Background: Chronic suppurative otitis media (CSMO) is an important cause of preventable hearing loss, particularly in developing world. The objective of this trial was to compare efficacy of 2% acetic acid versus 0.3% ciprofloxacin ear drops in achieving dry ears in CSMO in adult population of Islamabad, Pakistan. Materials & Methods: This trial was conducted at Department of ENT, HBS Medical College, Islamabad, Pakistan from March 2018 to February 2019. With alpha 5%, beta 20% and power of study 80%, sample size was calculated 47 for each group. All adult patients of CSOM, having ear discharge for more than three months were eligible. Patients with aural poly, external auditory canal pathology, ear malignancy, having mastoid surgery in preceding 12 months or having used antibiotics in last one week were excluded. Experimental group received 2% acetic acid, twice daily while control group received 0.3% ciprofloxacin eardrops twice daily. At two weeks, achievement of dry ears was noted. Sex and age in years were matching variables. Primary end point was achieving dry ears, which was compared between the two groups using McNemar chi-square test. Results: Experimental group included 30 (63.8%) men and 17 (36.2%) women and control group included 32 (68%) men and 15 (32%) women. Mean age of experimental group 36±2.14 years was matching to the control group 36±2.59 years. Dry ears were achieved in 35 (74.47%) patients in experimental group and in 11 (23.40%) patients in control group. The efficacy of 2% acetic acid was significantly higher than 0.3% ciprofloxacin eardrops in achieving dry ears (p
Objective: The objective of this study was to compare transseptal suture and anterior nasal packing after septoplasty in terms of frequency of postoperative crusting. Design: It’s a randomized controlled trial. Study Settings: Research was conducted at Department of ENT and Head & Neck Surgery Abbas Institute of Medical Sciences (AIMS) Muzaffarabad, Azad Kashmir for a period of six months from 26/5/2020 to 25/11/2020. Patients and Methods: This study involved 132 patients of both the genders undergoing septoplasty for deviated nasal septum. These patients were randomly divided into two groups. Patients in Group-A were treated with transseptal suturing of mucoperichondrial flaps while patients in Group-B were treated with anterior nasal packing. A written informed consent was obtained from every patient. Results: The mean age of patients was 28.44±6.16 years in the range of 18 years to 40 years. The study group had 53 (40.2%) female and 79 (59.8%) male with a female to male ratio of 1:1.5. In terms of gender distribution and mean age both the groups were comparable (p-value=0.859 and 0.978 respectively). In patients treated with transseptal suturing, the frequency of post-operative nasal crusting was significantly lower (4.5% vs. 27.3%; p=0.000) as compared to anterior nasal packing. This difference was observed across all age and gender groups. Conclusion: This study has reported transseptal suturing to be better than anterior nasal packing in terms of significantly lower frequency of post-operative nasal crusting regardless of patient’s age and gender in patients undergoing septoplasty for deviated nasal septum. The results of this study thus advocate the use of transseptal suturing in future practice. Keywords: Deviated Nasal Septum, Septoplasty, Transseptal Suturing, Anterior Nasal Packing, Post-Operative Nasal Crusting
Objective: To compare the conventional surgical turbinoplasty versus microdebrider assisted turbinoplasty in cases of inferior turbinate hypertrophy. Design of the Study: It was a cross-sectional survey. Place and Duration of Study: This study was carried at the Department of ENT Nishtar Medical University and Hospital, Multan from January 2022 to June 2022. Patients and Methods: Patients with hypertrophy of the inferior turbinates, the most common cause of nasal obstruction, were split into two groups of 30. The size of the inferior turbinates was classified as Grade I if they took up less than a third of the nasal cavity, Grade II if they took up more than a third but less than half, and Grade III if they took up more than half. Each group had either a standard partial inferior turbinectomy or a turbinoplasty with the help of a microdebrider. Visual evaluation was used to categorise blood loss during and after surgery. Patients were checked on at 1, 2, 4, and 6 months after surgery. Relief from symptoms and the occurrence of problems such crusting and synechiae formation were evaluated. Results of the Study: Both groups showed comparable significant improvements in nasal blockage. Most patients in the CPIT group experienced intraoperative blood loss of grade II (66.66%) or grade III (10%). When the packs were taken off, 60% of patients experienced grade I blood loss, 36.66% experienced grade II blood loss, and 3% experienced grade III blood loss after surgery. Most patients (46%) and surgeons (40%) in the MAT group experienced grade II or higher intraoperative blood loss. The majority of patients' postoperative blood loss was classified as grade I. Six months later, 6.66 percent of the CPIT group had acquired crusting, and 6.66 percent had developed synechiae. Those that received MAT did not have these problems. Practical implication: The choice of surgical procedure is up to the surgeon's attitude and experience due to the lack of agreement regarding their efficacy. That’s why we compared the effectiveness of these treatment methods for turbinate reduction in order to provide evidence to evaluate the results of the several surgical techniques in local population. Conclusion: According to the findings, both surgical approaches are effective in addressing nasal blockage. Complications are less likely to occur with microdebrider-assisted inferior turbinoplasty since the mucosa and nasal physiology are preserved. Keywords: Microdebrider assisted inferior turbinoplasty, Hypertrophied inferior turbinate, Conventional partial inferior turbinectomy,
Hearing is decreased in later age is due to aging and is normally seen in most of the elderly people all over the world. Objectives: To ascertain the degree of hearing in elders in relation to age, pattern and extent of hearing weakness in old age so that interventional strategies can be planned to improve their wellbeing. Study Design: Cross Sectional Study. Setting: ENT Outdoor Clinic of Akbar Niazi Teaching Hospital of Islamabad Medical and Dental College, Bhara Kahu, Islamabad. Period: December 2017 to October 2018. Material & Methods: 200 patients were part of the study with age > 50 years and no past history of drug therapy. Data was gathered by detailed clinical history, clinical examination and audiometric findings. Result: 57% patients were found with normal hearing and 43% had variable degree of hearing deterioration. Highest number of hearing weakness was found in 9th decade. Most of hearing deterioration was found in both the ears and that of sensorineural in type. Conclusion: Sensorineural type of hearing impairment is very frequently occurring problem seen in the latter part of life in our community. The frequency and severity of decreased hearing is directly proportional to age.
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