Multidetector-CT Profile of Benign and Malignant Neck Masses among Patients of Guwahati, Assam

BACKGROUND Multidetector computed tomography (MDCT) is the imaging of choice and the most commonly used investigation in head and neck lesions, because of its fast and readily available nature. Our study focused on contrast enhanced multidetector CT profile of neck masses in determining their nature among different demographic profile. It provides volumetric helical data, optimal multiplanar and 3D reconstructions. METHODS This is a retrospective observational study carried out in the Department of Radiology, Gauhati Medical College and Hospital, Guwahati, among 60 cases of clinically diagnosed neck masses, from December 2011 to June 2013. All patients were selected from out-patient departments (OPD) and indoor wards of various departments (mostly from ENT department). Few cases were also taken from Dr. B. Baruah Cancer Institute. Patients from both sexes and all ages were included as part of the study. Chi square test/Fischer exact test have been used to find the significance of association of CT scan findings with the final diagnosis. Diagnostic statistics such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy have been used to find the correlation of CT scan with the final diagnosis. RESULTS Thin slice scanning with thinner reconstructions, maximum intensity production (MIP), shaded surface display (SSD), multiplanar reformation (MPR) and curved reformatted images are the advantages of MDCT. CT has 100 % accuracy in bony involvement detection and 96 % accuracy in neck lesion diagnosis. Therefore, CT can accurately localise and characterise the neck lesions. CONCLUSIONS The neck lesion location and its characteristics determination has significantly improved because of computed tomography. Bone erosions and expansion are accurately determined by a CT scan. CT scan can accurately delineate the disease that provides a definite pre-operative diagnosis, planning radiotherapy ports and post therapy follow up. KEYWORDS Bone Invasion, Lymph Nodes, Neck Space Extensions, Multidetector-CT

Diagnosis and treatment of dysphonia at the present stage

The article discusses the main aspects of diagnosis and treatment of dysphonia at the present stage and provides best practice guidelines. There is a vast array of pathologies that can give rise to dysphonia. Neoplastic processes and neoplasms, which late diagnosis leads to higher mortality, are considered alarming in this context. If dysphonia persists for more than 4 weeks, it is required to make laryngoscopy to exclude serious larynx diseases. People whose work involves using their voice are the most susceptible to the development of dysphonia. It is important to identify risk factors in patients, which include recent operations in the head, neck and chest area, recent endotracheal intubation, the presence of neck lesion, voice and speech profession, smoking history, signs of respiratory failure. Treatment for dysphonia depends on the cause of the pathological process and may include management of the underlying disease, pharmacotherapy, non-drug treatment and surgical intervention. There are extremely few products among the health aids of allopathic medicine that specifically improve the quality of voice function. In this regard, homeopathic medicines play a large role in the treatment of voice disorders. Clinical studies showed the efficacy of these medicines, which have a wide range of indications and a minimal number of side effects. However, the use of traditional homeopathic medicines is limited by the need for homeopathy expertise. Complex homeopathic medicines have been developed to optimize the treatment of these patients. Any specialist without homeopathy expertise may use a combination of these medicines and conventional treatment.