Background: Recurrent laryngeal nerve (RLN) injury is one of the most important and preventable complications of thyroidectomy which is the cause of post-operative iatrogenic vocal cord paralysis. The non-recurrent laryngeal nerve (NRLN), which is found in 0.25–0.99 of the patients who undergo thyroid surgery, is a rare embryologically-derived variant of the recurrent laryngeal nerve (RLN). Identification and prevention of injury to the laryngeal nerve is very important in thyroid surgery. The objective of the study was to highlight the incidence of Non-recurrent laryngeal nerve in our series of thyroidectomy cases. Methods: In the Department of Otorhinolaryngology, Pondicherry a retrospective analysis of all the thyroid surgeries that were operated between August 2006-November 2018 for various indications on a total of 1006 patients was done with specific interest in the lookout for anatomical variant of recurrent laryngeal nerve and findings were recorded. Results: Among all the cases, two patients with MNG who had underwent Total thyroidectomy were found to have anatomical variants of recurrent laryngeal nerve (non recurrent laryngeal nerve) intra operatively. Conclusions: The NRLN is a rare finding and is associated to an increased risk in iatrogenic injury especially during thyroid surgeries unless thorough anatomical knowledge and cautious dissection is not done.

Background: Snoring is an important social problem seen in both men and women. Snoring occurs as a result of soft tissue vibration caused by a partial upper airway collapse during sleep. The aim of the study was to analyse the morbidity and efficacy of radiofrequency thermal ablation of upper airway in patients suffering from OSA. Methods: In the Department of ENT, Pondicherry, 40 patients between the age group of 20 to 60 years who were diagnosed to have OSA were operated according to the site of obstruction including RFVTR. Various parameters including ESS, partner scores, post-op pain, bleeding, pharyngeal dryness voice change were measured accordingly on the 1st day, 45th day, 90th day and 180th day postoperatively for the efficacy of treatment and also for assessing the morbidity of treatment provided. Results: There is a statistically significant reduction in ESS scores and partner scores between pre-operative period and post operatively on the 45th day, 90th day and 180th day. Post-operative pain assessment also showed that patients who underwent RFVTR had lesser pain when compared to other surgeries like zetaplasty, LAUP, etc. Conclusions: Radiofrequency surgery should be considered as the treatment of choice for mild OSA and hypopneic snorers. The important advantage of these procedures is technically simple and minimally invasive. RFTA of the soft palate leaves the mucosa intact contrary to LAUP, hence the pain comparably less. Relatively cost effective when compared to LASER and Coblator.

Background and aims: The adenoids (nasopharyngeal tonsils) are part of Waldeyer’s ring of lymphoid tissue. Endoscopic examination of the nasopharynx increasingly recognized that adenoidal tissue in adults is not an uncommon finding. The aims of this study were to determine prevalence of adult adenoid tissue and the possible reasons behind it. Methods: A retrospective study of 1,100 adult patients, who had routine nasal endoscopic examination for nasal obstruction and related pathologies, was undertaken. 84 cases with incidental hypertrophied adenoid were reviewed to determine the probable cause, presenting symptoms, clinical suspicion and final histological diagnosis. Results: The age of patients ranged from 18 years to 77 years. Median age was 32 years. 59 (70.24%) of adenoid hypertrophy patients were smokers and only 25 (29.76%) were nonsmokers suggesting strong association between smoking and adult adenoid hypertrophy with odds ratio=5.3251, %2value of 54.23 and an extremely significant p value. All the 84 cases were confirmed histopathologically as Reactive adenoid hyperplasia and no signs of malignancy in any of them. Conclusions: The true incidence of adenoidal hypertrophy in adults is unknown. Adenoidal tissue in adults, if present, must always be biopsied or removed irrespective of their macroscopic appearance. The result underlines the importance of considering adenoid hypertrophy as a cause or contributing factor in nasal obstruction and related pathologies in adults. It also supports the theory that it represents a long-standing inflammatory process rather than being a novel clinical entity.

Background and aims: The routine method of didactic lecture followed by dissection does not help for long-term retention of the subject, anatomy amongst medical students. The impact of clinical anatomy knowledge in medical profession is large and there is an absolute lack of positive reception in this regard amongst student community. Teaching methods play an important role to create interest and to make students appreciate the subject better. Studies evaluating different modes of teaching anatomy are scarce. The objective of the study was to assess the effectiveness of different modes of anatomy teaching among medical students. Materials and methods: First year medical students were divided randomly into three groups and different modes of teaching anatomy like blackboard and chalk, audio/visual and using plastic models were compared by examination based assessment. The data of multiple groups were analyzed by one-way ANOVA, followed by the Newman- Keuls multiple comparison test (PRISM Graph pad, version 4; Graph Pad Software, Inc., San Diego, CA). A P value of <0.05 was considered as statistically significant. Results: No single method is effective in increasing the performance of both theory and practical examination across different topics and so a suitable combination of the different modes for a particular topic in anatomy teaching should be framed.

Background & Aims: Pseudocyst of auricle otherwise called as auricular seromais a cystic swelling filled with serous fluid. It occurs spontaneously or following surgery or trauma. Successful treatment of seromas remain a challenge because this disease has a high propensity for recurrence. The aim was to study the role of triamcinolone in reducing recurrence of pseudocyst of the auricle. Materials and methods : A total of 50 patients with pseudocyst of auricle were randomized into two groups. They were followed up to a year for recurrence. The technique of intra-lesional injection of triamcinolone acetonide after aspirating the fluid was followed in one group as against aspiration and tight bandaging in another group. Results : Out of seroma patients who underwent aspiration and bandaging, 90.91% had recurrence as against only 25.64% recurrence in patients who underwent aspiration and Inj.Triamcinolone infiltration. Out of seroma patients who underwent aspiration and bandaging 54.55% had recurrence within 1 month of initial treatment and 27.27% of them had a second recurrence within 3 months. Conclusion : Intra- lesional injection of triamcinolone is a promising treatment option for management of auricular seroma. It prevents the recurrence also.

Introduction Total thyroidectomy for the management of benign Multinodular goiter is controversial and since the development of other subspecialties, it adds to further confusion. The present study aims to retrospectively compare the efficacy and morbidity of total thyroidectomy and subtotal thyroidectomy. Methods A total of 170 patients with multi nodular goiter were assigned to have either total thyroidectomy (n=100) or subtotal thyroidectomy (n=70) based on preoperative evaluation, FNAC and indications for surgery. Complications and hospital stay were also noted. Results There was no significant difference in the rate of major complications between the two procedures. There was no significant difference in distribution of post operative compl9ocations among the groups. Temporary hypoparathyroidism resulted in 37 (22%) patients in total out of which 28 (28%) belonged to total thyroidectomy group and 9 (13%) belonged to the subtotal thyroidectomy group respectively which was statistically insignificant. No permanent or temporary recurrent laryngeal nerve palsy was noted. Hematoma 2 (3%) and stitch granuloma 3 (4%) was recorded in Subtotal group. Incidental papillary carcinoma was noted in 10 (6%) patients with total thyroidectomy. Recurrence was noted in 20 (298%) of patients and 7 were taken up for further surgery and the rest managed with L-Thyroxine. 80% of the total thyroidectomies were devoid of any complications as compared to only 54.28% of subtotal Thyroidectomies without complications. Conclusion Subtotal thyroidectomy provides an unpredictable outcome and the risk of permanent complications is not less than or at par with total thyroidectomy, so there appears little or none logical reason to recommend subtotal thyroidectomy. In our experience total thyroidectomy is radical but a definitive treatment method without the risk of recurrence with a small incidence of major complications as that of a less radical procedure.