WAENT - World Articles in Ear Nose and Throat

Pictures & Videos of the Month - 2009, 2010, 2011, 2012, 2013

These Articles HaveVery Graphic Pictures and is Intended for
Medical Education Only

Fungal Laryngitis

Video of fiberoptic laryngoscopy in a patient with fungal laryngitis

Submitted by - Drs. Rupender K. Ranga & S.P.S. Yadau, India.

View YouTube Video

Fungal Laryngitis
Fungal Laryngitis

Nasal Myiasis

Video of endoscopic removal of nasal myiasis.

Submitted by Endoscopic Treatment of Nasal Myiasis - Drs. Rupender K. Ranga & S.P.S. Yadau, India.

View YouTube Video

Hansen's Disease of the Pinna

The picture on the right is a 31 year old male with a three day history of a swollen pinna. Skin biopsy was positive for mycobacteria lepre.

Submitted by Dr. Vadish Bhat,
K S Hegde Medical Academy, Mangalore, India.

Ossiculoplasty

Video of Repair of Ossicular Discontinuity between Incus and stapedial Head.

Submitted by Dr. Jaynat Watve, Kolhpur, India.

View YouTube Video

Tampanoplasty

Technique for removing blood from the ear canal during surgery.

View YouTube Video

Mar. 2012 -- Foreign Body in the Larynx

The Vast majority of inhaled or ingested foreign bodies are as
results of carelessness. A thorny foreign body (Achyranthus asprea) was impacted on vocal cord in a young girl which was removed by direct laryngoscopy using propofol as sole anesthetic. There was complete restoration of normal voice postoperatively.

Pictures & report submitted by Dr Ranga RK, Yadav SPS, Singh J, and Sehrawat R. Haryana, India

Click on Picture To View More Information Regarding The Picture and Patient

Jan. 2012 -- Retroauricular Approach to Lateral Cervical Masses

Step by step surgical video explaining the technique of a retroauricular approach to lateral cervical (neck) masses.

Submitted by Garcia C, Fdez-Freire R, Elhendi W,
Hospital Punta de Europa. Algeciras. Cádiz, Spain.

Click on Picture to Enlarge

Removed Due to Alleged Copyright Claim Involving The Music Used In the Video

July. 2011 -- Benign Osteoma of the Hyoid Bone
The appearance of a young Indian male with a slowly growing hard midline mass. On X-Ray and CT Examination he was found to have a benign osteoma of the hyoid bone. Treatment was surgical removal. Intraoperative pictures are shown in the presentation. View Flash Slide Show	Click on Picture to Enlarge

Mar. 2011 -- Internal Carotid Artery Aneurysm
Click on the picture to the right to view a Flash slide show of a year old Indian Male with a pseudoaneurysm of the Internal Carotid Artery. Pictures submitted by Dr Sudhakar Vaidya, and Dr Hariom Sharma, Ujjain, India View Flash Slide Show	Click on Picture to Enlarge

Feb. 2011 -- Lentigo Maligna Melanoma

Photograph to the right is of a 75 year old male with a lentigo maligna melanoma on the cheek. The lesion has an irregular border and variegated coloration.

Treatment consists of surgical excision with at least a one centimeter margin. This will produce a three centimeter defect which can be reconstructed with a rotation advancement flap.
View Example

Staging of Melanoma

Treatment Guidelines

Click on Picture to Enlarge

Dec. 2010 -- Inclusion Cyst of the Tonsil

This picture on the right shows a benign tonsillar cyst. The cyst can be treated by marsupialization. This can be performed using local anesthesia in the office. The removed tissue is sent to pathology to confirm a diagnosis. Drainage also prevents further enlargement.

Pictures submitted by Dr Sudhakar Vaidya, Ujjain, India

Click on Picture to Enlarge

Dec. 2010 -- Tympanosclerosis, atelectasis and perforation of the eardrum

The picture on the right shows an atelectatic eardrum with a large area of anterior tympanosclerosis and a dry inferior perforation.

Closure of the eardrum may be recommended to prevent infections and to allow the patient to get water in his ear canal. However, with the severe atelectasis and tympanosclerosis, improvement of in hearing would not be expected.

Click on Picture to Enlarge

Nov. 2010 -- Fixed Drug Reaction of the Oral Civity and Lips

This picture on the right shows a fixed drug reaction in a 23 year old Indian male. The patient was prescribed a quinolone antibiotic (ciprofloxacillin) which first caused bullous formation and then mucosal sloughing.

View patient after treatment with Steroids. View Picture

Pictures submitted by Dr Viral A. Chhaya and Dr Vikas Sinha from Jamnagar, India

Click on Picture to Enlarge

Oct. 2010 -- Mandibular Tori
The picture on the right shows bilateral mandibular tori in a 40 year old. These are benign bony growths which do not require treatment unless they interfere with denture placement.	Click on Picture to Enlarge

Sept. 2010 -- Leukoplakia on the True Vocal Cords
This pictures shows severe leukoplakia on the left true vocal cord in a 54 year old patient with a 45 pack year history of hoarseness. The patient presented with a three month history of hoarseness. Because of the possibility of cancer, the patient underwent a microdirect laryngoscopy and biopsy. View Post Op Picture	Click on Picture to Enlarge

Sept. 2010 -- Radiation Therapy and Smoker's Laryngitis

The above picture shows a 66 year old patient who is 3.5 years status post radiation therapy for squamous cell carcinoma of the larynx. He had a 75 pack year history of smoking and quit just 2 months prior to the video recording. The patient has a very weak voice which was barely more than a whisper.

Both the past radiation therapy and the recent heavy smoking has contributed to the patient's condition.

View Video

Click on Picture to Enlarge

Aug. 2010 -- Apthosis Ulcer

The picture show a large apthosis on the lateral tongue.. Trauma of the lateral side of the tongue from the teeth may be a predisposing factor. Apthosis ulcers are also often found in individuals that are under stress.

The ulcers are painful and shallow. Usually they are on mobile mucosa and are small.

The cause of these ulcers is unknown. A physician may elect to treat the patient by applying Amlexanox gel to the ulcers four times a day for 7 to 10 days.

Click on Picture to Enlarge

July 2010 -- Basal Cell Carcinoma of the Cheek
Picture of a basal cell carcinoma of the cheek. Note the central ulceration and pearly border. Many of these tumors are caused by sun exposure. Treatment may consist of surgery or radiation therapy. This patient was treated with surgical excision with primary closure. .	Click on Picture to Enlarge

Jun. 2010 -- Flash Slide Presentation of an Intrathorasic Thyroid Goiter
The pictures are from a 45 year of female with a large thyroid goiter extending to the prevertebral space and into the mediastinum to the level of the aortic arch.. View Flash Slide Presentation	Click on Pictures to Enlarge

May 2010 -- Video of a Biopsy of the Nasopharynx

The video show the ho had a suspected mass in the nasopharynx which was found incidentally on a MRI scan. .

View Video of Transnasal Endoscopic Biopsy of the Nasopharynx

Click on Pictures to Enlarge

Apr. 2010 -- Picture of a MRSA - Methicillin-resistant Staphylococcus Aureus
The patient is a 55 year old who had a 3 day history of progressive swelling and pain involving the right lower lip. The lip was incised which expressed 3 ml of pus. Final cultures revieled MRSA. A rubber band drain was placed for three days and the patient was placed on sulfamethoxazole and trimethoprim (Bactrim). The patient had an uneventful recovery. Learn More About MRSA	Click on Pictures to Enlarge

Apr. 2010 -- Video of Tympanoplasty
The picture on the right shows the elevation of the annular ligament during a tympanoplasty or repair of the eardrum. The middle ear mucosa is seen below the ligament. This mucosa is incised to obtain access to the middle ear. View Tympanoplasty Video	Click on Pictures to Enlarge

Mar. 2010 -- Video of Drainage of Ethmoid Mucocele.

This video shows an ethmoid mucocele and nasal polyp in a 80 year old patient who sought medical attention after an ethmoid sinus mass was found on CT Scan. On nasal endoscopy the mucocele cavity was entered and abundant thick fluid was removed. A wide opening into the mucocele's cavity was created.

View Video

Dr. Sudhakar Vaidya, Ujjain, India

Mar. 2010 -- Picture of a Post Auricular Abscess. Submitted By: Jasbir Bhandari
The pictures on the right shows a young girl with acute coalescent mastoiditis. Treatment of Coalescent Mastioditis and Subperiosteal Abscess

Feb. 2010 -- Video of the Month - Middle Ear Valsalva in a Patient With Bilateral Cholesteatomas.

Video of a 20 year old patient with bilateral cholesteatomas. The patient is able to valsalva her middle ear. Pictures of her otoscopic examination and CT Scan are presented.

View Video

Feb. 2010 -- Picture of the Month - Rhinophyma Submitted By: Bhandari, JS, Kangra, India.
Rhinophyma is a disease characterized by sebaceous hypertrophy. Rosacea has been implicated as a possible cause. Medical treatment with topical antibiotics such as metrogel and to keep the skin pores open, soaps, moisturizes, gels, sun screen may be recommended. In Severe cases, surgery may be required. View Surgical Treatment of Rhinophyma

Jan. 2010 -- Picture of the Month - Squamous Cell Carcinoma of the Ear Submitted By: Bhandari, JS, Kangra, India.
A large squamous cell carcinoma of the ear with has invaded the ear cabakm preauricular region and parotid salivary gland. This is a T4 cancer and would require a large surgical resection, including: 1) Total auriculectomy 2) Lateral temporal bone resection to 3) Total parotidectomy 4) Radical neck dissection And the patient would also require post operative radiation/chemo therapy.	Close-Up View of Picture

Jan. 2010 -- Picture of the Month - Squamous Cell Carcinoma of the Upper Lip
Submitted By: Bhandari, JS, Kangra, India.

A large squamous cell carcinoma of the upper lip. Note the chelitis and leukoplakia in the corners of the mouth. The inferior extension of the lesion needs to be defined. If the lesion does not extend too far inferiorly, this would then be a T2 cancer and amenable to treatment with surgical resection, possibly using an Abbe-Estlander Flap for reconstruction.

View Leukoplakia Pictures &
Read Discussion.

Close-Up View of Picture

Dec. 2009 -- Picture & Manuscript of the Month - Leukoplakia Submitted By: Santosh Patil, MDS, Nitin Kalla. BDS, Harshwardhan Singh, BDS
A 20 year old female patient reported with a complaint of a white lesion over cheek and gums for two years. Later, she noticed pain and secondary changes in the same area for two months. The patient had a habit of tobacco consumption and placed quid in the vestibule during the past 5 years. View Leukoplakia Pictures & Read Discussion.

Dec. 2009 -- Video of the Month Stapedectomy

This video demonstrates a stapedectomy technique where the prosthesis is placed into position and crimped on the incus before the stapes is removed.

Nov. 2009 -- Video of the Month - Vocal Cord Polyp Removal

This video is of a 47 year old female patient with a 45 pack year history of smoking. She has had a hoarse voice for over a year. On fiberoptic laryngoscopy she was found to have large vocal cord polyps. Notice how thin the overlying mucosa is and the clear gelatinous material in the polyps allow visualization of the vocalis tendon.

View Video of The Surgical Removal of the Polyps (Microdirect Laryngoscopy with Mucosal Flap Reconstruction)

Oct. 2009 -- Video of The Month - Debridement of Necrotic Nasal Tissue.

The picture of to the right shows extensive necrosis of the nasal cavity and septal perforation in a 35 year old mail who abused narcotics.

View Video of Debridement of the Necrotic Tissue.

Click on Picture to View Video of the Nasal Debridement.

Oct. 2009 -- Picture of The Month - Perilymph Fistula.

The picture on the right shows a large cholesteatoma involving the middle ear and mastoid cavity. The patient was 55 years old with a long history of hearing loss and a one week history of severe dizziness. Surgery was performed and a fistula with exposure of the endosteum of the horizontal semicircular canal was found.

View Flash Presentation of A Cholestetooma with a Fistula of Semicircular Canal.

Click on Picture to Flash Presentation of a Perilymph Fistula.

Sep. 2009 -- Picture of The Month - Esophageal Diverticulum.

The picture to the right shows a mid esophageal diverticulum in a 40 your old patient with dysphagia. Click on the picture to view a Flash Presentation of the X-Rays and endoscopic findings.

Click on Picture to View Flash Presentation

Sep. 2009 -- Picture of The Month - Dermoid Cyst of the Neck.

The picture to the right shows dermoid cyst in a 14 year old pediatric patient. Click on the picture to view a Flash Presentation of the CT Scan and surgery.

Click on Picture to View Flash Presentation

Aug. 2009 -- Picture of The Month - Vocal Cord Ulceration.

The picture to the right shows a larynx with extensive leukoplakia of the true vocal cords and ulceration of the right true vocal cord in a patient who smoked 1.5 packs of cigarettes per day for 42 years.

Click on Picture to Enlarge

Aug. 2009 -- Picture & Video of The Month - Large Vocal Cord Polyp.

The picture to the right shows a large right true vocal cord polyp in a 50 year old professional singer who smoked two packs of cigarettes per day for 35 years.

Click on Picture to Enlarge

Video of The Month - Myringotomy Tube Placement for Chronic Mucoid Otitis Media.

The picture on the right shows the insertion of a plastic bobbin myringotomy tube into an eardrum using a pair of micro cup forceps. The patient was a five year old who had chronic mucoid otitis meda (glue ear). Indications for ear tubes include:

The treatment of bilateral chronic serous otitis media being present for at least three months and causes a hearing loss.
The treatment of recurrent or persistent acute otitis media.
The treatment of severely retracted eardrums with retraction pocket formation or extreme thinning and retraction of the eardrum (atelectasis).

Click on Picture to Enlarge

Video of The Month - T2 Supraglottic Carcinoma

The picture on the right shows a T2 Squamous Cell Carcinoma of the Larynx in a 71 year old female patient with a 20 pack year history of smoking. The cancer involves both sides of the anterior portion of the epiglottic and descends onto the anterior right true vocal cord.

Click on Picture to Enlarge

Video of The Month - T2 Laryngeal Carcinoma

The picture on the right shows a T2 Squamous Cell Carcinoma of the Larynx in a 71 year old female patient with a 30 pack year history of smoking. The cancer involves both true vocal cords and the petiolus (inferior portion of the posterior epiglottis). The tumor also is deep to both false vocal cords and the airway is starting to be narrowed.

Click on Picture to Enlarge

Video of The Month - Stapedectomy & Restricted Oval Window Nitch

The picture on the right shows a very restricted oval window nitch. See video and learn possible solutions to this problem.
View Possible Solutions & Video

Click on Picture to Enlarge

Picture of The Month - Lingual Hematoma From Jaggery

One Otolaryngologist submitted: Jaggery is a less refined extract of sugarcane produced in cottage industries in the Indo-pak subcontinent. As jaggery is less refined, it also contains some physical as well as chemical impurities in it which have been added during its production. Logically there is a difference in the osmolarity of jaggery and sugar, hence jaggery also has a drying or parching effect on the oral mucosa. Thus, it was concluded that this picture is a case of submucosal haematoma due to jaggery consumption.

Click on Picture to Enlarge

This patient may also represent a case of Angina Bullosa Hemorrhagica, a rare and debated disease entity which presents with submucosal hemorragic blisters. The lesions are usually single and heal uneventfully. Many possible causes of ABH have been proposed and jaggery use is compatible with this disorder.

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