Aim: To determine the improvement of hearing after grommet insertion in patients with secretory otitis media. Study Design:A Quasi-Experimental study. Place and Duration: ENT, Head & Neck Surgery department of Lady Reading Hospital MTI, Peshawar and Azra Nahid Medical College, Lahore for duration of two years from February 2019 to February 2021. Methods: The study was performed on 48 ears with secretory otitis media. Before the operation,evaluation of both ears along with tympanmontometry and Pure Tone Audiometry were performed. Documentation ofhearing loss was done pre-operatively. During the operation accomplished under GA, a grommetwas placed in the anterior inferior quadrant of the tympanic membrane. After the surgery, PTA was repeated in the postoperative period before the patient was discharged from the hospital. Results:Our study included 28 patients with secretory otitis media and a total of 48 ears. Of the ears, 27 (56.25%) were male and 21 (43.75%) were female. Both ears were affected in 21 patients. Two patients had unilateral ear involvement. The right ear was affected in 26 cases (51.1%) and the left ear in 22 cases (48.9%). 7-55 years was the age range of the patients and 14.10 ± 9.11 years was the mean age. The degree of preoperative hearing loss was mild (20-40 dB) in 5 (10.41%) ears, moderate (40-60 dB) in 37 (77.1%) ears and severe (60-80 dB) in 6 (12.5%) ears. The degree of postoperative hearing loss was mild (20-40 dB) in 36 ears (75%), moderate (40-60 dB) in 11 ears (22.9%) and severe (60-80 dB) in one ear (2.1%). Hearing improvement was not seen in 8 (16.6%) ears, an improvement of 5-10 dB in 34 (70.8%) ears, and an improvement of 10-20 dB in 6 (12.5%) ears. There was a statistically significant difference between preoperative and postoperative hearing loss in the ears, the hearing loss was significantly less after grommet insertion; p = 0.017. Conclusion:The insertion of Grommet provides a significant improvement in hearing in patients with secretory otitis media. Keywords:Pure tone audiometry, Tympanometry, Middle ear, Secretory otitis Media and Grommets.
Objectives: Our study is comparing the effectiveness of 7.5% Povidone-iodine with 1% Clotrimazole ear drops and lignocaine in the management of Otomycosis to highlight the importance of replacing conventional antifungals in routine practice. Setting: Department of ENT and Head and Neck Surgery, Holy Family Hospital, Rawalpindi, Pakistan. Study design: A prospective randomized control trial Methodology: This study was conducted for 12 months in our institute from July 2014 to June 2015. A total number of 148 patients with clinically diagnosed Otomycosis between the age group 15 to 55 years were studied. All patients with a clinical diagnosis of Otomycosis presenting with all four features of earache, itching, ear-blockage, and ear discharge in ENT OPD were included. Ear swabs were taken and sent for fungal culture. Patients were divided into A and B groups each comprising of 74 patients. Group A received 1% Clotrimazole ear drops and lignocaine and group B received 7.5% Povidone-iodine for 14 days after the results of cultures were received. At the end of 14 days, patients of both groups were compared based on the resolution of symptoms and signs. Results: At the end of 14 days, 32 out of 74 patients (43%) in group A receiving 1% Clotrimazole ear drops and lignocaine reported resolution of all symptoms, and 52 out of 74 patients(70%) showed complete resolution of all signs, while in group B,68 out of 74 patients(91%) showed complete resolution of symptoms and 69 out of 74 patients (93%) showed complete resolution of signs. Our study showed significant improvement in signs and symptoms of Otomycosis achieved by treatment with 7.5% Povidone-iodine compared to that achieved by 1% Clotrimazole ear drops and lignocaine. Conclusion: 7.5% Povidone-iodine is a more effective antifungal agent in the treatment of Otomycosis as compared to 1% Clotrimazole ear drops and lignocaine.
Schwannoma is a benign tumor of axonal nerve sheath. Head and neck area, particularly parotid gland is an uncommon site for Schwannoma, however it can rarely arise from the intraparotid part of facial nerve and present as either a symptomless mass or facial paresis. Its diagnosis before surgical intervention is important for the conservation of parotid gland and facial nerve. On clinical examination and imaging studies, it can be misdiagnosed easily. FNAC is a helpful tool for its diagnosis. This entity should not be ignored while dealing with parotid masses. We present a case of a patient who came with the complaint of a parotid mass. Magnetic imaging resonance (MRI) scan suggested a parotid tumor which proved to be a spindle cell neoplasm on Fine Needle Aspiration Cytology (FNAC). A definite diagnosis of schwannoma of intraparotid facial nerve was made on histopathological examination of the excision sample.
Background: Oral tongue is found to be the most common intraoral subsite with worse prognosis despite the use of multimodality treatments. Extensive resections have resulted in loss of form and function of tongue in advanced tumors. The objective of the study was to analyze the role of induction chemotherapy (IC) in intermediate to advanced staged oral tongue cancer for organ preservation and survival outcome in a developing country. Materials and Methods: The records of oral tongue cancer patients treated from 2007 to 2016 were retrospectively analyzed. Results: Eighty-one oral tongue cancer patients with advanced stage were treated using induction arm in 10 years. The median follow-up was 24 months with 3- and 5-year survival of 77% and 58%, respectively. IC has an overall response in 87% of the patients at primary site. The chemotherapy has completely resolved the nodal disease in 17% of the patients, but 23% of the patients had failed to respond. Only 21% of the patients received reconstruction using local or regional flaps. Conclusion: IC has shown encouraging results in advanced staged oral tongue cancers with function preservation and improved survival outcome in less privileged high-volume centers.
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