Early detection and timely treatment of chronic suppurative otitis media in rural and illiterate patients may prevent life-threatening complications and reduce their incidence. Ears that harbour relatively large quantities of both cholesteatoma and granulation tissue together require more urgent surgical intervention and more extensive disease clearance in order to prevent complications.
CI is feasible in COM with cholesteatoma and open cavities with the use of STP and single-stage implantation can be performed in the absence of purulence. Despite low risk of residual cholesteatoma post meticulous disease removal, risk of DE remains, particularly in open cavity patients, and is higher than standard implantation. Reimplantation is often possible with careful considerations.
In the pre-vaccination era, diphtheria was a leading cause of childhood mortality. With the introduction of routine childhood immunization, paediatric care and improved hygiene status the disease has been almost completely eradicated in many developed countries. On the contrary developing countries, still account for 80-90% of the global burden. Retrospective analysis of 52 cases of diphtheria over a period of 12 years at a tertiary referral hospital was carried out. They were analyzed for mortality and morbidity trends, immunization status, microbiological confirmation rates and antidiphtheritic serum (ADS) administration. Incidence in those over 5 years was 59.61%. Only 11.54% cases were either partially or fully immunized. The case fatality rate was 36.53%. Culture was performed only in 17 cases whereas ADS was administered in only 16 cases. In conclusion, the occurrence of diphtheria even in those immunized highlights the flaws in the present immunization program. Poor immunization coverage, lack of ADS, antibiotic resistance are the main reasons for re-emergence of diphtheria.
Objective:
To study the early and late facial nerve (FN) outcomes in different tumor classes in addition to determining the predictive factors for the same.
Study Design:
A retrospective clinical study.
Setting:
A quaternary referral otology and skull base center.
Patients and Methods:
A retrospective study of 1983 cases of vestibular schwannomas (VSs) with preoperative normal FN function, undergoing total excision with anatomical preservation of the nerve by enlarged translabyrinthine approach (ETLA) were included. FN status was recorded postoperatively at day 1, at discharge, and at 1-year follow-up and were analyzed in different tumor sizes.
Results:
At 1 year, 988 patients with House–Brackmann (H–B) grade I and II FN at day 1 after surgery, 958 (96.9%) maintained their status up-to 1 year. Of the 216 patients with H–B grade III at day 1 after surgery, 113 (52.3%) improved to H–B grade I and II. Similarly, of the 779 patients with H–B grade IV and VI FN function at day 1 after surgery, improvement to H–B III and H–B I and II were noted in 442 (56.7%) and 80 (10.3%) of patients, respectively. Intrameatal and extrameatal tumors upto 2 cm showed better recovery from H–B grade III to H–B I and II and from H–B grade IV and VI to H–B I and III when compared with extrameatal tumors >2 cm (p = 0.001).
Conclusion:
Tumors of smaller sizes have good immediate postoperative FN results and recover well at the end of 1 year while more than 3 cm have poor outcomes and recover poorly at the end of 1 year. When the VSs reaches more than 1 cm, the HB I and II outcomes drop significantly.
Incorporating etiology into MEHs is a key-step that can be used as a guidance in choosing the right surgery. MEO is a part of armamentarium, and should be used whenever needed, if the objective is performing a definitive surgery.
In patients with good facial nerve function (House-Brackmann grade I-II), a wait-and-scan approach is recommended. In cases where the facial nerve has been interrupted during surgery, the cable nerve interpositioning technique is a convenient and well-accepted procedure for immediate restitution of the nerve.
Hypertrophy of inferior nasal turbinate is one of the most common causes for nasal obstruction (NO). As diode laser has proven to be as effective as any other lasers, our objective was to study various primary outcomes of its use of diode laser like improvement in NO, intraoperative bleeding, postoperative pain, and rapidity of healing. The study was undertaken to compare the various outcomes by diode laser turbinate reduction (LTR) and conventional partial inferior turbinectomy (PIT). A nonrandomized controlled trial was conducted on 2 groups: One group (30 cases) underwent LTR and PIT was performed in the other group (30 cases). The improvement in NO was measured postoperatively up to 6 months. Intraoperative bleeding was measured and postoperative pain scores were assessed each day up to fifth postoperative day. Lastly, rapidity of healing was evaluated until 6 months. Subjective relief of NO was 90.8% in LTR group, whereas it was 65% in PIT group at 6-month follow-up, which was statistically significant ( P < .05). Pain scores were higher until 5 days in PIT group compared to LTR group ( P = .0001). Intraoperative bleeding mean scores (milliliters) were 8.03 in LTR group compared to 23.29 in PIT group ( P = .00001). Rapidity of healing was faster in LTR group with mean scores of 3.03 weeks in comparison to PIT group where it was 6.33 weeks ( P = .00001). Compared to the conventional technique, the outcomes were better with diode laser and caused less morbidity.
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