Objective: To evaluate the graft takes rate of the myringoplasties performed by underlay technique using temporalis fascia graft for the last one year and to assess the hearing improvement in the successfully operated cases.Methods: This prospective Study included 52 ears of 50 patients, who underwent myringoplasty. All operations were performed using an underlay technique and mostly by postaural approach. In all the cases, temporalis fascia was used for the reconstruction of TM. The data of all the patients regarding preoperative disease, perforation size and localization, surgical approach, graft material, pre-and postoperative clinical and functional (hearing evaluation by pure-tone audiogram) results were analyzed.Results: Successful closure rate of the TM perforation was 82.69% and the graft failure rate was 17.30%. In this study, lowest and highest age of patients at presentation was 12 and 42 years respectively with a mean age of 25.5 years. The success rate was better with the advancing age. The most common approach was postaural. Medium size and posterior perforations were common and the graft take rate was 80.95%, and 88.89% respectively. The mean pre and post-operative air conduction threshold in the successful cases were 38.69dB and 30.35 dB respectively with a mean audiological improvement of around 8 dB. The improvement in the hearing was achieved in only 67.44% (29 out of 43) among the successful operated myringoplasties. Conclusion:Myringoplasty is a safe and effective technique to improve the quality of life of patients. The most common approach was postaural. The graft takes rate was better with the advancing ages and with the medium size and posterior perforations. The improvement in hearing was also achieved.
Background: The COVID-19 pandemic has ravaged the world and Nepal reported its first case on 23rd January 2020. Increasing people’s knowledge of the disease can modify attitude and change practice and is key in prevention. This study assessed the knowledge, attitude and practice (KAP) of patients presenting to the Ear, Nose and Throat (ENT) out-patient department (OPD). Methods: A hospital based cross-sectional study was conducted at the ENT OPD with 906 patients. Patients aged 20 years and above were studied regarding their KAP towards COVID-19. A questionnaire was used to collect data and analysed for gender, age group, education level and occupations. Statistical analysis was done using Mann-Whitney and Kruskal-Wallis tests. Results: Males had better knowledge and more positive attitude compared to females, which was statistically significant (p 0.001 and p 0.011). Similarly, there were significant statistical differences among the various age groups in knowledge (p <0.001), however, attitude and practice were not different. When KAP was compared to education, differences in knowledge and attitude were statistically significant p<0.001. Likewise, statistical differences existed with regard to knowledge and the various occupations (p <0.001), but a positive attitude was noted in all occupations. Practice was correct in the majority of studied groups with no statistical differences seen. Conclusions: Among the ENT patients correct practice was seen in all the groups namely, gender, age, education and occupation. However, there were differences in knowledge and attitude levels.
We report a rare case of intravascular papillary endothelial hyperplasia (IPEH) of the cheek. This neoplasm, known as Masson's tumor, is an unusual vascular lesion of proliferating endothelial cells. It is usually confined to the lumen of preexisting vessels or vascular malformations. The principal significance of IPEH is its resemblance to a variety of benign and malignant diseases and possible misdiagnosis as such. Achieving a correct diagnosis is essential to avoid subjecting a patient to either unnecessarily aggressive or inadequate therapy. For this reason, awareness of this lesion is very important.
from the nose or epistaxis is a common presentation in the Ear, Nose and Throat (ENT) department. Various factors are responsible for nose bleed. It has been observed that 60% of the people experience at least one episode of epistaxis in their life time and 6% seek medical attention for this condition. 1 The incidence of epistaxis at the hospital is more during the dry and cold seasons. The frequency of admission is greatest in the autumn and winter months. 2 This seasonal variation correlates with fluctuations in the environmental temperature. 3 In the few reports found in literature, most research supports that there is a correlation between the frequency of epistaxis and at least one of the meteorological factors i.e. temperature, humidity and atmospheric pressure. However, the studies done on this topic are still few. There are various classifications for epistaxis. It is clinically classified as primary if there is no proven cause and secondary if there is a definite identifiable cause. It is also classified according to age as childhood and adult. Another way of classifying epistaxis is based on the site of bleeding, where the bleeding can be anterior or posterior in relation to the piriform aperture. 4 The causes of epistaxis are local and systemic. A careful history, physical examination and laboratory assessments are required for proper diagnosis. This study was done to observe the frequency of primary epistaxis at Nepal Medical College and Teaching Hospital (NMCTH) and its correlation to the seasonal variations of temperature and humidity. M A T E R I A L A N D M E T H O D S :Two hundred and sixty two consecutive patients attending ENT outpatient department of Nepal Medical College and Teaching Hospital (NMCTH) with nose bleed were included in the study. The study period was 2 years from August 2008 to July 2010. The study group comprised both hospitalised and not hospitalised patients. Nose bleed without any known cause or primary cases of epistaxis were included in this study. The exclusion criteria were patients with obvious causes for epistaxis, patients with trauma, coagulopathies, tumours and systemic causes. Out of 262 patients,105 cases were primary epistaxis. Daily temperature and humidity as documented by the Department of Hydrology and Meteorology of the Government of Nepal were recorded during this study period. The daily arithmetic averages (mean) of temperature and humidity were taken from which the mean monthly temperature and relative humidity were calculated. The frequency of epistaxis on a monthly basis was recorded and the seasonal variations were observed. Statistical analysis with Pearsons correlation coefficient was used to see the correlation between EPISTAXIS AND ITS RELATION WITH TEMPERATURE AND HUMIDITY O b j e c t i v e :The objective of this study was to observe the frequency of primary epistaxis and its relation with temperature and relative humidity. M a t e r i a l s a n d M e t h o d s :This was a prospective study which included 262 patients with epistaxis attending th...
Deep neck space infection is characterized by infections of the deep neck space either in the form of abscess or cellulitis. Common infective conditions like aero-digestive tract infections like tonsillitis, pharyngitis and dental infections can lead to infection of the deep neck spaces. This can prove fatal in the form of acute respiratory obstruction, descending mediastinitis and septic shock. This was a descriptive cross-sectional study conducted in Department of Otorhinolaryngology in Nepal Medical College from July 2017 to June 2019. All the patients diagnosed as deep neck abscess were enrolled in the study and pus was collected and sent for gram stain and culture and sensitivity. Out of 87 patients, 50 were females and 37 males. The mean age was 24.2 years. Peritonsillar abscess was the commonest space involved followed by submandibular abscess and Ludwig’s angina (36.8%,24.1% and 11.5%). Upper respiratory tract infections (32.2%) and dental caries (27.6%) were the commonest source of infection. Empyema thoracis was seen as a complication in a patient of Ludwig’s angina. Growth in the sample accounted for 33.3%. The commonest organism found was Coagulase negative Staphylococcus (10.3%), followed by Mycobacterium tuberculosis (6.9%), Staphylococcus aureus (4.6%), Enterococcus species (3.4%) and methicillin-resistant S. aureus (3.4%) respectively. The growth between the culture with or without previous antibiotic exposure were statistically significant (p-value-0.04) which suggest that inadvertent use of antibiotics lead to difficulty in identifying causative organism. Deep neck abscess is a dreadful condition, therefore proper knowledge, early detection and timely intervention of the disease can prevent complications.
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