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Roshan Kumar Verma,Deepak Sarahan,Gautamjeet Raj Kumar 대한갑상선학회 2020 International Journal of Thyroidology Vol.13 No.2
Follicular variant of papillary carcinoma thyroid is an aggressive variant of papillary carcinoma thyroid. It is morecommonly associated with extrathyroidal extension and regional lymphadenopathy. It can rarely be associated withmicroscopic vascular invasion but tumor thrombus into great veins is a rare phenomenon. We present a caseof 60-year-old male with follicular variant of papillary carcinoma thyroid with tumor thrombosis in superior thyroidvein and internal jugular vein (IJV). We report a case of a 60-year-old male who presented with a large swellingin the lower part of left side of neck for 4 months. Clinical examination revealed a hard swelling of 12x8 cmin left side of neck. Ultrasonography showed a solitary thyroid mass of the left lobe and a dilated left superiorthyroid vein and ipsilateral IJV. Fine-needle aspiration cytology revealed follicular variant of PTC cells. Totalthyroidectomy was done. A tumor thrombus was discovered in the superior thyroid vein and left IJV was foundto be dilated. The left IJV with superior thyroid vein was ligated and excised. The patient recovered well afterthe operation with no local or distant metastasis detected. Follicular variant of PTC commonly spreads to the lymphnodes. Vascular spread via direct intravascular extension through superior thyroid vein is extremely rare. Onpalpation cord like IJV is felt on the involved side. Neck ultrasound play important role in the diagnosis. Aggressivesurgical treatment with IJV ligation above and below the tumor thrombus is recommended to minimize the riskof potentially fatal complications of the intraluminal masses. Intravascular tumor extension into IJV of neck infollicular variant of PTC is rare and can be associated with serious consequences. Total thyroidectomy withthrombectomy with ligation of IJV must be done.
Niveditha Damodharan,Roshan Kumar Verma,Archana Angrup,Naresh K Panda,Naresh K Panda 대한이비인후과학회 2020 대한이비인후과학회지 두경부외과학 Vol.63 No.5
Background and Objectives This study investigates the role of manuka honey in the healingof postoperative mastoid cavity. Subjects and Method This was a single centre prospective study on 40 consecutive patientsof chronic otitis media undergoing canal wall down mastoidectomy. Manuka honey soaked ingel foam was kept in the mastoid cavity for the study group and antibiotic soaked gel foam waskept for the control group. Culture swabs from mastoid granulations were sent at various timesfrom both groups. The healing of the mastoid cavity was assessed in the follow up period. Results Preoperatively 15 out of 20 patients (75%) had a positive aural swab culture in thestudy group while 11 out of 20 (55%) in the control group had a positive aural swab culture. Themost common organism isolated was Pseudomonas aeruginosa and Proteus mirabilis. Onemonth after mastoidectomy only 4 patients (20%) had sterile culture and 16 patients (80%) hadgrown organisms; in the control group, 7 patients (35%) had sterile culture and 13 patients (65%)had growth on culture. The mean merchant scores for the study group and the control were 2.61(2-5) and 2.05 (1-4), respectively. At 3 months 13 patients (65%) with sterile culture and 7 patients(35%) had growth on culture; in the control group, 16 patients (80%) had sterile cultureand 4 had shown persistent growth on culture (p=0.28). All positive cultures were aerobic inboth groups. The mean merchant scores for the study group and the control were 1.03 (0-4)and 0.7 (0-3), respectively (p=0.09). Conclusion Healing of mastoid cavity was almost similar in both groups (p>0.05). Manukahoney exhibited antibacterial activity against Pseudomonas, Proteus, Klebsiella, Escherichiacoli, Staphylococcus