Background:Inferior turbinate hypertrophy is one of the most common causes of nasal blockage for patients to seek an otorhinolaryngologist, who is often seen in cases of allergic rhinitis, nonallergic rhinitis with eosinophilic syndrome, or iatrogenic rhinopathy. Although most cases of ITH can be managed medically but surgical intervention sometimes becomes necessary in certain non-responding patients which are managed by Submucous Inferior Turbinate Reduction (ITR) surgery. Large variation in surgical techniques available denotes lack of consensus on optimal technique. With advent of Microdebrider to Rhinosurgery by Setliff et al., many surgeons have recently started using microdebrider for the same indication.Aim: To compare the outcome following submucosal Inferior turbinate reduction using microdebrider and diathermy. Methods and results: A prospective interventional comparative clinical study between Submucosal inferior turbinate reduction using microdebrider (SITRM) and submucosal inferior turbinate reduction using diathermy (SITRD) was conducted. A total of 150 patients were included in the study. Patients were evenly randomized into Pool A and Pool B by chit allocation technique. Patients in pool A underwent SITRD and in pool B underwent SITRM. Comparisons were made between pre and post-operative NOSE score, endoscopic inferior turbinate size and mucociliary transit time and possible complications from both techniques and result were statistically significant in SITRM. Conclusion:To conclude submucosal resection with microdebrider produce better results in the treatment of inferior turbinate hypertrophy, both in the short term and long term compared to the submucosal diathermy, where the latter produce comparable results in the early postoperative period. Limitation of this study was that different etiological causes for inferior turbinate reduction were not taken into consideration and ITH due to any cause were included in the study irrespective of its cause. Another limitation of this study was that objective method of nasal patency assessment like rhinomanometry were not used due to cost restrains. A more elaborate larger randomized studies with use of rhinomanometry would definitely be helpful to confirm or refute the same.
<p class="abstract"><strong>Background:</strong> Rabies is a zoonotic disease caused by lyssavirus and spread through saliva of rabid animal bite. This study was taken to compare primary closure versus non-closure of animal bite wounds.</p><p class="abstract"><strong>Methods:</strong> This is a prospective randomized study. Patients were divided into 2 groups. Group A consisted of patients with non-closure of wounds and group B with primary closure of wounds. Patients were followed up for wound healing time, infection and cosmesis. </p><p class="abstract"><strong>Results:</strong> This study consists of 540 patients (323 males and 217 females). The common age group was paediatric and geriatric age. Most common animal bite was from dogs. The average healing time in non-infected wound in group A versus group B with Lackman’s I and II grading was 10.5±1.25 and 12.5±1.5 days versus 7±1.25 and 8.5±1.5 days respectively. There were 19 cases in group A and 17 cases in group B with infection which subsided with antibiotics in 24 hrs. Cosmesis graded on VSS was better in group B (average 4.03±1.5) as compared to group A (average 2.44±0.185). Only one patient from group A with Lackman’s grade II contacted rabies died 2yrs after the bite.</p><p class="abstract"><strong>Conclusions:</strong> Animal bite wounds over head and neck were found to be more common in paediatric and geriatric population who are more vulnerable. Infection and spread of rabies virus through these wounds can be prevented by thorough debridement and cleaning whereas primary suturing helps in achieving early wound healing and better cosmesis producing a socially and functionally acceptable scar.</p><p class="abstract"> </p>
Background:Vertigo is one of the most distressing symptom seen in patients encountered in clinical practice by otolaryngologist and neurologist. It results from dysfunction of vestibular system, among which most common is BBPV(benign paroxysmal positional vertigo). BPPV present with short episodes of vertigo lasting for few seconds, usually precipitated by change in head position. In BPPV, otoconia from utricles are thought to collect in semicircular canal making them abnormally gravity sensitive. BPPV is clinical diagnosis on the basis of typical history and Dix Hallpike testing. Dr. T Brandt and Daroff introduced Brandt daroff home exercises based on cupulolithiasis theory. In 1980, John M Epley introduced canalolith repositioning procedure of Epley in the treatment of BPPV. Because of lack of consensus regarding the optimal treatment maneuver, in our study we have compared the effectiveness of Brandt Daroff and Epleys maneuver.
Background: Invasive Fungal Sinusitis(IFS) is seen in both immunocompromised and immunocompetent patients. All fungi elaborate uptake mechanisms to sequester iron, and produce siderophores with higher affinity for iron. The availability of iron and ability to utilize them are essential for viability and growth of Mucor and Aspergillus. Currently, IFS is dealt with surgical debridement and aggressive medical therapy. Amphotericin B being currently used in medical management. Considering the importance of iron in fungal growth, addition of iron chelating agent as an adjunct has potential beneficial role. The newer iron chelator deferasirox, share higher affinity for iron and hence, deprive the fungi of iron, inhibiting their growth. However, the evidence for deferasirox as adjunct therapy in IFS is limited thus, prompting us for this study. Aim: To study the role of deferasirox as an adjuvant to parenteral antifungal therapy in invasive fungal sinusitis. Materials and Methods: A prospective interventional comparative clinical study was conducted. A total of 42 IFS patients were selected for study. About 12 patients were lost due to attrition. Remainder of 30 patients were evenly randomized into Group A and B by chit allocation. After surgical debridement, Patients in group A received only parenteral Amphotericin B and group B received parenteral Amphotericin B and oral deferasirox. The outcomes in two groups were compared clinically,endoscopically and radiologically and analysed using Mann Whitney test. Conclusion: Parenteral Amphotericin B and deferasirox combination is better than parenteral Amphotericin B alone in treatment of IFS.
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