Aim To evaluate the effect of collagen membrane on the healing of through‐and‐through periapical lesions using 2‐dimensional (2D) and 3‐dimensional (3D) imaging techniques. Methodology Thirty‐two patients with periapical radiolucencies measuring at least 10 mm and with confirmed loss of buccal and lingual cortical plates were randomly divided into GTR and control groups. Periapical surgery was performed in both groups, using a resorbable collagen membrane in the GTR group only. 2D healing was evaluated according to Molven's criteria, while 3D healing was assessed using modified PENN 3D criteria, RAC indices and the B index, 12 months after surgery. Data were analysed using Chi‐square, Mann–Whitney and Wilcoxon signed rank tests. Results Thirty patients were analysed at the 12 months follow‐up. Both groups had a significant reduction in the size of lesions [92 ± 12% (control) and 86 ± 14% (GTR) in 2D and 85 ± 19% (Control) and 82 ± 13% (GTR) in 3D], with no significant difference between the groups (P > 0.05). A total of 29(14 control, 15 GTR) teeth and 26(13 control, 13 GTR) teeth were classified as success according to Molven's (2D) and modified PENN 3D criteria, respectively, with no significant difference in success between 2D and 3D assessments. RAC indices of 3D images revealed the greatest percentage of complete healing in R scores (55% for Control, 41% for GTR), whereas cortical plate had the lowest percentage of healing (30% for Control, 27% for GTR) (P > 0.05). Only 2 (13%) patients in each group had complete healing using the B index. Conclusion Periapical surgery with or without GTR was a predictable and viable solution for through‐and‐through lesions. There was no benefit in using a collagen membrane with regard to the outcome of periapical surgery in through‐and‐through lesions. Both cone beam computed tomography (CBCT) and periapical radiographs (PA) allowed similar assessment of healing after periapical surgery.
Aim: To ascertain whether the A-B gap improvement of tragal perichondrial grafting is better than TF grafting in CSOM patients undergoing type 1 tympanoplasty by underlay technique. Methodology: A prospective comparative study was done in CSOM patients presenting to a tertiary health care establishment. 60 patients underwent type 1 tympanoplasty, using TF graft in 30 and tragal perichondrial graft in 30 patients. Both groups of patients were compared in terms of A-B gap improvement following surgery. Results: A-B gap improvement of all the 60 patients were analysed. 8(26.67%) patients had A-B gap improvement </= 15dB in both the tragal perichondrium and TF graft group. Rest 22(73.33%) patients had A-B gap improvement of 16-25dB in either group. In cartilage group, 14 out of 15 patients i.e, 93.33%, while in Fascia group, 10 out of 12 pateints i.e, 83.33% patients who had perforation involving anterior quadrant had A-B gap closure between 16-25dB post- operatively. Therefore, cartilage graft showed better A-B gap closure than fascia graft in anterior quadrant. When both the quadrants were taken into consideration, 11 out 17 i.e, 65% patients in fascia group while 8 out of 13 i.e, 61% patients in cartilage group showed AB gap closure between 16-25dB. Therefore, fascia graft showed better result. Conclusions: This study showed that A-B gap improvement is similar in CSOM patients undergoing type 1 tympanoplasty using either TF or tragal perichondrial graft. Either of these can be good for improving the hearing in CSOM patients but tragal cartilage with perichodrium showed better results with perforation involving anterior quadrants.
Introduction: HRCT temporal bone is the currently widely used investigation for the chronic otitis media patient especially in unsafe disease. Aim: This study was conducted to assess the condition of the middle ear in CSOM by HRCT temporal bone and compare them with intraoperative finding of the middle ear cleft . Method: Study group includes patients of Attico-antral variety of CSOM presenting in ENT OPD in our institution over a period of 18 months who undergone Computed Tomography Temporal bone followed by Surgical Procedure. Results: After study it was observed that CT scan can reliably detect bony & soft tissue changes in middle ear and intracranial complication. It can detect soft tissue in the middle ear but can not differentiate between soft tissue and cholesteatoma. Conclusion: CT scan provides excellent anatomical details and pathological changes of the ear and mastoid. Scanning all the patients is not feasible and justified, so we need to select patients in whom diagnosis and extend of the diseases is in doubt.
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