The purpose of this study is to compare the efficacy of myringoplasty with or without cortical mastoidectomy in terms of freedom from discharge, graft take up and improvement in hearing. This is a Clinical prospective study of 120 patients from among a group of patients with chronic suppurative otitis media. A detailed history and examination was conducted including pure tone audiogram. Patients were randomly divided into two groups; group A would undergo myringoplasty only and group B would undergo cortical mastoidectomy with myringoplasty. Patients were reviewed after 3 weeks for inspection of the operated ear. Second post-operative review was at 3 months for clinicoaudiological assessment. Group B was found to have slightly more improvement as compared to the other group. No significant difference in the success rates of graft take-up in patients with unilateral or bilateral disease was found. Higher take up rates were seen in large (91.83 %) and medium perforations (90.69 %). In all our failed cases, post-operative ear discharge continued to be a persistent and troubling problem. The average audiological gain was 12.88 dB in group B, whereas it was 12.40 dB in group A. The reduction of air bone gap within each group was found to be significant. There is no statistical significant data indicating that tympanoplasty with mastoidectomy yields better results. When considering the addition of a mastoidectomy to a Tympanoplasty, the performing surgeon should consider not only the potential added benefit but also potential risks and costs to the patient.
Lobular capillary hemangioma is a benign, rapidly growing lesion of the skin and mucous membranes. It may rarely present as a mass that entirely fill the nasal cavity with an unknown etiology. Although it has no predilection for age, it is more common in the third decade and in females. Lobular capillary hemangioma usually involves the gingiva, lips, tongue, and buccal mucosa. The nasal cavity is a rare location. The most common symptoms are nasal obstruction and epistaxis. The treatment is nasal endoscopic surgery even for large lesions as it does not require embolization preoperatively. We present a case report of a 45-year-old male patient with lobular capillary hemangioma who presented with epistaxis and nasal obstruction. The diagnosis of capillary hemangioma must always be kept in mind when discussing the differential diagnosis of a rapidly growing bleeding mass of the nasal cavity even though it is a rare entity.
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