Abhimanyu Kadapathri

Ageing is a natural biological property of all living beings. There is an estimated 120 crore population around the world currently over the age of 65 years, it is also estimated that half of the world’s population would be in geriatric group by year 2050. Developed nations have about 30% of their population in geriatric age group. In India 10% of population belong to geriatric age, even though it comparatively low with other nations the numbers are huge due to population size. Special senses such as hearing and smell are impaired along with ageing body. Other otorhinolaryngological problems are also common due to degenerative changes in head and neck region. Cosmetic problems are a concern too due to the ever increasing zeal for youthfulness in modern society. We review some of the common problems faced in the elderly. Keywords: Gerontology head and neck otorhinolaryngology ageing.

Anticancer immunity modulation is the current standpoint of research and has revolutionized the standard of care of platinum refractory recurrent/metastatic head and neck carcinoma of squamous cell origin (R/M HNSCC). Checkpoint inhibitors are targeted at PD-1/ PD-L1 axis, which is involved in the genesis, maintenance and progression of HNSCC. Head and neck cancer has an immunosuppressive character and a high inflammatory response component in the tumor microenvironment. The clinical settings in which these agents are highly useful are in study all around the globe. We discuss the current up to date clinical trial results and the future prospective of cancer immunotherapy in the field of HNSCC. Keywords: Immunotherapy, Head and neck cancer, Metastatic cancer, Squamous cell carcinoma.

Ameloblastic carcinoma is an extremely rare malignancy arising from odontogenic epithelium. The present work aimed to report clinical, histopathological, surgical and treatment-related details of four patients identified in our hospital database. We also present the disease behavior on follow-up of these patients. All patients underwent an adequate initial assessment and were treated with curative intent. The study population has a median follow-up of 68.5 months with no disease-related mortality. Literature suggests ameloblastic carcinoma to be chemo resistant and radio resistant. Surgical resection with wide margins is the standard of care. We also present a case of solitary lung lesion identified on follow-up imaging and addressed surgically. As surgery is the mainstay treatment in ameloblastic carcinoma, pulmonary metastasectomy is a valid tool in treating patients with isolated metastases. Keywords: Ameloblastic, Ameloblastoma.

Introduction : Inverted papilloma of sinonasal system is a benign tumour comprising of 0.5% to 4% of all nasal tumours having locally aggressive features. Recurrence is common and can cause bone destruction. Clinically, the most common presentation is unilateral nasal obstruction. Isolated frontal sinus inverted papilloma maybe hidden for long time without any symptoms. Case Report : A 55 yr old man with recurrent sinonasal polyposis who underwent endonasal surgery on multiple occasions presented to us with complaints of unilateral nasal obstruction, anosmia, fronto-temporal headache since 9 years which aggravated during past 6 months . Following admission CT – Para Nasal Sinuses showed sinonasal polyposis involving bilateral frontal , right maxillary sinuses with hyperdense lesions in frontal sinuses and multiple sinus wall erosions with exposure of dura. Patient was planned for Functional Endoscopic Sinus Surgery and osteoplastic flap without frontal sinus obliteration after adequate premedication. Intra-operatively frozen section revealed inverted papilloma histopathologically. Complete clearance of tumour was achieved via osteoplastic approach. Conclusion : In our case complete excision of the mass was very important because recurrence after surgery is between 25% -35% for inverted papillomas. There are difficulties in handling papillomas of the frontal sinus. Despite advances in endoscopic sinus surgery these may require open surgical approach to the frontal sinus. So, osteoplastic flap approach provides a safe and effective way to deal with these pathologies. Keywords: Frontal sinus surgery, FESS, Inverted papilloma, Osteoplastic flap.