<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Tuberculosis has become a common occurrence in Otorhinolaryngology with increasing number of extra pulmonary cases. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This is a study of 27 patients who visited ENT OPD of Dr. D. Y. Patil Medical College, Pune, with variety of manifestations of tuberculosis in the ENT region. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Majority of those suffered from tuberculous cervical lymphadenopathy, other manifestations included laryngeal tuberculosis, tuberculous otitis media, lupus vulgaris and tuberculous infection of a pre auricular sinus. FNAC and histopathologic examination proved to be reliable tools of diagnosis. Five of these patients suffered from concurrent pulmonary tuberculosis. All these responded well to category 1 anti-tubercular therapy well. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Tuberculosis in Otorhinolaryngology shows a variety of manifestations so it should be kept in mind whenever dealing with unusual presentations.</span></p>
AIM: To focus on difficulties in endoscopic endonasal DCR, to improve the final outcome of endoscopic endonasal DCR. To elaborate the steps this will avoid recurrence. MATERIAL AND METHODS: This article presents retrospective study of 861 cases that underwent Endoscopic endonasal DCR between Oct 2004 and Nov 2011. The patients operated were in the age group from 5 years to 94 years. The cases of lacrimal abscesses were tackled by endo DCR which gave a substantial advantage over the conventional external approach by avoiding a scar. The stenting of the canalicular system was restricted to the situations where the patency of the lacrimal canaliculi was absent and the sac syringing done on operation table showed no fluid coming from the new stoma due to the blocked canaliculi or fibrosis of lacrimal sac. The stent used was silicon bicanalicular lacrimal intubation set. CONCLUSIONS: Local anaesthesia preferred over general anaesthesia as it has less bleeding and less morbidity. Endoscopic DCR avoids scar of external approach. Coexistent sinonasal disease can be tackled at same sitting. Adequate marsupialization of sac mucosa is key for avoiding recurrence.
<p><strong>Background:</strong> Thyroid swellings are very frequently encountered in ENT practice, ranging from a simple cyst to a malignant tumour. Disorder of structure of thyroid gland, due to various etiological factors, will give rise to swelling in the neck region. Clinical signs and symptoms are inadequate to diagnose thyroid disorders as similar presentations are seen in various thyroid disorders. So, this study of thyroid swellings was done to know different clinical presentations, age and sex distribution, correlation between thyroid swellings and thyroid function tests, analyse various thyroid swellings and etiological factors based on pathological reports.</p><p class="abstract"><strong>Methods:</strong> A prospective study with 50 patients of thyroid swellings was conducted over 2 years, after taking consent from each patient. Patients were clinically examined by inspection, palpation, percussion, auscultation and underwent thyroid function tests. Ultrasonography (USG) and fine needle aspiration cytology (FNAC) was done in all patients. </p><p class="abstract"><strong>Results:</strong> Total 50 patients of thyroid swellings were studied. Mean age of the patients was 38.92 years with female preponderance (74%). Thyroid swellings were commonly present bilaterally (54%). 82% cases showed euthyroid state. USG revealed that most of the patients had colloid nodule (46%), followed by MNG (26%). Majority of lesions were benign on both USG and FNAC reports. MNG (44%) was reported frequently in the provisional diagnosis, followed by colloid nodule (24%).</p><p class="abstract"><strong>Conclusions:</strong> In all cases of thyroid swellings, detailed clinical history, thorough clinical examination is required. Thyroid function test, USG and FNAC reports help to reach the definitive diagnosis. Histopathological report confirms and gives final diagnosis.</p><p> </p>
Glomus tympanicum is a slow-growing benign tumor that can be locally destructive, spreading along the path of least resistance. Conventionally seen as soft tissue mass in the middle ear, it is difficult to distinguish glomus tympanicum from other soft tissue masses of the tympanic cavity, especially as it hides behind an intact tympanic membrane. The primary diagnostic modalities are CT scan and MRI for evaluation of the exact anatomical extent and size of the glomus tumors. Embolization following an angiographic study helps to identify the feeding arteries with subsequent blocking of the same, thus helping in the reduction of intraoperative hemorrhage. The currently available modalities of treatment are mainly surgery and radiotherapy.Here, we report a case of a 40-year-old female who presented with unilateral deafness and tinnitus, with no co-morbidities. She showed a red bulging mass behind an intact tympanic membrane on otoscopy and otomicroscopy with mild conductive hearing loss. MRI showed an intensely enhancing lesion in the mesotympanum and hypotympanum along the cochlear promontory. A diagnosis of glomus tympanicum was made based on clinical, audiological, and radiological findings. Pre-operative embolization was carried out 48 hours before the surgery. Complete resection of the tumor was achieved by microsurgery.
Background: Squamosal COM is a condition caused by various etiological factors which are likely to affect the other side too. If diagnosed and intervened in time, the progression of the disease from simple negative middle ear pressure to cholesteatoma formation can be prevented and ear can be protected from hearing loss. Therefore it is important to assess and evaluate the contralateral ear appropriately. Methods: This prospective study included patients above six years of age suffering from unilateral squamosal chronic otitis media. Their contralateral ears were examined and assessed for any ear disease. Results: We found various conditions in contralateral ears ranging from normal tympanic membrane to various types and grades of retractions of pars tensa as well as pars flaccida and some infectious conditions too. The commonest finding was secretory otitis media (23%) and the least common was otomycosis (3%). Conclusions: Most common status in contralateral ear was found to be secretory otitis media in adult and paediatric age groups (23%). In our study, 84% of the patients showed pathology in the contralateral ear and 16% were normal, so the study proves that in patients with unilateral squamosal otitis media, with no complaints or previous history of discharge in contralateral ear shows pathology to quite a good extent¸ so the contralateral ear should always be evaluated comprehensively to efficiently diagnose any alterations and provide timely therapeutic intervention to prevent further progression of the disease and hearing loss.
<p class="abstract"><strong>Background:</strong> Most of the anomalies of the facial nerve have been encountered during otological surgery or dissection of the temporal bones. ENT surgeons are taught from a nascent stage to always be wary of an anomalous facial nerve during otological surgery. Today’s surgeon is assisted with high definition imaging and nerve monitoring; yet iatrogenic facial palsy still is encountered even today.</p><p class="abstract"><strong>Methods:</strong> This study was conducted in a select population of patients who reported with aural symptoms with an aim to see the number of facial nerve anomalies one encounters during aural surgery. The filter applied was no patient with congenital anomaly was considered and patients with squamous COM were also excluded. </p><p class="abstract"><strong>Results:</strong> Almost 4.5% of the patients subjected to surgery had varying kinds of facial nerve anomaly, the most common being dehiscence of the fallopian canal.</p><p class="abstract"><strong>Conclusions:</strong> Facial nerve anomalies are not so uncommon as one expects it to be. So it is mandatory that every ENT surgeon should be well versed with facial nerve anatomy and be wary of any structural anatomical abnormality, and irrespective of the experience it pays to be extra cautious when operating on the ear because in the event of damage to the facial nerve the patient has to carry the stigma of a facial deformity for his/her life.</p>
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