Browsing by Author "Toran, KC"
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Publication Odontogenic origin of necrotizing fasciitis of head and neck - a case report(Kathmandu University, 2004) Toran, KC; S, Nath; S, Shrestha; BBS JB, RanaNecrotizing fasciitis (NF) of head and neck is a fulminant infection associated with necrosis of connective tissue which spreads along the fascial planes with high mortality rate. It is usually polymicrobial, odontogenic and occurs more frequently in immunocompromised patients. Because of the rarity of the disease, early diagnosis and early management is often delayed. We present a diabetic patient who developed NF of head and neck following tooth extraction. Because of vigorous teamwork he could be saved from the fatal disease but required extensive plastic repair. Every clinician should be aware of such a disease, particularly in immunocompromised patients and necessitates earliest diagnosis and intervention to save their life. Keywords: Necrotizing fasciitis, necrotizing soft tissue infections,Publication Surgical management of sinus tympani cholesteatoma(Kathmandu University, 2004) Toran, KC; S, Shrestha; P, Kafle; SK, DeyasiObjective: the aim of this study is to describe the extension of unsafe middle ear disease in the sinus tympani and to review the methods of surgical access to remove the disease from this area. Methods: Of the 164 operated ears with unsafe chronic suppurative otitis media 64(39%) ears had variable disease extension into the sinus tympani and were included in the study. Sixty-two ears underwent canal wall down (CWD) procedure while remaining two underwent tympanoplasty with bone work. Result: Five operated ears had deeper extension of the disease into the sinus tympani. And despite of different maneuver the complete removal of the disease could not be confirmed. Six ears (9.4%) had recidivism. Conclusion: The study emphasizes on the greater incidence of this disease extension into this difficult anatomical area and their complete removal may not be always possible. But one should require thorough knowledge and surgical expertise to work in this difficult area of posterior mesotympanum. Keywords: Cholesteatoma, sinus tympani