BACKGROUND Chronic suppurative otitis media (CSOM) is a common disease seen in otolaryngology practice. Two clinical types are seen, squamous epithelial and mucosal. The squamous epithelial type is associated with cholesteatoma in the tympanomastoid area. Cholesteatoma has bone eroding properties. This can result in erosion of bony plates surrounding the middle ear and mastoid leading to life-threatening complications. The propensity of ossicular destruction is also higher in patients with cholesteatoma. Pure tone audiometry is used to establish the type and severity of hearing loss. The degree of hearing loss worsens with increased destruction of the tympanic membrane and ossicular chain. Hence, the objective of this study is to evaluate the relationship of ossicular chain defects with the degree of hearing loss in patients with CSOM squamous epithelial type. MATERIALS AND METHODS This is a prospective study conducted from 1 st November 2016 to 30 th April 2017 on 102 patients, who had CSOM squamous epithelial type. These patients were selected randomly and were examined using otoendoscopy, microscopy and pure tone audiometry preoperatively. During surgery tympanic membrane pathology, ossicular chain status and disease in the middle ear like cholesteatoma and granulations were recorded and analysed. RESULTS Majority of patients ranged between 21 to 30 years with male: female ratio being 1.6: 1. Epitympanic cholesteatoma was the commonest finding. The most frequently eroded ossicle was the Incus (94.1%) with Stapes being eroded in 47.1% of patients. The Malleus was the most resilient ossicle and was eroded in 32.4%. Type A defect was commonest and hearing loss was highest for type D defect with a pure tone average (PTA) of 55.83 db and average air bone gap (ABG) of 39.68 db. CONCLUSION This study defines the status of individual ossicles with the degree of hearing loss in patients with CSOM squamous epithelial type. Malleus was found to be the most resistant ossicle to erosion, whereas the Incus was the most susceptible. Pure tone audiometry gives a broad perspective about the ossicular status and serviceable hearing that can be attained postoperatively.
A polypoidal mass in the nasal cavity is a condition commonly encountered by the Otorhinolaryngologist. A diverse group of lesions may present themselves as polypoidal masses. A number of benign looking polyps often turn out to be malignant lesions or vice versa. OBJECTIVES: This study is intended to clinically differentiate the various conditions presenting as nasal polypoidal lesions, to understand their exact nature by histopathological examination and thereby learn the relative incidence of individual conditions encountered. METHODOLOGY: Detailed history, clinical examination and histopathological examination of nasal polypoid masses were done in 73 patients. Incidence, clinical features and histopathological correlation of all the polypoidal masses were ascertained. RESULTS: Of the 73 cases, 53 (72.6%) cases were non-neoplastic and 20 (27.4%) were neoplastic lesions. The non-neoplastic lesions included nasal polyps, rhinosporidiosis, pyogenic granuloma and mucocoele. Benign neoplasms included inverted papilloma, haemangioma, angiofibroma, neurilemmoma and pleomorphic adenoma. Malignant neoplasms included squamous cell carcinoma, adenoid cystic carcinoma and olfactory neuroblastoma. CONCLUSION: Polypoidal masses in the nose may range from non-neoplastic lesions to benign and malignant neoplasms with various histopathologic findings. It is impossible to distinguish between such lesions clinically. Hence, it is essential that all polypoidal masses removed should be evaluated histopathologically, to make a correct diagnosis.
BACKGROUNDNot long ago, HIV was an infection which used to be a progressive, advancing and incurable illness with no effective treatment and leading to fast deterioration in health resulting in death. The advent of ART (Anti-Retroviral Treatment) has made a remarkable effect on the management, as HIV/AIDS are living longer and this often means living with ailments that include auditory dysfunction. This study was done to know the effect of ART on hearing in HIV positive patients.
Cigarette smoking and alcohol consumption has multiple effects on the thyroid gland. Ingestion of alcohol produces striking of metabolic imbalance in the liver, it leads to formation of reactive oxygen species, cigarette smoke is known to stimulate the alveolar macrophages to release excessive amount of free radicals which causes pathogenicity. Our study was designed to assess the thyroid status in smoking & alcoholism, also oxidant and antioxidant status in smokers and alcoholics. MATERIALS & METHODS: The study was conducted in50 smokers & alcoholics, they smoke 10-15 cigarettes per day and all are having history of alcohol intake from past 10-15years, as well as 25 healthy non-smoker volunteers served as controls. All the subjects are attended to O.P.D and admitted in medicine department P.E.S. Medical College & Hospital, Kuppam, A.P. The study was done by assessing thyroid profile (FreeT3,FreeT4,TSH) by ELISA method and oxidative stress parameters protein carbonylation, reduced glutathione were studied in RBC by colorimetric method. RESULTS: There is slightly elevated levels of TSH compared with controls (p=0.005). Free T3 levels slightly lowered compared with controls (p=0.001). Free T4 levels are normal in range for smokers and alcoholics. Reduced glutathione levels are decreased slightly compared with controls (P=0.076). Protein carbonylation is increased compared with controls (P=0.001). CONCLUSIONS: The above findings suggest that there is fall in thyroid action due to alcoholic liver damage, Antioxidants levels are decreased and oxidant levels are increased due to oxidative damage.
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