BackgroundHealth related behaviour specially smoking and tobacco in any form are major determinants of health and lead to health inequities. Tobacco leads to various health problems including ear, nose and throat diseases.ObjectiveTo determine the influence of smoking or tobacco use on ear diseases we performed a retrospective study among men.MethodOf 11454 subjects of different age-groups there were 4143 men aged 20-60 years who were evaluated for demographic variables, smoking/tobacco use and middle and internal ear diseases. Descriptive statistics and age adjusted logistic regression analyses were performed.ResultsAmong the 4143 men, 1739 (42.0%) were smokers or used tobacco. In smokers/tobacco users compared to non-users the age adjusted odds ratios and 95% confidence intervals (CI) for chronic suppurative otitis media were 1.13 (CI 0.96-1.34), acute otitis media 1.16 (CI 0.82-1.64), suppurative otitis media 1.21 (CI 0.79-1.84), otosclerosis 0.97 (CI 0.52-1.33) (p > 0.05) and for overall middle ear diseases was 1.15 (CI 0.99-1.33, p = 0.05). For internal ear diseases the age adjusted odds ratios were for sensorineural hearing loss 1.12 (CI 0.92-1.58), 0.12 (CI 0.42-0.93) for vertigo and tinnitus and overall internal ear diseases were 0.97 (CI 0.77-1.22, p = 0.81). Among men 40-60 years there was a significantly greater risk for both middle ear (OR 1.73, CI 1.29-2.30) and internal ear diseases (OR 1.94, CI 1.24-3.04) (p < 0.001).ConclusionSmoking/tobacco use is significantly associated with greater prevalence of middle and internal ear diseases among middle-aged men in India.

Our aim was to study the effects of dexmedetomidine on anesthetic consumption, duration of surgery, time to extubation and post-operative emergence when used as an adjunct to general anesthesia in endoscopic nasal surgeries. Fifty two patients scheduled for elective nasal surgery (Functional Endoscopic Sinus Surgery and Functional Endoscopic Nasal surgery) were randomized into two groups. Dexmedetomidine-group (D) and placebo or control-group (C). Dexmedetomidine was administered to the D group at a bolus dose of 0.5 ug/kg via an intravenous infusion pump over 10 min. Intraoperative maintenance was supplied by a continuous infusion of 0.2 ug/kg/hr. Infusion of Dexmedetomidine was stopped when the major surgical intervention was over. Group C was given equal amounts of normal saline, instead of Dexmedetomidine. The intraoperative hemodynamics during the surgery were recorded on a proforma. The duration of surgery, time to extubation and amount of anesthetic agents consumed in both the groups were noted. We found that there was a statistically significant difference in anesthetic consumption between both groups. The time to extubation was more in group C(p value < 0.05) .Awakening scores were better in group D(p value < 0.05).No significant difference in the duration of surgery was found.Our conclusion was that Dexmedetomidine reduces anesthetic agent consumption significantly when used as an adjunct in endoscopic nasal surgeries, thereby leading to shorter extubation times and better awakening scores.

Background: Coblation based bipolar plasma devices are designed to operate at a relatively low temperature to gently dissolve and/or shrink target tissue with minimal thermal damage to surrounding healthy tissue. Coblation technology provides ablation, resection, coagulation of soft tissue and hemostasis of blood vessels in one convenient surgical device. Coblation technology can be used in the larynx and trachea for removing or debulking sessile polyps, lesions or tumors. Minimally invasive coblation technology can offer less invasive treatment with quicker recovery and shorter hospitalization. Aim: This case study aims to explore the advantages of coblation combined with microscopy to treat benign laryngeal lesions. Case report: We report the case of laryngeal papilloma treated with minimally invasive coblation resection. Fiberoptic laryngoscopy was done pre-operatively and that showed papillomatous mass at anterior half of right vocal cord involving inferior surface and also extending upto anterior commissure. Mobility of both vocal cords was normal. On the basis of the above findings with normal vocal cords mobility, the microlaryngeal surgery with coblation was planned. After complete pre-op work up, the patient underwent trans-oral microscopic coblation excision of mass under general anaesthesia. Power level was set to 7 for ablation and 3 for coagulation. The PROcise TM LW Plasma Wand system was chosen such that it was malleable to reach the papillomatous mass without obstructing the vision. It was totally excised and sent for histopathology examination. Post-operatively after four hours, he was able to take normal diet comfortably. He was followed up after 10 days. Histopathological report confirmed the diagnosis of papilloma. Check laryngoscopy was performed after 3 weeks. Laryngeal examination was absolutely normal with almost normal vocal cords and normal voice post-operatively. Conclusion: Microscopic surgery with coblation has the advantages of less bleeding, short procedure duration, increased completion rate and few complications.

This study from an Indian urban ENT center shows a significantly increasing trend in chronic and degenerative ear diseases and decline in infection related diseases.

Wegener's granulomatosis is an autoimmune disease affecting the lungs, kidneys and upper respiratory organs. Major salivary gland enlargement is a rare presenting symptom. We are reporting a rare case of Wegener's granulomatosis presenting with pain in right ear with moderate hearing loss and unilateral painless parotid gland enlargement.