Closure of uncomplicated tympanic membrane perforation (tympanoplasty) is usually a straightforward procedure with a good success rate. Many studies report a success rate from 60 to 99% in adults, whereas a 35-94% success rate in children. The definition of successful tympanoplasty varies from one author to other. Some authors report that an intact tympanic membrane considered a successful surgical result, whereas the other authors may also consider the postoperative hearing, as well as middle ear aeration, as a part of good outcome. This review is an insight into the recent and as well as the past literature on prognostic factors in pediatric tympanoplasty. This article reports an overview of the commonly reported factors which are thought to affect the tympanoplasty in children. Age is considered as one of the most important factor determining the successful outcome of tympanoplasty. Most of the studies did not reveal any significant difference in result between pediatric tympanoplasty from those of adult ones. Interestingly, in one study; it was found that patients younger than 16 years had decreased graft uptake compared with adults. However, in this same study; it was found that the younger patients had better postoperative hearing with better postoperative AB gap closure. The other factors which seem to influence the success rate of tympanoplasty are the size of perforation, technique used, presence or absence of otorrhoea, eustachian tube function and status of the contralateral ear. A study has revealed that posterior perforation had poorer results but it may be a distorted finding as the surgical method was not controlled. Regarding the size of perforation and its influence on the success rate of tympanoplasty, there is again difference of opinion. In one study, it was found that perforations greater than 50% had poorer results, but other studies contradict this statement stating that the success of tympanoplasty has no bearing with the size of perforation. Poor eustachian tube function has been offered as an explanation by some authors as younger age may be correlated with lower tympanoplasty success rates, but some authors refute this by stating that poor eustachian tube function not necessarily an indicator of poor surgical outcome. In conclusion, the success of tympanoplasty in children, with little doubt, depends on a number of factors. The past and recent literature has not produced a consensus of convincing evidence supporting any one parameter.
From this study we have found that FB lodgement is a very common complaint with which patients come to otolaryngologist. The commonest site of FB lodgement is in the throat. Most of the FB could be removed in emergency room (ER) with or without Local Anesthesia.
Intraoperative Mitomycin C application does not alter the long-term results in endoscopic DCR. A properly and adequately performed surgery is more vital for successful result.
Serum Antistreptolysin O (ASO) titre is raised when there is infection of any organ of the body, by Group A beta haemolytic streptococci (GABHS), Group C or Group G streptococci [1]. Increased serum ASO titre should not be the only deciding criterion for tonsillectomy if GABHS is not present in the palatine tonsils. In this study, we evaluate the rationality of performing tonsillectomy in raised serum ASO titre only, in absence of GABHS in palatine tonsil. The study was designed as a prospective cohort study in which the main out come measure is to find out: The main outcome measure is to find out whether only the raised serum ASO titre is to be considered to perform tonsillectomy or not. Fifty consecutive patients (both children and adults) clinically diagnosed to have chronic tonsillitis were included in this prospective cohort study. Throat swab culture, tonsilar core tissue culture and Serum ASO titre tests were performed in all the patients. The results showed that out of the 50 patients 45 had raised ASO titre and 5 patients had normal ASO titre. GABHS was found in 5 cases (10 %) in throat swab culture and 8 cases (16 %) in FNA of tonsil core culture. The sensitivity of throat swab culture as compared to FNA Tonsil core culture was 62.5 % and positive predictive value was 100 %. The sensitivity of ASO titre as compared to core culture was 100 % and positive predictive value was 17.8 %. Specificity was only 12 %. From the results of this study, it is evident that FNA culture of the tonsil core is a valid and a reliable test for the diagnosis of bacterial micro flora in recurrent tonsillitis. One should perform throat swab culture and FNA culture from tonsil core along with ASO titre before doing tonsillectomy in absence of any other indications. Identifying GABHS in the tonsil by FNA test and/or in the throat swab culture along with high serum ASO titre may be one of the ideal indications for tonsillectomy.
The rising incidence of acute epiglottitis in the adults necessitates the close observance on the part of the otolaryngologist. Selective airway intervention is recommended for patients with more than 50% airway obstruction.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.