Nasal packing has evolved over the years. Though effective in preventing postoperative bleeding complications, they are associated with significant morbidity and pain. In recent years nasal splints have been used to reduce the duration of nasal packs. The aim of this study is to compare the postoperative results in 200 nasal surgeries where in nasal packing was replaced by trans-septal splint suturing. Two hundred cases of septoplasties were prospectively studied over a period of 5 years at Adichunchanagiri Institute of Medical Sciences. In 100 cases (group A) nasal packing was done postoperatively whereas in other 100 (group B) trans-septal splint suturing was done. Post operatively patients were followed up in both groups regarding the presence of pain, bleeding, crusting and synechiae for a period of 6 months. Two hundred patients were prospectively studied over a period of 5 years with a male-female ratio of 1.35:1 and the mean age was 31. In group A out of 100 patients followed postoperatively, ten had mild bleeding on second day after pack removal none of which required repacking, 22 patients had mild pain on second and third day, 18 had moderate crusting on day 4, 12 had synechiae after 2 weeks. In group B, out of 100 patients, minimal bleeding was noted in 13 patients on day 1 and 2, mild discomfort was noted in the nose in 34 patients till day 7 (day of splint removal), crusting was noted in six patients, synechiae was noted in one patient. Elimination of pain and discomfort for the patients and absence of complications like synechiae. Also the hospital stay is less than with nasal packing. Therefore, suturing of the nasal septum with a splint after septoplasty should be a preferred alternative to nasal packing.

No abstract

Ectopic thyroid is an uncommon embryological aberration of the thyroid descent. Subhyoid median ectopic thyroid gland is a result of incomplete descent of the thyroid anlage and is characterized by a cosmetically unacceptable ovoid mass of thyroid tissue in the midline overlying the thyroid cartilage and thyrohyoid membrane. A normally placed thyroid gland is not detectable and in most cases all functioning thyroid tissue is located within the mass. Most of the ectopic thyroids are usually mistaken for a thyroglossal cyst and excised. Severe myxedema follows removal. Many cases have been reported in the literature, none of which was recognized prior to operation. All patients were operated upon for removal of a thyroglossal duct cyst. The diagnosis was missed at operation and in these cases severe myxedema was universal. The cause of the myxedema was not always immediately recognized. Therefore, many diagnostic tests including thyroid function test, ultrasound of the neck, and thyroid scanning had been recommended in the preoperative evaluation of a thyroglossal cyst. Here, we present a case of ectopic thyroid mass which was the only thyroid tissue present in the neck. So, division and repositioning of the thyroid mass thereby redefining the anatomy was done with good cosmetic results.

Introduction: A new novel technique was used to manage seroma of the auricle as a primary treatment.

Background and objectives: To study the efficacy of peri-tonsillar infiltration of 0.75%ropivacaine with adrenaline in the management of post-tonsillectomy pain. Materials and methods: This prospective study was conducted in the department of Otorhinolaryngology and Head and Neck Surgery, Adichunchanagiri Institute of Medical Sciences, B.G. Nagara, Mandya district. The study period was from November 2017 to July 2019. A sample size of 30 patients which satisfied the inclusion criteria was included in the study. Ropivacaine (0.75%) with Adrenaline (1:200000) was locally infiltrated on the right side (R-side) in the peri-tonsillar region before the surgery and in the tonsillar fossa after the surgery. The left side was considered as the control side. Patients were followed up on 1st and 7th post-operative days for the measurement of post-operative pain. For the assessment of post-operative pain, Visual Analogue Scale was used (VAS). Results: 17(56.7%) females and 13(43.3%) males participated in the study. Majority of the cases belonged to <10 years of age group. On 1st post-operative day, pain on the right side was significantly lower compared to the left side (p value <0.0001), however the reduction of pain scores on right side compared with that of the left side was not significant (p value=0.536) on the 7th post-operative day. Interpretation and conclusion: The peri-tonsillar infiltration of ropivacaine(0.75%) with adrenaline (1:200000) is effective and significant in reducing post-operative pain on the 1st post-operative day, but not so significant on the 7th post-operative day .Hence we recommend the use of peri-tonsillar infiltration of ropivacaine (0.75%) with adrenaline in view of better management of post-operative pain.