Brig. (Dr.) Ramakrishnan Narayanaswamy - Academia.edu (original) (raw)

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Papers by Brig. (Dr.) Ramakrishnan Narayanaswamy

International Journal of Otorhinolaryngology and Head and Neck Surgery, Jul 4, 2015

Lingual Thyroid is a rare developmental anomaly. It is the most common benign mass found at the j... more Lingual Thyroid is a rare developmental anomaly. It is the most common benign mass found at the junction of the anterior two third and the posterior one third of the tongue. It requires to be excised if it becomes symptomatic by becoming a goiter. It is usually treated medically by thyroxin suppression therapy. However, in cases where the response to medical treatment is poor, it can be excised or transposed. We present a case report of a 28-year-old female with Lingual thyroid who underwent a novel surgical cervical transposition procedure with good result.

Bengal Journal of Otolaryngology and Head Neck Surgery, Apr 28, 2018

Introduction Juvenile Nasopharyngeal Angiofibroma (JNA) is a tumor of young and adolescent males.... more Introduction Juvenile Nasopharyngeal Angiofibroma (JNA) is a tumor of young and adolescent males. It is a benign vascular tumor arising from the spheno-palatine foramen. It is best managed surgically at present by endoscopic methods with or without pre-operative embolization. Tumor attributes like intracranial extent and residual vascularity after embolization need to be assessed preoperatively before undertaking endoscopic surgery, in order to reduce surgical blood loss and morbidity. Materials and Methods Twenty-three cases of JNA (n=23) were operated endoscopically at a tertiary level military hospital. They were staged with the Snyderman staging system. Demographic variables including stage wise management were brought out with intraoperative time and blood loss recorded for different stages. Results The intraoperative surgical time, intra-operative blood loss and recurrence/residual rates were compared with similar studies in existing literature and correlated well. Conclusion Endoscopic Endonasal approach to JNA is now a well-established technique. With improvements in embolization techniques and better instrumentation like HD camera systems, endo-bipolar cautery, Coblation and endo-liga clips and neuro-navigation, better visualization and better haemostatis can be achieved, resulting in significant reduction in the morbidity and improvement in surgical results.

International Journal of Otorhinolaryngology and Head and Neck Surgery, 2015

Lingual Thyroid is a rare developmental anomaly. It is the most common benign mass found at the j... more Lingual Thyroid is a rare developmental anomaly. It is the most common benign mass found at the junction of the anterior two third and the posterior one third of the tongue. It requires to be excised if it becomes symptomatic by becoming a goiter. It is usually treated medically by thyroxin suppression therapy. However, in cases where the response to medical treatment is poor, it can be excised or transposed. We present a case report of a 28-year-old female with Lingual thyroid who underwent a novel surgical cervical transposition procedure with good result.

Bengal Journal of Otolaryngology and Head Neck Surgery, 2018

Introduction The current study reports the correlation of clinical and endoscopic evaluation with... more Introduction The current study reports the correlation of clinical and endoscopic evaluation with 18F-Fluorine Fluorodeoxyglucose Positron emission tomography/Computed tomography (18F-FDG PET/CT) findings in detecting the residual/recurrence tumor after definitive treatment in the follow up cases of squamous cell carcinoma head and neck. Materials and Methods A prospective comparative study carried out on 30 follow-up cancer patients after definitive primary treatment. All patients were evaluated by clinical examination, endoscopy and 18F-FDG PET/CT and these results correlated to detect residual/recurrence. Suspicious lesion at primary site suggesting residual/recurrence was confirmed by gold standard investigation, histopathological examination (HPE). Result The age group mostly involved is 40-70 with male predominance. Predominant sites were oral cavity and larynx. 20 patients showed recurrence on clinical and endoscopic evaluation with 03 false positive results, 10 patients sh...

Bengal Journal of Otolaryngology and Head Neck Surgery, Dec 7, 2018

Bengal Journal of Otolaryngology and Head Neck Surgery, 2018

Introduction This comparative study aims to analyze findings and their significance in the co... more Introduction This comparative study aims to analyze findings and their significance in the contralateral ears of patients with unilateral Chronic Otitis Media (COM) and compare it with a control group of healthy subjects. Materials and Methods One hundred patients of unilateral COM and 100 healthy individuals were included in this study from Jan 2015 to July 2016. The findings were noted in the contralateral ears of patients with unilateral COM and 100 control subjects. The changes found in the contralateral ears were assessed statistically for significance. Results In 100 cases of unilateral COM, 58 patients had some abnormality in the contralateral ear. Myringosclerosis patches being the most common finding were seen in 29 patients followed by TM retractions seen in 28 patients. Prevalence of abnormal findings was found to be significantly higher in the squamous group as compared to the mucosal group. In 100 ears in the control group, only 11 % had positive findings. TM ...

Bengal Journal of Otolaryngology and Head Neck Surgery, Dec 29, 2019

Introduction Bleeding during surgery is one of the most important concerns in endoscopic sinus su... more Introduction Bleeding during surgery is one of the most important concerns in endoscopic sinus surgery (ESS). The study conducted was aimed at assessing the efficacy of tranexamic acid on bleeding during endoscopic sinus surgeries. Materials and Methods A total of 30 patients were enrolled for the study. Lund and Mackay symptom score and radiological staging was used to compare clinical profile. The surgical field was assessed by the surgeon who was blinded, i.e., was not aware of which set of patients were receiving the drug. Boezaart and van de Merwe grading scale was used to assess the intraoperative surgical field. Both groups were selected so as to comprise of patients having similar clinical profile in terms of symptom score and radiological staging. Results In the arm receiving tranexamic acid, blood loss was found to be less and statistically significant (p=0.0157). The surgical field in endoscopic sinus surgery is more important factor in determining the completion and satisfactory outcomes of the surgery. Significantly high percentage (80%) of patients who were given the drug had a grade 2 scale when compared to (26.7%) in patients not receiving the drug. The difference in score in surgical field grading scale was also statistically significant (p=0.0034). The reported side effects of tranexamic acid mainly include nausea, vomiting, and possibly arterial or venous thrombosis, however none of the patients in our study had any side effects of the drug. Post-operative stay in the hospital was uneventful. Conclusion Intravenous Tranexamic acid reduced the intraoperative bleeding significantly and was useful in providing a better operative field.

Bengal Journal of Otolaryngology and Head Neck Surgery, 2019

Introduction Bleeding during surgery is one of the most important concerns in endoscopic sinus su... more Introduction Bleeding during surgery is one of the most important concerns in endoscopic sinus surgery (ESS). The study conducted was aimed at assessing the efficacy of tranexamic acid on bleeding during endoscopic sinus surgeries. Materials and Methods A total of 30 patients were enrolled for the study. Lund and Mackay symptom score and radiological staging was used to compare clinical profile. The surgical field was assessed by the surgeon who was blinded, i.e., was not aware of which set of patients were receiving the drug. Boezaart and van de Merwe grading scale was used to assess the intraoperative surgical field. Both groups were selected so as to comprise of patients having similar clinical profile in terms of symptom score and radiological staging. Results In the arm receiving tranexamic acid, blood loss was found to be less and statistically significant (p=0.0157). The surgical field in endoscopic sinus surgery is more important factor in determining the completion and sa...

Bengal Journal of Otolaryngology and Head Neck Surgery, 2018

Introduction Juvenile Nasopharyngeal Angiofibroma (JNA) is a tumor of young and adolescent males.... more Introduction Juvenile Nasopharyngeal Angiofibroma (JNA) is a tumor of young and adolescent males. It is a benign vascular tumor arising from the spheno-palatine foramen. It is best managed surgically at present by endoscopic methods with or without pre-operative embolization. Tumor attributes like intracranial extent and residual vascularity after embolization need to be assessed pre-operatively before undertaking endoscopic surgery, in order to reduce surgical blood loss and morbidity. Materials and Methods Twenty-three cases of JNA (n=23) were operated endoscopically at a tertiary level military hospital. They were staged with the Snyderman staging system. Demographic variables including stage wise management were brought out with intraoperative time and blood loss recorded for different stages. Results The intraoperative surgical time, intra-operative blood loss and recurrence/residual rates were compared with similar studies in exis...

International Journal of Otorhinolaryngology and Head and Neck Surgery, Jul 4, 2015

Lingual Thyroid is a rare developmental anomaly. It is the most common benign mass found at the j... more Lingual Thyroid is a rare developmental anomaly. It is the most common benign mass found at the junction of the anterior two third and the posterior one third of the tongue. It requires to be excised if it becomes symptomatic by becoming a goiter. It is usually treated medically by thyroxin suppression therapy. However, in cases where the response to medical treatment is poor, it can be excised or transposed. We present a case report of a 28-year-old female with Lingual thyroid who underwent a novel surgical cervical transposition procedure with good result.

Bengal Journal of Otolaryngology and Head Neck Surgery, Apr 28, 2018

Introduction Juvenile Nasopharyngeal Angiofibroma (JNA) is a tumor of young and adolescent males.... more Introduction Juvenile Nasopharyngeal Angiofibroma (JNA) is a tumor of young and adolescent males. It is a benign vascular tumor arising from the spheno-palatine foramen. It is best managed surgically at present by endoscopic methods with or without pre-operative embolization. Tumor attributes like intracranial extent and residual vascularity after embolization need to be assessed preoperatively before undertaking endoscopic surgery, in order to reduce surgical blood loss and morbidity. Materials and Methods Twenty-three cases of JNA (n=23) were operated endoscopically at a tertiary level military hospital. They were staged with the Snyderman staging system. Demographic variables including stage wise management were brought out with intraoperative time and blood loss recorded for different stages. Results The intraoperative surgical time, intra-operative blood loss and recurrence/residual rates were compared with similar studies in existing literature and correlated well. Conclusion Endoscopic Endonasal approach to JNA is now a well-established technique. With improvements in embolization techniques and better instrumentation like HD camera systems, endo-bipolar cautery, Coblation and endo-liga clips and neuro-navigation, better visualization and better haemostatis can be achieved, resulting in significant reduction in the morbidity and improvement in surgical results.

International Journal of Otorhinolaryngology and Head and Neck Surgery, 2015

Lingual Thyroid is a rare developmental anomaly. It is the most common benign mass found at the j... more Lingual Thyroid is a rare developmental anomaly. It is the most common benign mass found at the junction of the anterior two third and the posterior one third of the tongue. It requires to be excised if it becomes symptomatic by becoming a goiter. It is usually treated medically by thyroxin suppression therapy. However, in cases where the response to medical treatment is poor, it can be excised or transposed. We present a case report of a 28-year-old female with Lingual thyroid who underwent a novel surgical cervical transposition procedure with good result.

Bengal Journal of Otolaryngology and Head Neck Surgery, 2018

Introduction The current study reports the correlation of clinical and endoscopic evaluation with... more Introduction The current study reports the correlation of clinical and endoscopic evaluation with 18F-Fluorine Fluorodeoxyglucose Positron emission tomography/Computed tomography (18F-FDG PET/CT) findings in detecting the residual/recurrence tumor after definitive treatment in the follow up cases of squamous cell carcinoma head and neck. Materials and Methods A prospective comparative study carried out on 30 follow-up cancer patients after definitive primary treatment. All patients were evaluated by clinical examination, endoscopy and 18F-FDG PET/CT and these results correlated to detect residual/recurrence. Suspicious lesion at primary site suggesting residual/recurrence was confirmed by gold standard investigation, histopathological examination (HPE). Result The age group mostly involved is 40-70 with male predominance. Predominant sites were oral cavity and larynx. 20 patients showed recurrence on clinical and endoscopic evaluation with 03 false positive results, 10 patients sh...

Bengal Journal of Otolaryngology and Head Neck Surgery, Dec 7, 2018

Bengal Journal of Otolaryngology and Head Neck Surgery, 2018

Introduction This comparative study aims to analyze findings and their significance in the co... more Introduction This comparative study aims to analyze findings and their significance in the contralateral ears of patients with unilateral Chronic Otitis Media (COM) and compare it with a control group of healthy subjects. Materials and Methods One hundred patients of unilateral COM and 100 healthy individuals were included in this study from Jan 2015 to July 2016. The findings were noted in the contralateral ears of patients with unilateral COM and 100 control subjects. The changes found in the contralateral ears were assessed statistically for significance. Results In 100 cases of unilateral COM, 58 patients had some abnormality in the contralateral ear. Myringosclerosis patches being the most common finding were seen in 29 patients followed by TM retractions seen in 28 patients. Prevalence of abnormal findings was found to be significantly higher in the squamous group as compared to the mucosal group. In 100 ears in the control group, only 11 % had positive findings. TM ...

Bengal Journal of Otolaryngology and Head Neck Surgery, Dec 29, 2019

Introduction Bleeding during surgery is one of the most important concerns in endoscopic sinus su... more Introduction Bleeding during surgery is one of the most important concerns in endoscopic sinus surgery (ESS). The study conducted was aimed at assessing the efficacy of tranexamic acid on bleeding during endoscopic sinus surgeries. Materials and Methods A total of 30 patients were enrolled for the study. Lund and Mackay symptom score and radiological staging was used to compare clinical profile. The surgical field was assessed by the surgeon who was blinded, i.e., was not aware of which set of patients were receiving the drug. Boezaart and van de Merwe grading scale was used to assess the intraoperative surgical field. Both groups were selected so as to comprise of patients having similar clinical profile in terms of symptom score and radiological staging. Results In the arm receiving tranexamic acid, blood loss was found to be less and statistically significant (p=0.0157). The surgical field in endoscopic sinus surgery is more important factor in determining the completion and satisfactory outcomes of the surgery. Significantly high percentage (80%) of patients who were given the drug had a grade 2 scale when compared to (26.7%) in patients not receiving the drug. The difference in score in surgical field grading scale was also statistically significant (p=0.0034). The reported side effects of tranexamic acid mainly include nausea, vomiting, and possibly arterial or venous thrombosis, however none of the patients in our study had any side effects of the drug. Post-operative stay in the hospital was uneventful. Conclusion Intravenous Tranexamic acid reduced the intraoperative bleeding significantly and was useful in providing a better operative field.

Bengal Journal of Otolaryngology and Head Neck Surgery, 2019

Introduction Bleeding during surgery is one of the most important concerns in endoscopic sinus su... more Introduction Bleeding during surgery is one of the most important concerns in endoscopic sinus surgery (ESS). The study conducted was aimed at assessing the efficacy of tranexamic acid on bleeding during endoscopic sinus surgeries. Materials and Methods A total of 30 patients were enrolled for the study. Lund and Mackay symptom score and radiological staging was used to compare clinical profile. The surgical field was assessed by the surgeon who was blinded, i.e., was not aware of which set of patients were receiving the drug. Boezaart and van de Merwe grading scale was used to assess the intraoperative surgical field. Both groups were selected so as to comprise of patients having similar clinical profile in terms of symptom score and radiological staging. Results In the arm receiving tranexamic acid, blood loss was found to be less and statistically significant (p=0.0157). The surgical field in endoscopic sinus surgery is more important factor in determining the completion and sa...

Bengal Journal of Otolaryngology and Head Neck Surgery, 2018

Introduction Juvenile Nasopharyngeal Angiofibroma (JNA) is a tumor of young and adolescent males.... more Introduction Juvenile Nasopharyngeal Angiofibroma (JNA) is a tumor of young and adolescent males. It is a benign vascular tumor arising from the spheno-palatine foramen. It is best managed surgically at present by endoscopic methods with or without pre-operative embolization. Tumor attributes like intracranial extent and residual vascularity after embolization need to be assessed pre-operatively before undertaking endoscopic surgery, in order to reduce surgical blood loss and morbidity. Materials and Methods Twenty-three cases of JNA (n=23) were operated endoscopically at a tertiary level military hospital. They were staged with the Snyderman staging system. Demographic variables including stage wise management were brought out with intraoperative time and blood loss recorded for different stages. Results The intraoperative surgical time, intra-operative blood loss and recurrence/residual rates were compared with similar studies in exis...