Ectasia of external jugular vein is a rare entity presenting as an intermittent neck swelling. High index of suspicion is required to diagnose the condition. Ultrasonography with Doppler before, during and after valsalva manoeuvre is the preferred method for diagnosis. The treatment is conservative for asymptomatic patients and surgery is reserved for patients with complications.
Objective: This prospective comparative study determined the efficacy of type III tympanoplasty using homologous septal spur cartilage in patients with chronic otitis media (COM).
Methods:We selected patients by random sampling. Complete otolaryngological examination including otological examination, tuning fork tests, pure tone audiometry (PTA), and relevant investigations was done. Post-tympanoplasty residual air-bone gap (ABG) was graded. Type III tympanoplasty was done for all and followed up until month 6.Results: Of 50 patients, 70.0% were men. Mean age was 27.72±10.81 years, 24 and 26 patients underwent type III-A and III-B tympanoplasty, respectively. Pre-operative mean PTA and ABG was 50.08 dB and 38.27 dB, respectively. Pre-operative ABG of 31-60 dB was seen in 41 patients while nine had an ABG of 0-30 dB. Overall, pre and post-operative PTA was 50.24 dB and 28.54 dB, respectively. Overall, pre-and post-operative ABG was 38.32 dB and 16.40 dB (III-A 36.92 dB and 14.79 dB; III-B 39.62 dB and 17.88 dB). Mean overall hearing gain postoperatively in PTA was 21.70 dB (type III A 22.33 dB, III B −21.115 dB). Overall, ABG closure was 23.53 dB (type III-A 22.333 dB, III-B −21.115 dB). None had failure (>30 dB). Good ABG of 10-20 dB was seen in 72% and 78% of patients at month 3 and 6, respectively.Conclusion: Significant post-operative hearing improvement was seen in both types of tympanoplasty using homologous cartilage graft for ossicular reconstruction. Type III-A is better than type III-B as the stapes superstructure is vital for hearing.
Branchial cysts are uncommon but a known reason of swelling in the neck. They lie deep to the sternocleidomastoid muscle and present in the anterior triangle of the neck. These cysts are usually seen in young adults. We report a case of Branchial cyst in a 60 year old female presenting with a painless swelling on the right side of the neck.
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