Otorhinological Problems Arising During the Management of Chronic Renal Failure

Abstract

CONTEXT: Chronic renal is the common end point of diffuse, severe renal parenchymal disease, regardless of the initial cause. Patients with chronic renal failure may be asymptomatic or may have symptoms which may be high frequency hearing loss, epistaxis, hoarseness of voice, uremic stomatitis & salivary adenitis. Finally, there are emotional, social, &economic problems that accompany all illness. AIMS: The present study deals with the prevalence of otorhinological problems arising during the management of CRF we have studied about hundred CRF patients who were undergoing dialysis &the influence of dialysis if any on these manifestations. SETTINGS AND DESIGN: Retrospective METHODS AND MATERIAL: Prevalence of otorhinolaryngological manifestations arising during the management of 100 cases of c. r. f &to find out the influence of dialysis on these manifestations if any Statistical analysis used: RESULTS: Out of the 100cases of c. r. f studied 58 patients were male &42 were female with a male to female ratio of 1. 38:1. 38%of the study group manifested with otorhinolaryngeal symptoms, of which 23were male &15 were female patients, rest of the 62%had no E.N.T complications. Of the 38%who developed E. N. T complications ear manifestations predominated accounting for 27cases, followed by 8 &3cases 0f nose &throat manifestations respectively. 27 cases had ear manifestations which included only nerve deafness in 9 cases (33.33%) and conductive hearing loss in 2cases (7.41%). the rest were a combination of either pure tinnitus (3cases, 11.11%)tinnitus with nerve deafness (5 cases, 18.52%), giddiness (3 cases, 11. 11%) & giddiness with nerve deafness (5cases, 18.52%). Out of the 8cases who manifested with nasal symptoms 5 cases (62.5%) had epistaxis, & 3cases (37.5%) had sinusitis. Out of the 3cases who had throat manifestations 2patients (33.33%) had oral thrush and 1patient (66.67%) had oral ulcers 6months following the institution of dialysis among the 27patients with ear manifestations11patients (40.74%) showed improvement, which included both the cases with conductive hearing loss (100%), 2cases (66.7) with only tinnitus, 1case (20%) with tinnitus and nerve deafness, all3cases (100%) with giddiness and3cases (60%) who had giddiness with nerve deafness. Out of the 8cases who manifested with nose symptoms 6cases (75%) showed improvement. 4cases (80%) with epistaxis and 2 cases (66.67%) with sinusitis showed improvement following dialysis. Out of the 3patients with throat manifestations following dialysis only 33% showed improvement. CONCLUSIONS: The manifestations are showing a decreasing trend because of the equally effective methods used in the diagnosis and management. Despite the better treatment the ear manifestations are still the most common and most difficult to treat. Whereas the nasal and oral manifestations have reduced in incidence and respond well to dialysis.