Background: Chronic otorrhea in chronic suppurative otitis media (CSOM) has become a difficult task to treat for ENT specialists because of emerging resistance to the available antibiotics and patient's affordability for its cost. Also biofilms have been responsible for the chronicity of disease. Use of vinegar as an antiseptic and altering the pH of middle ear to treat otorrhea in CSOM needs to be studied. Methods: 120 patients with active CSOM were recruited randomly for either vinegar wash or antibiotic therapy. Vinegar diluted with water in 1:1 ratio at pH 4 was used twice a day for 3weeks to one group. Oral antibiotics based on culture sensitivity report were given to other group for 3weeks. Both groups were followed up for a month and observed for resolution of ear discharge. Results: Pseudomonas (40%) and Staphylococcus aureus (25%) were the most common organisms detected. 96.2% of Pseudomonas and 50% of Staphylococcus aureus ears became dry with vinegar wash. 81.67% of antibiotic group and 68.33% of vinegar group ears became dry in 3weeks. No statistically significant difference between vinegar wash and culture based oral antibiotic therapy in resolution of ear discharge was seen in active CSOM (p >0.05). Conclusions: Management of otorrhea is long term in CSOM and vinegar can be used as an alternative to costly oral antibiotics for resolution of ear discharge in active CSOM. Two fold dilution of vinegar prevents chance of ototoxicity.
<p class="abstract"><strong>Background:</strong> The objectives of the study were to compare the anatomical variants of maxillary and ethmoid sinus in CT PNS and diagnostic nasal endoscopy, to determine the incidence of variations of maxillary and ethmoid sinus and to determine the association of anatomical variations with extent of the disease.</p><p class="abstract"><strong>Methods:</strong> Patients with chronic rhinosinusitis attending the outpatient department of otorhinolaryngology, head and neck surgery (ENT-HNS) of KVG Medical College for a period of 12 months from December 2016 to November 2017. 100 consecutive patients with history of CRS subjected for nasal endoscopy and CT-PNS. </p><p class="abstract"><strong>Results:</strong> The majority of patients were females. Male to female ratio was 1:1.46. Headache and postnasal drip were the main symptoms (76%). Concha bullosa (42.4%) was most common anatomical variation, which was detected in 59(42.4%) patients on CT PNS and DNE. There was statistically significant correlation between right septal deviation and right maxillary sinusitis (p<0.01), left septal deviation and left maxillary sinusitis (p=0.001) and left deviation and left ethmoid sinusitis (p=0.017). We also found correlation between left Haller cells and left ethmoid sinusitis (p=0.003).</p><p><strong>Conclusions:</strong> By using diagnostic nasal endoscopy and CT PNS, anatomic variations can be easily identified and aid as a guide map during functional endoscopic sinus surgeries. </p>
<p class="abstract"><span lang="EN-IN">Pleomorphic adenomas are benign tumors that are uncommon in the nasal cavity. However, they can rarely arise from septum, erode hard palate and thus masquerade a bone tumor. We report one such rare case of septal pleomorphic adenoma with hard palatal extension and ossification. A combined endoscopic intranasal and transpalatal surgical approach was performed and tumor was excised completely. A high index of clinical suspicion and biopsy can diagnose such swellings.</span></p>
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