Abstract:The Foreign bodies in respiratory tract have been major cause of morbidity and present as challenge to otolaryngologists. Despite improvement in medical care and public awareness, they are major concern for otolaryngologists. The spectrum of presentation varies widely from sudden death due to respiratory obstruction to accidental finding during routine investigations. A case of unusual presentation of laryngeal foreign body with just loss of voice is described here.
Role of high resolution computerized tomography (HRCT) of temporal bone is established in cases of atticoantral chronic suppurative otitis media (CSOM) with intracranial complications. Routine use of HRCT in management of patients of atticoantral CSOM without intracranial complications has been an issue of debate. The aim of this study was to evaluate the routine use of HRCT of temporal bone in such cases. This study was a prospective study done at LG hospital, AMC MET Medical College, Ahmedabad to evaluate and compare the temporal bone findings in HRCT and intraoperative findings in 100 patients with atticoantral CSOM. All patients underwent HRCT screening followed by surgical exploration of middle ear cleft. In extent of disease HRCT showed very high sensitivity and specificity for epitympanum (100, 94%) and mesotympanum (98, 98%) areas. It gave valuable information of disease extent in hidden areas like sinus tympani and facial recess of mesotympanum. HRCT satisfactorily delineated malleus and incus erosion but had 75% sensitivity for detecting erosion of stapes suprastructure, though specificity was of 97%. For bony anatomical landmarks HRCT showed very high sensitivity and specificity for detecting erosion of lateral semicircular canal, tegmen tympani and sinus plate. Detection of facial canal erosion on HRCT had moderate sensitivity of 75%. We concluded that routine use of HRCT is justified as a reliable preoperative tool in patients with atticoantral CSOM without intracranial complications and it helps to plan type of surgical intervention. HRCT has limited role to distinguish between granulations and cholesteatoma and also to delineate stapes supra structure and facial nerve canal.
<p class="abstract"><strong>Background:</strong> Operations on tonsils and adenoids are performed since many years. Tonsillectomy produces an open wound that heals by secondary intention. Tonsillectomy is still a very common surgical procedure. There are various modalities to perform surgery (diathermy, laser, harmonic scalpel, radiofrequency cautery, cryosurgery and coblation). Among these, dissection and snare method are commonly done by ENT surgeons.</p><p class="abstract"><strong>Methods:</strong> We carried out the prospective cross-sectional study to compare intraoperative blood loss, time taken for the surgery, post-operative pain score, degree of slough formation and complications between these two methods. </p><p class="abstract"><strong>Results:</strong> Average time for surgery on coblation side was less (15.1 min) than conventional side (36.04 min). For haemostasis on conventional side, all patients required bipolar cauterization while on coblation side only 8 patients (16%) required hemostasis. Average blood loss on coblation side (left) was 3.40ml while on conventional side (right) 25.57 ml. In my study, mean pain score on 1st day, 2<sup>nd</sup> day, 5<sup>th</sup> and 10<sup>th</sup> day of surgery was 6.18, 4.10, 2.30 and 1.64 on conventional side and 4.36, 3.00, 1 and 0 on coblation side. In my study, only one patient had Secondary haemorrhage on conventional side on 7<sup>th</sup> day.</p><p class="abstract"><strong>Conclusions:</strong> The use of coblator reduces the time required for surgery, per-operative blood loss is very much less, chances of damage to surrounding structures are less, charring of tissue is less, post-operative severity of pain after 24 hours is very much less than that of dissection method. Slough formation was more on coblation side as compared to conventional side.</p>
Minor salivary glands tumours are very rare in nose, paranasal sinuses and in nasopharynx. Pleomorphic Adenoma of minor salivary glands may occur some times in that area which is usually of benign variety. Here we report a case of a male, aged 44 years, presented with a mass in his rt. nostril which turned out to be Pleomorphic Adenoma of minor salivary gland. A brief review of the literature and management of the case is discussed herewith.
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