BACKGROUND Chronic otitis media is one of the most common health problems of our country. Perforation in their tympanic membrane and hearing loss are the presenting feature of chronic otitis media. Reconstruction of the hearing mechanism can be done by surgical procedure namely tympanoplasty. This study is being conducted to compare the success rate of tympanoplasty regarding graft uptake, hearing improvement and also to assess the advantage and disadvantage of endoscope and microscope during surgery. MATERIALS AND METHODS This randomized prospective study was conducted in Malda Medical College between August 2015 to July 2018. In this study, 60 patients of chronic otitis media with dry perforation for at-least 3 weeks, in the age group 16-49 years were divided into two equal groups of 30 each. First group underwent type 1 tympanoplasty by microscope and another group underwent type 1 tympanoplasty by endoscope. Data was collected from above patients and statistically analysed regarding graft taken or rejected and hearing improvement. RESULTS This study included 60 patients, 30 patients in each group. Success rate regarding the drum closure in endoscopic group is 86.66%, whereas in microscopic group it was 83.33%. Post-operative A-B gap improvement is also little better in endoscopic group than microscopic group. In endoscopic technique, one patient had medialisation of graft postoperatively. We got one case of medialisation and another case of lateralisation of graft in microscopic method postoperatively. CONCLUSION Endoscope is better for closure of perforated tympanic membrane than microscope because of better field of vision.
BACKGROUND Dacryocystorhinostomy (DCR) operation is the gold standard treatment for management of chronic dacryocystitis due to nasolacrimal duct block. This operation directs the lacrimal flow into the nasal cavity creating an artificial opening made at the level of lacrimal bone, thus obtaining a low-pressure lacrimal bypass system which will relieve epiphora and dacryocystitis. But the commonest reason for failure of this surgery is closure of the rhinostomy (neo-ostium). To overcome this difficulty, silicone tube catheter stent insertion has been advocated. Here in this study, we wanted to compare the success rate of endoscopic DCR with or without silicone tube catheter (STC) stent. METHODS This study was a prospective study conducted among 50 patients divided in to two equal groups randomly. One group underwent Endoscopic DCR with silicone tube catheter stent and another group underwent DCR without stent. We compared outcomes of both groups subjectively with five-point scale and objectively examined patency of the stoma by syringing with water postoperatively after 3 months and results were compared. RESULTS During subjective evaluation, we used five-point scales to get the grade of epiphora relief. First three grades (grade 1 to grade 3) were considered as success. We got an overall success rate of 92 % in without stent group and we got 88 % success rate in silicone tube catheter stent group. CONCLUSIONS Surgical success for Endoscopic DCR surgery encompassed both anatomical patency and symptom relief. We found overall success rate of 92 % in without stent group and 88 % success rate in silicone tube catheter stent group which were closely comparable to other studies. We also found failure due to granulation tissue formation in STC stent group. So the role of stent is yet to be confirmed and further large scale trials are needed. KEYWORDS Endoscopic DCR, Silicone Tube Catheter (STC) Stent
BACKGROUND Head and neck cancers are among the 10 most frequent cancers and are the sixth most common cancers worldwide. Among these cancers, oral cavity in general and gingivobuccal complex in particular is prone to a myriad of changes with advancing age as well as a result of environmental and lifestyle-related factors.The objective of this study was to gain appreciation of the correlation of clinical presentation and habit patterns as well as to note the pathological differentiation and the TNM (Tumour, Node, Metastasis) classification of squamous cell carcinoma (SCC) of gingivobuccal complex in Punjab. MATERIALS AND METHODSThis prospective study was conducted on 30 patients of diagnosed cases of SCC of the gingivobuccal complex in the Department of ENT and Department of Pathology of Government Medical College and Rajindra Hospital, Patiala, Punjab, India. The selected patients were those who reported a definitive history of ulcerative lesion of gingivobuccal complex. Detailed history of patients was taken and tumour data including site, subsite, grade and TNM stage were collected. RESULTSThe mean age of the patients was 52.53 ± 12.91 years. There were 83.33% male and 16.67% female patients. The most common presenting symptoms of SCC of gingivobuccal complex were ulceration, pain and mass in the oral cavity (in all cases) followed by trismus. The most common substance abuse observed was tobacco use. The most common subsite of SCC of gingivobuccal complex was buccal mucosa. The majority of the patients presented in stages I and III (26.67% each). SCC of the buccal mucosa was positively correlated with alcohol use, but the association was statistically non-significant (r= 0.01), but it was positively correlated with smoking and tobacco use (in other form) and the correlation was statistically significant (r= 0.553 and 0.517). CONCLUSIONSCC of the retromolar trigone was positively correlated with alcohol, smoking and tobacco use (in other form) and the correlation was statistically significant.
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