N Bhattacharjee

Cut throat injuries and associated deaths are common in our society. Majority succumb to their injuries. In this study, the hospital records of twenty six such cases (13 M & 13 F) were reviewed. Eleven victims were in their third decade. Eighteen cases came from poor socio-economic class. Eleven had suicidal, eleven homicidal and four accidental injuries. Familial troubles, psychiatric illness and poverty were the triggering factors in suicidal attempts. The motives of homicide included political conflict, sex related crimes, dacoity, familial, land related disputes, etc. All had their hypopharynx and/or larynx exposed. Tracheostomy was done in fifteen cases. All but two had uneventful recovery. One died in the hospital due to hemorrhage, shock and asphyxia from aspirated blood. It was observed that appropriate measures could save lives in vast majority.

Although tracheobronchial foreign bodies are not rare, fractured tracheostomy tubes presenting as such, is rare indeed. Three such cases (one metallic and two Polyvenyl Chloride (P.V.C. tubes) are reported here. These foreign bodies were removed bronchoscopically with uneventful recovery.

ABSTRACT: Esophageal atresia (EA) with or without Tracheoesophageal fistula (TEF) represents significant number of neonatal surgical emergencies and its survival testifies the level of advancement in neonatal care, as it is considered as epitome of neonatal surgery even today. Here we report a female neonate presented on 16th day of life with classical history of EA with TEF. It was a type-C anomaly with extensive bilateral pneumonitis on 20th day of life. Higher antibiotics, TPN and prolonged postoperative oxygenation were continued till 20th postoperative day and the baby was discharged from the hospital once she started sucking adequately and there was improvement in lung pathology. A 2-D echo was done at this stage which revealed an ASD with left-to-right shunt. She is alive and healthy at 6 months of age at the time of reporting. Delayed reference from the primary physician with history of continued oral feeding are not uncommon features of neonates with EA & TEF in developing countries like India. This calls for spreading awareness amongst the rural physicians.

24 cases of recurrent respiratory papillomatosis (RRP) in children were treated by surgical removal with cup forceps and followed up for variable periods between 1990-95. Most of the patients required multiple operations due to recurrence. No anaesthetic death or complication was recorded. Voice changes of different degrees were noted. Four patients has glottic web formation. The findings suggest that recurrence of RRP is very common & needs multiple session of surgery. For children with persistent and progressive voice change/cry, the necessity of precise & comprehensive endoscopic examination of the upper aerodigestive tract under general anesthesia (GA) is emphasized.