The purpose of this retrospective study was to evaluate the hearing outcomes using temporalis fascia graft for tympanic membrane reconstruction in type 1 tympanoplasty. It included 100 patients with tubotympanic type of chronic suppurative otitis media requiring only tympanic membrane reconstruction. Patients requiring ossicular reconstruction or with attico antral disease were excluded. Patients were assessed after 3, 6 months and 1 year for graft status and hearing outcome. Hearing evaluation was done using tuning fork tests and pure tone audiometry. In total, 88 out of 100 patients had intact and completely healed grafts at 1 year postoperatively (success rate of 88 %). The Hearing gain achieved was 14.55 dBs and the mean air bone gap reduction was 11.94 dBs. This reduction was statistically significant when compared to the pre operative hearing conditions.
The most commonly observed clinical findings in otological practice is discharging ear in which perforation of the tympanic membrane is the commonest, yet the patients hardly ever seek advice for deafness as the presenting symptom. In patients with the symptoms of ear ache or ear discharge when relieved seldom present for follow up and are not very much concerned about the hearing loss present there. There is a different correlation between surface area of tympanic membrane and amplification of sound. Conductive hearing loss is seen in lower tones than higher tones. When the surface area of tympanic membrane is reduced in case of perforations there is decreased in amplification of sound waves. Hearing loss is less in smaller perforations than in larger ones and more for lower tones than for higher tones. A perforation has more serious effect on hearing when it is located in the vicinity of the attachment of malleus. Perforations situated in the postero-inferior quadrant will cause more hearing loss than in other quadrants. The aim of the study is to know the exact location and exact size of perforation and to make a comparative study on the amount of hearing loss produced respectively-in cases of central perforations. Data of 100 patients was collected and studied from May 2015 to April 2016. Hearing loss is related to site and size of perforation with postero-inferior quadrant perforations caising more degree of hearing loss. It varies between 2 and 25 dB more at lower 2 frequencies. Hearing loss is related to size and site of perforation. Small perforation in the postero-inferior quadrant cause more hearing loss than a perforation of same size in other quadrants. Similarly the size of perforation also affects the amount of hearing loss.
Cervical lymphadenopathy is one of the commonest presenting complaint of patient in ENT OPD Fine Needle Aspiration Cytology (FNAC) is one of the most reliable, less expensive, and basic diagnostic procedure for the definitive and conclusive diagnosis for the immune system which reciprocates in the form of enlarged lymph nodes. A study was conducted in ENT Department of Santosh Medical College, Ghazibad from August 2015 to May 2016 on 64 patients with enlarged cervical lymph nodes. FNAC was done to make the diagnosis. Out of 64 patients (51.5 %) was reactive non-specific, 28 % tubercular, 3.1 % lymphoma and 17 % were malignant. FNAC is one of the most dependable diagnostic tools in case of cervical lymphadenopathy for early diagnosis and detection for the better management.
Endonasal dacryocystorhinostomy is widely accepted and effective treatment option for nasolacrimal duct obstruction. It can be done with or without the use of stents. This study was carried out to evaluate the results of endonasal DCR surgery and to access efficacy of this procedure without stenting. This is a prospective clinical study conducted in Departments of ENT and Ophthalmology, L.N. Medical College and J.K. Hospital, Bhopal from October 2008 to April 2012. A total of 90 patients with epiphora as evidenced by nasolacrimal duct blockage on syringing were included in the study. These patients underwent endoscopic DCR without stenting. The cases were followed up to 18 months postoperative. Surgical success was defined as anatomical patency and symptomatic relief at the end of the follow up period. Failure was defined as no symptomatic relief, and/or acute dacryocystitis, and/or non patent lacrimal drainage system. Surgical success was observed in 80 of 90 (88.89 %) patients. Incidence of complication was low as only 6 patients had minor complication of bleeding, synechie and granulation tissue formation. It was concluded that high success rates could be achieved in case of nasolacrimal duct obstruction by endoscopic DCR. Thus, we can minimize complications, discomfort, the cost of stenting and follow up visits after endonasal DCR surgery.
Dacryocystitis is defined as inflammation of lacrimal sac. This can be congenital or acquired. Congenital dacryocystitis is commonly chronic while acquired dacryocystitis is acute and chronic both. Endonasal DCR surgery is the most commonly used treatment in chronic DCR but recent use of cautery technique in endonasal DCR surgery rather than traditional surgical blade technique has emerged with promising results with good success rate and fewer complications.
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