INTRODUCTIONCholesteatoma is a long-standing infection of the middle ear cleft. It is a three-dimensional stratified squamous epithelial sac confirming to the middle ear cleft, containing keratin debris and having the capacity for progressive and independent growth at the expense of the underlying bone, displacing or replacing the middle ear mucosa, and has a tendency to recur after removal.1 It has a destructive nature that erodes the bone and causes rapid bone destruction. Cholesteatoma have characteristics of growth, migration and osseous erosion and are thus locally destructive, the only treatment is their full surgical removal since there is no effective clinical treatment for eradication of the disease so far. 2Chronic ear discharge and decreased hearing are most common clinical presentation in cholesteatoma disease. Other symptoms are tinnitus, earache, ear bleeding. Other warning symptoms are headache, high grade fever, vomiting, giddiness and facial asymmetry suggestive of intratemporal and intracranial complications. ABSTRACTBackground: Cholesteatoma is a long-standing infection of the middle ear cleft having erosive properties. Chronic ear discharge and decreased hearing are most common clinical presentation. Multi-directional tomography of high quality can provide a detailed understanding of the interpretation of anatomical structures visualized by HRCT. Knowledge of the anatomical variations and changes induced by pathology in the temporal bone are the guiding marbles for surgery. Methods: This is a prospective study consisted of 100 cases of chronic suppurative otitis media of unsafe type requiring ear surgery admitted in the E.N.T. department of P.D.U. Civil Hospital Rajkot in 2 years from December 2015 to December 2017. A total no. of 100 patients of both gender between 5 to 80 years has been included in the study. Results: In this study, 58% patients were females while males were 42%. Left ear (46%) was involved more as compared to right ear (40%). Most of the patients belonged to 11-20 (25%) years of age group. Mean age is 24.5 years. Most common symptoms were ear discharge (98%) and decreased hearing (83%). Conclusions: HRCT guides the surgeon on the possible surgical hazards before the surgery and helps in earlier management and operative complications. The use of CT in the case of chronic suppurative otitis media does provide valuable information. HRCT scanning is a unique method of detection of early cholesteatoma as well as detection of cholesteatoma in hidden areas. In addition, HRCT scanning serves as a road map to assist the surgeon during cholesteatoma surgery.
<p class="abstract"><strong>Background:</strong> Deep neck spaces infection is a common challenging condition for otolaryngologist in day to day practice even after availability of higher antibiotics. It may leads to considerable morbidity and complications. The aim of the study was to find out prevalence, predisposing factors and changing trend of deep neck spaces infection in this broad spectrum antibiotics era.</p><p class="abstract"><strong>Methods:</strong> This prospective study was carried out at P.D.U. Medical College and Hospital, Rajkot. 120 Patients were studied who came with deep neck space infection. </p><p class="abstract"><strong>Results:</strong> In this study majority of patient were in the age group of 41-60 year. Odontogenic and oropharyngeal infectionare the most common etiologies. <em>Staphylococcus aureus, Streptococcus, E. colli, Klebsiella</em> and anaerobes were the microorganisms commonly isolated in pus culture and sensitivity test.</p><p class="abstract"><strong>Conclusions:</strong> In spite of availability of broad spectrum antibiotics in present day deep neck spaces infection is the most commonly noticeable condition in developing countries and may lead to considerable morbidity and complications. Inadequate nutritional status, poor oral hygiene and lack of awareness in dental health are common predisposing factors for deep neck spaces infection.</p>
<p class="abstract"><strong>Background:</strong> Nasal blockage is the most common nasal symptom with which patients present in ENT OPD. Sometimes, it is associated with headache and facial pain. The symptoms are secondary to mucosal contact points in the nasal cavity without any observable nasal mass, nasal discharge or turbinate hypertrophy, hence, known as rhinogenic headache or facial pain syndrome.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study done in the department of otorhinolaryngology, at P.D.U. Medical College and Hospital, Rajkot, for a period of twenty months from May 2017 to December 2018. A total number of 100 CT scans of patients aged above 5 years of both genders who presented with complaints of nasal blockage at department of otorhinolaryngology, P.D.U. Hospital, Rajkot. </p><p class="abstract"><strong>Results:</strong> Out of 100 patients above 5 years with symptoms of nasal blockage and CT scan showing anatomical variants, 78 patients had deviated nasal septum as the most common anatomical variant presenting with nasal blockage. Males (62%) were more commonly affected with different anatomical variants; 25-45 year old age group (48%) was the most common affected age group. The other anatomical variants: concha bullosa (13%), paradoxically curved middle turbinate (4%), Onodi cell (2%), Haller cell (2%) and unilateral choanal atresia (1%).</p><p class="abstract"><strong>Conclusions:</strong> Nasal blockage is more common in 25-45 year old males and deviated nasal septum is the most common anatomical variant.</p>
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