<p class="abstract"><strong>Background:</strong> Adenoidectomy is conventionally performed using adenoid curette as a blind procedure. Suction diathermy adenoidectomy is a technique of ablating the adenoid tissue using thermal energy and removing it by suction. This audit aims to study the efficacy and complications of this technique in a tertiary care center.</p><p class="abstract"><strong>Methods:</strong> Retrospective analysis of hospital database was conducted. Twenty-seven patients who underwent suction diathermy adenoidectomy were identified and hospital records studied. Parents were contacted and enquired regarding improvement in child's symptoms.</p><p class="abstract"><strong>Results:</strong> No instances of postoperative complications identified. All except 2 parents were completely satisfied with the improvement in their child's symptoms. Two children had occasional mouth breathing.</p><p class="Standard"><strong>Conclusions:</strong> Suction diathermy adenoidectomy is a feasible alternative to conventional adenoidectomy with few complications and minimal rate of recurrence.</p>
<p>COVID-19 pandemic has significantly changed ENT practice. Most elective ENT (ear, nose, throat) surgeries possess a risk of infection, as well as potentially increasing complication.<sup>1</sup> With the current pandemic slowly evolving and ever-increasing demand for elective services to restart, service delivery with minimal risk to healthcare workers is a challenge. ENT procedures like adenotonsillectomy, microdebrider FESS and mastoidectomy and many more are aerosol generating procedures. Adenotonsillectomy is particularly challenging with high risk to the operating room personnel as the viral load is significantly high in the nasopharynx and oropharynx. Evidence from China shows us that the pandemic could last for at least six months<sup>2</sup> and modifications of techniques and adapting to the new norm is the key.</p>
Background: The second wave of the COVID-19 pandemic in India was associated with an increased incidence of rhino-orbital-cerebral mucormycosis. The objective of this paper was to prospectively explore the epidemiology, management, and results of 18 months follow-up of patients presenting with COVID associated mucormycosis at a tertiary referral centre in India.
Methods: Patients presenting with symptoms suggestive of COVID-associated mucormycosis over two months were included in the study. Patients were staged based on the extent of the disease. Surgery was the primary modality of treatment except in those with intracranial spread, altered sensorium, and poor prognosis. A combination of liposomal amphotericin B and posaconazole was used as adjunct medical treatment. Patients were followed up and outcomes at one year of treatment were recorded.
Results: Out of a total of 26 patients who were diagnosed with COVID associated mucormycosis, 21 patients underwent bimodality treatment (medical and surgical). The extent of surgery was based on the stage of the disease. Six eyes received retrobulbar injections of Amphotericin B to salvage vision. The overall mortality was 38.46% and 23.8% in those where the intent of treatment was curative. At the end of one year, 16 of 21 operated patients survived with mild to severe sequelae.
Conclusions: Mucormycosis is a deadly fungal infection with high mortality. Early diagnosis and prompt, aggressive treatment is paramount in preventing mortality. A multidisciplinary approach is useful for effective management. Continuous follow up is paramount to identifying and treating complications.
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