<p class="abstract"><strong>Background:</strong> Nasal polyps are benign, chronic, inflammatory lesions arising from the mucosa of the nasal sinuses or from the mucosa of the nasal cavity. They are a challenge to treat due to their uncertain etiology and tendency to recur. Therapy involves both medical and surgical treatment. Surgical management includes Endoscopic sinus surgery using conventional instruments or by microdebrider.</p><p class="abstract"><strong>Methods:</strong> We conducted a study on 80 patients with nasal polyposis in whom conservative management failed. They were equally randomised into powered and conventional instruments Endoscopic Sinus Surgery (ESS) groups. The groups were compared for surgical outcomes, intra and postoperative complications and recurrence rates. </p><p class="abstract"><strong>Results:</strong> Age of patients suffering from bilateral nasal polyposis ranged from 18 to 55 years with maximum number of patients in the group 31 to 40 years. Nasal polyps were more commonly seen in men (53.75%) than women (46.25%). Most common symptom experienced was nasal obstruction (100%), followed by olfactory disturbance in 88.7% and nasal discharge in 76.25%. There was statistically significant difference in operative time, blood loss and postoperative synechiae, with the microdebrider group showing better outcomes. There was no statistically significant difference in the postoperative VAS (visual analogue score) and recurrence rates between the two groups.</p><p class="abstract"><strong>Conclusions:</strong> Powered endoscopic sinus surgery offers a better therapeutic approach for patients with nasal polyposis than with conventional instruments. It provides bloodless operative field with better visualisation for a more precise, less traumatic procedure with shorter operative time.</p>
Chronic Otitis Media (COM) is a major cause of acquired hearing impairment especially in developing countries. Persistent perforations occur either due to improper treatment of recurrent otitis media or infected traumatic perforation. Myringoplasty, repair of the Tympanic membrane using autologous temporalis fascia, is the standard procedure for COM. Other graft materials commonly used include tragal perichondrium, tragal cartilage and adipose tissue. This prospective study aims to compare the surgical and audiological outcome of fat plug myringoplasty [FPM] and conventional myringoplasty using temporalis fascia [CM-TF] in COM with small dry central perforation. A total of 60 patients of COM with small dry central perforation, aged 16-60 years, during the study period of October 2013 to August 2015 were divided into two groups of 30 cases each. The first group underwent FPM while the second group underwent CM-TF. The graft uptake and hearing outcome [pre operative and 3 months post operative PTA] were assessed. The surgical outcome of FPM with graft uptake of 86.7% was comparable to CM-TF with a graft uptake of 90%. The mean post operative hearing gain in FPM was 3.43 ± 2.81 dB which correlated well with that of CM-TF with 3.85 ± 3.05 dB. The duration of hospital stay and operative time was significantly lower in FPM group. FPM can be safely performed in cases with dry, small central perforations of the tympanic membrane with outcomes comparable to CM-TF.
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