Background: Chronic rhinosinusitis (CRS) is a group of disorders characterized by inflammation of the mucosa of the nose and paranasal sinuses of at least 12 consecutive weeks duration. Surgical intervention may be required if severe symptoms of obstruction and infection prove medical treatment to be ineffective. Little is known about the outcomes of patients electing to continue medical management or the comparative effectiveness of continued medical therapy with FESS. Methods: The study was conducted on 126 adult patients in the age group of 18-55 who fulfilled the CRS criteria with nasal polyposis. All patients were medically treated for the CRS, and observed after 3 weeks. In case the treatment was not effective; they were scheduled for FESS intervention and further observed after another 6 weeks. The improvement of the patients was measured by Visual analogue score, nasal endoscopy score and saccharine test. Results: Males between 41-50 were the most common patients with CRS. There was a significant improvement in the VAS score, nasal endoscopy score after 3 weeks of medical treatment. In 88% of patients the saccharine score was normal showing that this was not an effective measure for assessing the improvement. Conclusions: Medical treatment was found to be sufficient to treat most symptoms of CRS with nasal polyposis (grade 1 and 2). Surgery should only be done in refractory cases. Selection of those patients who will benefit from surgery should be based on the patient's symptoms and not on the examiner's polyp score. Quality of life is not proportional to polyp size (Upto grade 2).
Introduction: Most cases of sudden sensorineural hearing loss (SSHL) are idiopathic, so there is no specific treatment protocol for this set of patients, which is accepted worldwide. Some temporal bone studies regarding histopathological findings in SSHL cases found that most of the lesions were in the cochlea and its structures. The histological findings suggest that some inflammatory, vascular or immunological aetiology are present behind such lesions in cochlea. Inflammation being one of the major among all the aetiologies, so steroids are the mainstay of treatment for Idiopathic sudden sensorineural hearing loss (ISSHL) cases. Material and methods: A prospective comparative study was done on 56 patients aged 18 to 70 years. Patients received 4mg/ml dose (Arm A) or 8mg/ml dose (Arm B) ofintratympanic dexamethasone injection. The targeted recovery on 5th day after 1st intratympanic steroid injection was compared with baseline Pure tone Audiometry (PTA)of day 1 for both the groups. Statistical analysis: More than 20db improvement in PTA average (0.5K,1k and 2k) onassessment at 5th day after 1stinjection was considered as recovery criteria. A comparison was done on improvement between two arms.
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