Multidetector computed tomography virtual bronchoscopy is a sensitive and specific diagnostic tool for identifying radiolucent vegetable foreign bodies in the tracheobronchial tree. It can also provide a useful pre-operative road map for rigid bronchoscopy. Patients suspected of having an airway foreign body or chronic unexplained respiratory symptoms should undergo multidetector computed tomography virtual bronchoscopy to rule out a vegetable foreign body in the tracheobronchial tree and avoid general anaesthesia and invasive rigid bronchoscopy.
The aim of this study is to evaluate the results of closure of subtotal perforation by tympanoplasty using underlay technique with the perichondrium/temporalis fascia graft supported by single cartilage slice anteriorly. Our hypothesis was that the cartilage support, single slice, offers an extremely reliable method for reconstruction of the tympanic membrane in cases of advanced middle ear pathology and Eustachian tube dysfunction. Retrospective and prospective study of patient undergoing tympanoplasty in subtotal perforation with graft supported by a slice of cartilage between March 2000 and October 2005. Intact perichondrium/temporalis fascia was placed as graft in subtotal perforation, supported by a slice of cartilage. Slice was placed anteriorly from hypotympanum to anterior part of attic. It does not obstruct Eustachian tube opening, as it is curved with concavity facing towards medial wall and lined by perichondrium without any raw area, which prevents adhesion formation. Hearing results were reported using four frequency (500, 1,000, 2,000 and 3,000) pure tone average air-bone gap. During the study period, perichondrium/temporalis fascia graft with support of cartilage slice was used for tympanic membrane reconstruction in 94 patients. Overall graft take rate was 98.94 %. In 95.74 % of patients of different types of tympanoplasty achieved hearing level of 30 dB or less. Complications included residual perforation in (1.06 %), infection or gaping of wound in 2 (2.13 %). Cartilage slice support offers an extremely reliable method for reconstruction of tympanic membrane in cases of high-risk perforation (subtotal perforation, retraction pocket, cholesteatoma, anterior perforation of tympanic membrane).
Spontaneous retropharyngeal haematoma is an unusual condition and difficult to diagnosis early especially in infants. It has multiple aetiological factors and can present to a number of specialists including the otolaryngologist. We describe an unusual case of a spontaneous huge retropharyngeal haematoma in 1-year-old male child which demonstrates the dramatic presentation and emphasizes the need for immediate surgical approach.
A significant number of patients seen in otorhinolaryngology have symptoms of vestibular dysfunction. Examination of vestibulo-ocular reflex has been and still is the principal method of evaluating vestibular functions. Electronystagmography (ENG) has been the gold standard to test the vestibular functions. The present study aims to evaluate the utility of ENG in diagnosing the etiology of vertigo. Total of 50 patients of either sex presenting with vertigo underwent ENG after a detailed history according to the proforma of questionnaire and routine ENT examination attending ENT OPD. In selected cases CT/MRI scan and other relevant investigations were done. Nystagmorite 2 ? 1 channel machine was used to study the spontaneous nystagmus and bithermal caloric tests, parameter used for evaluation of ENG being central culmination frequency. The results were transferred on Claussan's Butterfly chart. In our study Peripheral lesion was observed in 29 cases, 19 cases had central lesion while 2 cases were mixed lesion. The data obtained was compared with those reported in other series. It was concluded that, supported by detailed history and neuro-otological examination ENG was found to be an essential tool for the diagnosis of vertigo whether central or peripheral origin along with identification of etiology of vertigo.
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