Introduction The surgical treatment of Chronic Otitis Media by modified radical mastoidectomy usually results in an open cavity, with chronic discharge, hearing loss of 30 to 40 dB, frequent visits to OPD for debris removal and none the less dizziness on cold air exposure. One way to deal with these issues effectively is to obliterate the mastoid cavity. In our study we used vascularised periosteo-temporofascial swing flap with medicated bone dust to obliterate the mastoid cavity. Material and Methods In this prospective study, 50 patients who suffered from chronic otitis media, active squamous (cholesteatoma) disease, and underwent modified radical mastoidectomy with tympanoplasty procedure were and split between two equally sized groups. Group 1 had patients with open mastoid cavity and Group 2 had obliteration of mastoid cavity using vascularised periosteo-temporofascial swing flap with medicated bone dust. Patients were followed at 3rd week, 6th week, 3rd month and 6th month. Results Patients with cavity obliteration had better and statistically significant outcomes in term of discharge status of cavity and epithelization at 3 weeks. Patients with obliteration also had positive and statistically significant results in hearing levels and hearing gain at 6 months follow up. Conclusion Mastoid cavity obliteration with vascularised periosteo-temporofascial swing flap with medicated bone dust is a good and effective method for better post-operative outcomes and curtailing dependency on doctors for cavity care.
The present study aimed to discuss the patient's perspectives on recurrent epistaxis and post-operative synechia formation. Endoscopic SMR with spurectomy was performed after detailed evaluation of etiology and anatomical variations of the patient. The CT scan showed a mucosal thickening in left maxillary sinus and the bilateral inferior turbinates were hypertrophied. Following a successful surgical procedure with nasal packaging for two post-operative days, the patient developed synechia after 15 days and thus silicon splints were applied in both nostrils and kept for 7 days. The patient was reviewed regularly and after 1 month, his nasal obstruction had improved significantly with no further epistaxis. Endoscopic submucosal resection (SMR) is an easier and widely used method to correct the nasal deviation. However, the patient's discomfort and distress in endoscopic SMR with spurectomy, nasal packaging and post-operative complications arises many questions from the patient's perspectives.
Introduction This study aims to evaluate the efficacy of open reduction and the combination of open reduction with mandibulomaxillary fixation (MMF) in cases of unfavourable mandible fractures. Materials and Methods This is a prospective study carried out from 2010 to 2015 on 60 patients with mandible fracture attending the Dept. of ENT. The diagnosis and classification of mandible fracture into favourable and unfavourable types were done on the basis of clinical and CT faciomaxillary findings. The outcomes were assessed by comparing the preoperative and postoperative occlusion, mouth opening and symmetry of mandibular ramus. Patients with favourable mandible fractures were excluded from the study. Results We found that out of 60 patients, 40 cases were of the unfavourable type. ORIF with MMF gave better outcome compared to ORIF alone. The data were statistically analysed using Z score and P value. Conclusion Initial assessment of mandible fractures into favourable and unfavourable category plays a significant role in planning the management. Management of unfavourable mandible fractures with ORIF and MMF gives functionally and aesthetically better results as compared to ORIF alone.
<p class="abstract"><strong>Background: </strong>A prospective study to cite our experience in adult and pediatric patients undergoing coblation tonsillectomy. We emphasised on the intra operative and post operative morbidity in coblation tonsillectomy and its feasibility as a day care procedure.</p><p class="abstract"><strong>Methods: </strong>It is a prospective study done on both paediatric and adult cases presenting to our tertiary care centre between January 2018 to February 2020. Study was done to analyse operating time, intraoperative blood loss, post-operative pain, post-operative haemorrhage and post-operative return to home and normal diet.</p><p class="abstract"><strong>Results: </strong>114 cases were selected where bilateral tonsillectomy was performed using Coblation technique. 83 were adult patients and 31 paediatric. 56 were females and 58 males. 1 case presented with secondary haemorrhage, none with primary haemorrhage. No other complications were noted.</p><p class="abstract"><strong>Conclusions: </strong>Coblation tonsillectomy yielded good results in reference to patient morbidity and low complication rate. It turned out to be a success as a day care procedure. Short operating time, minimal blood loss, less post-operative pain specially in the early post-operative period, minimal chance of complication and short stay at hospital as a day care surgery, Coblation tonsillectomy stood out as a hands down winner in our study. In this fast paced life, where consumerism demands everything instant, coblation tonsillectomy as a day care procedure provides good alternative to the patient requiring tonsillectomy. yroidectomies.</p>
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