Hypertrophy of inferior nasal turbinate is one of the most common causes for nasal obstruction (NO). As diode laser has proven to be as effective as any other lasers, our objective was to study various primary outcomes of its use of diode laser like improvement in NO, intraoperative bleeding, postoperative pain, and rapidity of healing. The study was undertaken to compare the various outcomes by diode laser turbinate reduction (LTR) and conventional partial inferior turbinectomy (PIT). A nonrandomized controlled trial was conducted on 2 groups: One group (30 cases) underwent LTR and PIT was performed in the other group (30 cases). The improvement in NO was measured postoperatively up to 6 months. Intraoperative bleeding was measured and postoperative pain scores were assessed each day up to fifth postoperative day. Lastly, rapidity of healing was evaluated until 6 months. Subjective relief of NO was 90.8% in LTR group, whereas it was 65% in PIT group at 6-month follow-up, which was statistically significant ( P < .05). Pain scores were higher until 5 days in PIT group compared to LTR group ( P = .0001). Intraoperative bleeding mean scores (milliliters) were 8.03 in LTR group compared to 23.29 in PIT group ( P = .00001). Rapidity of healing was faster in LTR group with mean scores of 3.03 weeks in comparison to PIT group where it was 6.33 weeks ( P = .00001). Compared to the conventional technique, the outcomes were better with diode laser and caused less morbidity.

Background: Chronic otorrhea in chronic suppurative otitis media (CSOM) has become a difficult task to treat for ENT specialists because of emerging resistance to the available antibiotics and patient's affordability for its cost. Also biofilms have been responsible for the chronicity of disease. Use of vinegar as an antiseptic and altering the pH of middle ear to treat otorrhea in CSOM needs to be studied. Methods: 120 patients with active CSOM were recruited randomly for either vinegar wash or antibiotic therapy. Vinegar diluted with water in 1:1 ratio at pH 4 was used twice a day for 3weeks to one group. Oral antibiotics based on culture sensitivity report were given to other group for 3weeks. Both groups were followed up for a month and observed for resolution of ear discharge. Results: Pseudomonas (40%) and Staphylococcus aureus (25%) were the most common organisms detected. 96.2% of Pseudomonas and 50% of Staphylococcus aureus ears became dry with vinegar wash. 81.67% of antibiotic group and 68.33% of vinegar group ears became dry in 3weeks. No statistically significant difference between vinegar wash and culture based oral antibiotic therapy in resolution of ear discharge was seen in active CSOM (p >0.05). Conclusions: Management of otorrhea is long term in CSOM and vinegar can be used as an alternative to costly oral antibiotics for resolution of ear discharge in active CSOM. Two fold dilution of vinegar prevents chance of ototoxicity.

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Objective To compare the outcome of conservative management vs surgical intervention (realignment of torn edges) in traumatic perforations of the tympanic membrane (TM). Design Cohort study, Interventional, Observational, Prospective. Setting Karnataka Institute of Medical Sciences, Hubli, Karnataka. Patients All patients attending the Department of Otolaryngology with otological injuries. Interventions Patients with isolated traumatic tympanic membrane perforations without evidence of temporal bone fractures were managed either conservatively or surgically by realigning the torn edges of perforation under local anesthesia and supporting with gelfoam. Main outcome measures Healing of perforation, duration taken for complete healing and hearing outcome by pure tone audiometry. Results Perforations in patients taken up for surgical intervention healed faster. Though the difference in outcome, i.e. healed TM perforation between the 2 groups was not statistically significant, the difference in duration taken for healing was observed to be statistically significant (p < 0.05). Conclusion Minimal surgical intervention involving realignment of torn edges of perforation and supporting with gelfoam enables faster healing. How to cite this article Saimanohar S, Gadag RP, Subramaniam V. Management of Traumatic Perforations of the Tympanic Membrane: A Clinical Study. Int J Otorhinolaryngol Clin 2015;7(3):114-116.

Background: Hearing impairment is known to hamper the quality of life among patients, especially among diabetics due to the association of neuropathy with diabetes. However, the prevalence and degree of the SNHL depends upon different factors, such as age, gender, disease duration of DM, family history and glycemic status of the patients. Therefore, this study aimed to assess the association of SNHL with DM duration and familial DM and gender preponderance among SNHL–DM patients. Methods: Total 140 patients with DM were assessed for hearing impairment using Rinne, Weber and Absolute Bone Conduction Tests along with pure tone audiometry. Patients’ glycaemic status was determined by estimating fasting blood glucose (FBG) and post prandial blood glucose (PPBG) levels. Independent t-test, chi-square, ANOVA and Pearson’s correlation tests along with linear regression model were used to find association and correlation using R software. Results: Out of 140 patients, 60 were suffering from SNHL and majority were suffering from bilateral minimal hearing loss. SNHL was significantly associated with family history, age, duration of DM, FBG and PPBG levels were(Pvalues:1.79E08, 4.41E-06 and 0.02), however, significant correlated with duration of DM, FBS and PPBG level (r value:0.14–0.41).Furthermore, significant SNHL at 500 and 8000Hz was observed in the present study (Pvalue:0.002). Conclusion: A conclusive proof was drawn that family history of DM serve as a valuable variable in assessing the SNHL among DM patients.

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media is a widespread disease with a significant cause of morbidity with a greater burden in the poor communities of the developing countries for which tympanoplasty is frequently undertaken. Gelfoam may show detrimental effects such as adhesions and fibrosis and improper packing may physically alter the structure of the tympanic membrane leading to failure of tympanoplasty. The graft can be placed without any middle ear supporting agent wherein the graft is held in position by the surface tension between the novel graft placed and the remnant tympanic membrane. This provides the added advantage of facilitating middle ear ventilation through the Eustachian tube. The objectives of the study were to assess the graft uptake and hearing improvement following type 1 tympanoplasty with gelfoam in the middle ear and without gelfoam in the middle ear and to compare and assess results for complications</p><p class="abstract"><strong>Methods:</strong> This was a randomised control trial done for a period of one year conducted in the department of otorhinolaryngology and head and neck surgery, Karnataka Institute of Medical Sciences, Hubballi which is a tertiary referral hospital. 30 patients underwent type 1 tympanoplasty without gelfoam in the middle ear and 31 patients underwent type 1 tympanoplasty with gelfoam in the middle ear. Post-operative follow up was done to look for graft uptake, hearing assessment by pure tone audiometry and impedance audiometry was done 90 days post-operatively.  </p><p class="abstract"><strong>Results:</strong> Graft uptake was 80% in type 1 tympanoplasty without gelfoam in the middle ear and 80.6% with gelfoam in the middle ear. Both types of surgeries had significant hearing improvement, and complications like retraction and residual perforation were also comparable. Ad type of impedance curve is most common post operatively.</p><p><strong>Conclusions:</strong> Graft uptake is equally good in cases with gelfoam and without gelfoam. Hearing gain is comparable in both groups of patients. No significant complications occurred in our study. ‘Ad’ is the most common type of impedance curve after surgery. Long term follow up is important in these patients. </p>

<p class="abstract"><strong>Background:</strong> Despite major advances in the design of endotracheal tubes and developments in the management of difficult airways, endotracheal intubation remains by far the most common cause of laryngotracheal injuries (LTI). These LTI are challenging to manage and are associated with significant morbidity and mortality. Hence, the present study was done to find out the incidence, types of LTI and to study the factors affecting the same.</p><p class="abstract"><strong>Methods:</strong> A prospective study was conducted on patients who were intubated for more than 48 hours and admitted in medical intensive care units in a tertiary referral hospital, for a period of 1 year. All patients following extubation were evaluated for LTI by x-ray neck (antero-posterior and lateral view), rigid endoscopy and flexible naso-pharyngo-laryngoscopy.  </p><p class="abstract"><strong>Results:</strong> Thirty patients were included in the study. Majority of the patients (56.6%) were found normal while 43.2% patients were having LTI following extubation in the form of bilateral vocal cord fixation, subglottic stenosis, granulation tissue in the posterior commissure and in the trachea. Majority of these patients were aged less than 45 years, with duration of intubation for more than 10 days, with tube size more than 7 mm. Organo-phosphourous (OP) poisoning was the etiology for LTI in 69.2% cases.</p><p class="abstract"><strong>Conclusions:</strong> A high incidence of LTI especially in cases of OP poisoning warrants one to be cautious in managing these intubated patients. Those patients requiring prolonged intubation should be considered for other alternative airway managements like tracheostomy in addition to using low pressure, high volume cuffed tubes. Adequate training of the emergency personnel in the intubation technique and its subsequent care is important especially in a tertiary referral center.</p>

To give the message that a sharp foreign body in the upper gastrointestinal tract in a female child is to be seen with caution as it could be a case of infanticidal attempt. CASE REPORT: A two and half month old baby presented with history of refusal of feeds for one day of sudden onset and was irritable. X ray neck revealed two pieces of radio-opaque razor blades in the region of cricopharynx and proximal oesophagus. They were retrieved immediately by performing rigid oesophagoscopy with minimal mucosal tears. CONCLUSION: In developing countries where female infanticide rates are high, any sharp foreign bodies in upper digestive tract could be a case of infanticide and early removal is the key to prevent serious life threatening complications.