Objectives: The purpose of this study was to find out the presenting features, diagnostic problems, treatment, and prognosis of Wegener`s granulomatosis (WG), with special reference to ENT manifestations. Study Design: It was a prospective descriptive study. Study Setting: The study was conducted at the Department of Otorhinolaryngology and Head & Neck surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from 1st March1999 to 30th Sep 2001. Results: The ten patients included in this study comprised of six males and four females, with a male to female ratio of 1.5:1. The age of patients ranged from 16 years to 55 years with an average age of 38.5 years. The most common presentation in our patients was due to nasal involvement of disease. Nasal obstruction, epistaxis, and rhinorrhoea was seen in 80% of patients with WG. Next common symptom was headache (60%) followed by other symptoms Two patients had ear pain and conductive deafness along with nasal symptoms. One patient in addition to nasal symptoms mentioned presented with saddle nose deformity. One patient presented with hoarseness and progressive stridor, having subglottic stenosis as an isolated finding. Conclusion: Most common symptoms in WG localized to ENT region are nasal obstruction, rhinorrhoea and epistaxis. Biopsy and c-ANCA have key role in diagnosis of WG. ESR has a good prognostic relevance
Meniere’s disease is chronic progressive disease with unclear idiopathic etiologyand symptomatic improvements with treatment. Objectives: To analyze the efficacy of lowdose intratympanic injection of gentamicin for vertigo control in unilateral Meniere’s disease.Study Design: Quasi experimental study. Settings: Department of ENT, PIMS, NESCOM &IMDC Islamabad. Materials & Methods: Gentamicin was used intra tympanically in thismulticentre study of 75 patients over a period of 8.5 years between 1st January 2005 to 30th June2013 in definite Meniere’s disease according to the 1995 Document of American academy ofotolaryngology- Head and Neck Surgery (AAO-HNS).All these centers followed same criteriaand procedures. Single dose of 1 ml Gentamicin solution 40 mg/ml was instilled in the middleear through the grommet under microscope and followed up for 3 months and two years. Thestaging of disease (hearing thresholds) the degree of disability (frequency of attacks per month)and the functional level were assessed before and after treatment. Results: Among 75 patients,41 were female & 34 were males between age ranges of 25 to 70 years. Most of the patients inthe study had stage 2 (23/75) and stage 3 (41/75) Meniere’s disease. About 68(91%) patientswere having good control of vertigo at the end of two year of intratympanic gentamicin withoutany loss of hearing. Conclusion: A single Low dose intratympanic gentamicin is effective incontrolling vertigo in patients with Meniere’s disease with no further deterioration in hearing forat least two years follow up.
Meniere's disease is chronic progressive disease with unclear idiopathic etiology and symptomatic improvements with treatment. Objectives: To analyze the efficacy of low dose intratympanic injection of gentamicin for vertigo control in unilateral Meniere's disease. Study Design: Quasi experimental study. Settings: Department of ENT, PIMS, NESCOM & IMDC Islamabad. Materials & Methods: Gentamicin was used intra tympanically in this multicentre study of 75 patients over a period of 8.5 years between 1 st January 2005 to 30 th June 2013 in definite Meniere's disease according to the 1995 Document of American academy of otolaryngology-Head and Neck Surgery (AAO-HNS).All these centers followed same criteria and procedures. Single dose of 1 ml Gentamicin solution 40 mg/ml was instilled in the middle ear through the grommet under microscope and followed up for 3 months and two years. The staging of disease (hearing thresholds) the degree of disability (frequency of attacks per month) and the functional level were assessed before and after treatment. Results: Among 75 patients, 41 were female & 34 were males between age ranges of 25 to 70 years. Most of the patients in the study had stage 2 (23/75) and stage 3 (41/75) Meniere's disease. About 68(91%) patients were having good control of vertigo at the end of two year of intratympanic gentamicin without any loss of hearing. Conclusion: A single Low dose intratympanic gentamicin is effective in controlling vertigo in patients with Meniere's disease with no further deterioration in hearing for at least two years follow up.
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