Mastoidotympanoplasty was not found to be superior to tympanoplasty alone over a short term follow-up period. Hence, it may not be necessary to undertake routine mastoid exploration at this stage of disease.
In the presence of a positive clinical diagnosis and negative chest radiography, computed tomography virtual bronchoscopy must be considered in all cases of tracheobronchial foreign body aspiration, in order to avoid needless rigid bronchoscopy. Computed tomography virtual bronchoscopy is particularly useful in screening cases of occult foreign body aspiration, as it has high sensitivity, specificity and validity.
Diphtheria is a forgotten communicable disease and presumed to be under sufficient control so much so that life savings drugs required for its treatment has disappeared from most hospitals. Contrary to this belief, classical diphtheria continues to exist in many parts of India despite extensive immunizations campaigns raising the suspicion of resurgence. The absence of essential drugs in treatment of this condition has further worsened the situation. The expenditure involved in procuring these drugs is yet another constraint. We here by present one such case of adult diphtheria and discuss the problems associated with its diagnosis and treatment.
Atrophic rhinitis (AR) is a chronic debilitating nasal mucosal disease of unknown aetiology and the definitive treatment is still elusive. This often leads to the patient suffering during the entire life span often depleting the individual psychologically. On the contrary, Rhinoscleroma (RS) for which the aetiology is clearly known and is completely curable has atrophic stage which is clinically indistinguishable from AR. Many cases of atrophic stage of RS are undetected and often they end up being treated as AR. This study was conducted to know the role of histopathology and other factors in differentiating AR and Atrophic stage of RS, which can significantly alter the course of treatment and outcome. Forty-five cases of clinically diagnosed AR were included in the study. Punch biopsy of nasal mucosa was obtained from the anterior end of inferior turbinate. Core culture was performed on one sample and histopathological examination for the other sample. Among the 45 patients, 38 (84.44%) of cases were diagnosed to be AR and 7 (15.56%) cases were diagnosed to be RS by histopathology. Core culture of RS subjects showed positive culture for Klebsiella rhinoscleromatis in five subjects (71%). To conclude, AR cases should be confirmed by histopathological examination to rule out RS, for effective management and to prevent complications.
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