any adverse effects, the company said.
The medicines were made and distributed in the United States, and exported to Canada, the Dominican Republic, Dubai, Fiji, Guam, Guatemala, Jamaica, Puerto Rico, Panama, Trinidad and Tobago and Kuwait.
Details, including NDC numbers, are available by telephone at 1-888-222-6036 or on the Web at http://www.mcneilproductrecall.com.

Does thyroid gland examination by palpation alter serum hormone levels?

Does thyroid gland examination by palpation alter serum hormone levels?
Sema Zer Toros, MD 1 *, Leyla Ozel, MD 2, Mehmet Murat Yekrek, MD 3, Ahmet Burak Toros, MD 4, Bars Naiboglu, MD 1, Melih Kara, MD 2, Erdal Erdodu, MD 2, Erol Egeli, MD 1, zzet Titiz, MD 2
1Department of Otorhinolaryngology/Head and Neck Surgery, Istanbul, Turkey
2Department of General Surgery, Istanbul, Turkey
3Department of Biochemistry, Haydarpaa Numune Educational and Research Hospital; Istanbul, Turkey
4Department of Internal Medicine, Istanbul Educational and Research Hospital, Istanbul, Turkey
email: Sema Zer Toros (semazertoros@yahoo.com)
*Correspondence to Sema Zer Toros, M. Saadettin Sokak, Saadet Apartmen, No:3D:4, Ortaköy/Beikta Istanbul, Turkey

The authors have no funding, financial relationships, or conflicts of interest to disclose.
KEYWORDS
Thyroid • thyroid hormones • palpation • Level of Evidence: 2c
ABSTRACT

Objectives/Hypothesis:
The goal of this study was to investigate the effects of routine thyroid gland palpation on serum thyroid hormone levels.

Study Design:
Prospective study at Haydarpaa Numune Research and Education Hospital, Istanbul, Turkey.

Methods:
This study was carried out in two groups with a total of 50 consecutive adults. Group I consisted of 20 patients (12 female and 8 male, aged 20-48 years) with a diagnosis of nodular thyroid disease confirmed by ultrasound imaging techniques. The second group consisted of 30 otherwise healthy subjects (17 female and 13 male, aged 18-50 years) referred for neck and thyroid ultrasound and with no thyroid pathology detected. Thyroid gland palpations were performed by the same physician. Blood samples were obtained before and 2 hours after thyroid gland palpation. Serum total T3 (TT3), total T4 (TT4), free T3 (FT3), free T4 (FT4), thyroid stimulating hormone (TSH), and thyroglobulin (TG) measurements were made.

Results:
We found that routine palpation in the first group caused a significant increase in serum TT3 (P < .05), FT3 (P < .01), FT4 (P < .05), and TG (P < .05) levels. In the second group, TT3 (P < .01), FT3 (P < .05), FT4 (P < .05), and TG (P < .05) levels also increased significantly after palpation. Differences in TSH and TT4 levels were not significant in any of the groups (P > .05).

Conclusions:
Preliminary data proposing a possible effect of routine thyroid gland palpation on serum thyroid hormone levels suggest that serum thyroid hormone measurements should be performed before any manipulation of the gland, including palpation, to avoid misdiagnosis. Laryngoscope, 2010

Spot the Diagnosis:Dr Harpreet S Kochar

A 58 year old lady presented with a bony hard swelling of the palate which has been there since last 2 years. She complains of occasional mild pain, especially upon touching it. Otherwise there is no history of pus discharge from the area, no adjacent carious teeth, no history of nasal pathology and no history of diabetes. What's your differential?

--
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

guyton said...
solitary osteoma of the palatine process of maxilla/alveolar ridge

May 2, 2010 8:30 PM