<p class="abstract"><strong>Background:</strong> Tympanoplasty is one of the common surgical procedure performed in CSOM (TTD), this study was undertaken to determine the outcome of tympanoplasty at a tertiary care teaching hospital.</p><p class="abstract"><strong>Methods:</strong> This analytical observational study was conducted in the department of E.N.T, School of Medical Sciences and Research, from January 2017 to December 2018. Informed consent was taken to participate in the study pure tone audiometry (PTA) was performed before surgery and post-operatively six months. Air-bone gap (ABG) was calculated in pre- and postoperative PTA. The data were analyzed using SPSS (version 20). The p value ≤0.05 was considered statistically significant. </p><p class="abstract"><strong>Results:</strong> Over a peroid of 2 years 168 patients underwent type 1 tympanoplasty 86 were male 21 (51.19%), female 82 (48.80%), age (range 15–53 years). Mean pre-operative air-conduction of 43.12 dB was significantly reduced to 16.12 dB with p value of <0.05. Similarly the pre-operative mean air bone gap on PTA of 35.63±6.35 dB was also reduced to statistically significant level of 7.41±3.51 dB on post-operative PTA with p value of <0.05. Graft was taken up well in 152 cases (90.2%).</p><p class="abstract"><strong>Conclusions:</strong> According to our study surgical outcome of tympanoplasty is fairly good and should be done if patient gives consent.</p>
Introduction A cholesteatoma is a three-dimensional sac lined by keratinized squamous epithelium containing desquamated keratinized epithelial cell which secretes enzymes that have the tendency to expand and erode the bony structure underlying it and cause intracranial and extracranial complications. This cystic mass is in an abnormal location such as the middle ear, the petrous apex, or the external auditory canal (EAC). It is mostly found in the middle ear and rarely in the EAC. Here we have reported a rare case of unilateral primary EAC cholesteatoma with mild hearing loss in a middle-aged male. Case Report We have reported a case of a 34-year-old male with complaints of right-sided ear discharge and right-sided decreased hearing for the last 5 to 6 years. On examination, right ear EAC was found to be dry, and a sac was observed in posterior wall extending to mastoid present with clear attic, and intact retracted tympanic membrane that was then followed by radiological evaluation to establish the diagnosis of EAC cholesteatoma. This was surgically treated and ear was cleared of all disease. Patient's symptoms improved postoperatively. Conclusion Primary EAC cholesteatoma with disease-free middle ear is a rare finding and there is very less definitive literature available on the pathogenesis of the same.
Background Deep neck space infections (DNIs) are a major medical concern in the Indian community. Owing to the complex anatomy of the neck spaces and their communication with each other, accurate diagnosis becomes challenging. A thorough knowledge of the anatomy as well as the microbiological profile and antibiotic sensitivity is imperative to institute the appropriate surgical and medical management to the patient. Due to the advent of broad-spectrum antibiotics, the incidence of these infections have declined considerably over the last couple of decades. However, due to the extensive and unregulated use, the incidence of antibiotic resistance has also been increasing at an alarming pace. Materials and Methods This cross-sectional observational study was conducted in the Department of Otorhinolaryngology at a tertiary care government hospital in an urban area. All patients who presented to the OPD or emergency over a period of 18 months and who fulfilled the eligibility criteria were included in the study. Pus was collected from the abscess, aseptically by needle aspiration using wide bore (18G) needle and transported under all aseptic measures within 24 hours for culture and sensitivity, KOH mount, and detection of AFB. Antibiotic sensitivity testing was done using the Kirby Bauer disc diffusion method and E-test. Results Staphylococcus aureus as the most common infective organism followed by MRSA in the pediatric age group and Klebsiella pneumoniae in adults. Conclusion Primary knowledge of individual antibiotic sensitivity is imperative to ensure prompt and adequate treatment of the patient with higher chances of complete resolution, concomitantly minimizing the risk of resistance. Inadequate and delayed treatment may lead to swift progression of the disease with significant morbidity and mortality.
This study was conducted in Bombay, India, to evaluate and compare the safety and effectiveness of laparoscopic application of the spring‐loaded clip and the tubal ring in 300 immediate postabortion patients. The two techniques were randomly assigned to the study subjects and, to minimize interoperation variability, performed by the same operator. Another physician, unaware of the procedure used, evaluated and cared for the patient after surgery. All but one of these women returned for follow‐up 7–21 days after sterilization, and 74.7% and 81.3%, respectively, of the clip and tubal ring groups reported for the six‐ and 12‐month follow‐up visits. There was one technical failure among the tubal ring cases. Surgical difficulties were encountered in 7.3% of the clip and 8.0% of the ring procedures. The incidence of complications until the first follow‐up visit was significantly higher for the clip (9.3%) than for the ring (4.7%) cases, although none of a serious nature were reported. There were significantly more immediate postoperative complaints among subjects sterilized with the ring than with the clip, but the incidence of early postoperative complaints was similar for the two groups. The rate of pelvic pathology was low at six and 12 months after sterilization, and none of these patients required surgery within a year of sterilization. Three of the women sterilized with the spring‐loaded clip, but none of those sterilized with the tubal ring, became pregnant. Thus, while both devices were associated with clinically acceptable morbidity, the tubal ring was found to be the more effective.
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