Temporalis fascia has long been regarded as the ideal graft material for tympanic membrane repair. However it often does not seem to withstand negative middle ear pressure in the post operative period. Tragal cartilage with perichondrium would appear to be a better graft material with good hearing outcome. It can be obtained easily with cosmetically acceptable incision. In the present study, we have compared the graft properties of temporalis fascia verses tragal cartilage perichondrium with respect to healing, hearing and rate of post operative retraction or reperforation. 132 patients of chronic otitis media with pure conductive hearing loss were posted for tympanoplasty. Temporalis fascia graft was used in 71 patients and cartilage perichondrium (composite graft) was used in 61 patients. Post operative healing, hearing and rate of retraction or reperforation was compared for both the graft materials. All the patients were followed up for 2 years. Patients where temporalis fascia graft was used, 60 (84.5%) showed a good neotympanum, 7(9.85%) had reperforation and 5(7.04%) had retraction pockets. Patients where tragal cartilage perichondrium was used, 60(98.36%) showed a healed tympanic membrane and only 1(1.63%) had reperforation. None of the patients showed retraction pocket or cholestetoma. Postoperative hearing was accessed 6 months after surgery. Patients with temporalis fascia graft showed an air bone gap of less than 10 dB in 49 (82%) patients and more than 10 dB in 11 (18%) patients. Air bone gap closure with tragal cartilage perichondrium was less than 10 dB in 45 (78%) patients and more than 10 dB in 13 patients (22%). Tragal cartilage perichondrium (\0.5 mm) seems to be an ideal graft material for tympanic membrane in terms of postoperative healing and acoustic properties. It can easily withstand negative middle ear pressure which may have contributed to the development of otitis media and significantly affect healing outcomes in postoperative period. Tragal cartilage being composed of collagen type II is also physiologically similar to the nature of the tympanic membrane.
A chronic discharging ear has been a perpetual problem and a source of worry to the otologists for centuries because of its high rate of morbidity. Active squamous chronic otitis media is a commonly encountered disease entity which requires prompt surgical management. The surgical procedure most commonly employed is modified radical mastoidectomy. This results in an 'open' cavity with its attendant problems of recurrent breakdown and discharge. Mastoid obliteration technique would appear to be the best solution for these cavity problems. Forty cases of active squamous chronic otitis media were studied. The patients were randomly divided into two groups of 20 each. The group of 20 controls had an open mastoid cavity. Out of the 20 cases, patients were divided in four groups of 5 each. For each group the mastoid cavity was obliterated with cartilage, bone dust, hydroxyapetite and Singapore swing. Healing of the cavity and the associated cavity problems in terms of pain, discharge, giddiness and wax formation, were assessed. The incidence of pain, discharge, giddiness and wax formation was markedly reduced in obliterated cavities as compared to open cavities. Healing of the cavity as evidenced by epithelialisation, at the end of 6 months, was better in those ears where cavity was obliterated (90%) as compared to those with open cavity (70%). Cases obliterated with bone dust and Singapore swing had better and early epithelialisation (100%) as compared to cartilage and hydroxyapetite (80%).
Background: Despite the prevalence of ultrasonography in medical practice, its use in laryngeal disorders appears underutilized. It provides a simple, easy, cheap and non-invasive method to diagnose vocal cord palsy in real time, dynamic 2 or 3-dimensional image mode. It can be an alternative diagnostic tool where fl exible fi breoptic laryngoscopy is limited by an uncooperative patient, xylocaine sensitivity or where stroboscopy is not available due to cost restraints. Especially it is useful in the preoperative workup of a patient undergoing thyroid surgery. Aims: The present study evaluates the accuracy of ultrasonography in diagnosis of vocal cord palsy in 25 patients. We have used fi breoptic laryngoscopy purely as a comparative tool for purposes of this study. Materials and Methods: It was a prospective study carried out in 25 patients presenting with hoarseness. Patients underwent laryngeal ultrasound followed by fl exible fi breoptic laryngoscopy. Results: We were able to accurately diagnose vocal cord palsy by ultrasound in all but two patients where the examination was limited by extensive laryngeal cartilage calcifi cation. Discussion and Conclusion: There is every evidence to suggest that ultrasonography has a place in diagnosis of vocal cord palsies. It is easy, cheap, available, and non-invasive. It is a useful tool where fi breoptic laryngoscopy is limited by an uncooperative patient and where strobolaryngoscopy is not available. Further study and more familiarity would extend its use to other laryngeal disorders.
Introduction We report a rare case of isolated parotid abscess due to Mycobacterium fortuitum in an immunocompetent adult female, which to the best of our knowledge (on internet search) is the first case of its type. Methodology Diagnosis was based on MTBDR CM assay (Hain's) culture, followed by a positive TBAg MPT64 culture for MOTT. The patient was treated with abscess drainage and antibiotics with good results. A parotidectomy was not required in our patient. Conclusion Mycobacterium fortuitum parotid abscess is very rare. A knowledge of the pathogenicity of this organism and careful culture methods seem to be the key of accurate diagnosis. Treatment protocols are still subject to research. How to cite this article Chhapola Shukla S, Matta I. Mycobacterium Fortuitum causing Isolated Parotid Abscess in an Immunocompetent Adult Female: A Case Report and Review of Literature. Int J Head Neck Surg 2015;6(3):125-127.
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