Introduction The study was aimed to find out whether any correlation exists between Middle Ear Risk Index (MERI) and the diagnostic ability of otoendoscopes to help in the decision making to preserve the posterior canal wall in management of cases of chronic otitis media(COM) squamous type. Materials and Methods Patients of chronic otitis media squamous active type were subjected to tympanomastoid surgery under the microscope and adjunctive use of otoendoscope. After proper disease clearance under microscope, otoendoscopes were taken as an adjunct to find out whether any residual disease was being left behind and to confirm whether the posterior canal wall could be preserved. Dubious cases in which the canal wall could be saved due to conclusive evidence of disease removal through the endoscope were taken as the ones being influenced by otoendoscopic decision-making. Results Patients having moderate MERI score were likely to have their canal walls spared by endoscopic evaluation. Discussion The percentage of residual disease detected with otoendoscopes were concurrent with other studies reporting similar figures. Conclusion The otoendoscope is decidedly more helpful in conclusive decision making in preserving the posterior canal wall in a case of chronic otitis media.
BackgroundArsenic exposure is an established cause of skin, lung and bladder cancer [1][2][3][4]. Several animal studies show that arsenic toxicity affects thyroid hormone metabolism. A single case report documents development of thyroid cancer in a patient of promyelocytic leukemia after oral arsenic trioxide therapy [5]. There is no study in the English scientific literature of the relationship between thyroid disease and arsenic exposure in human population.The Indian state of West Bengal is affected by arsenic contamination of ground water. According to The World Health Organisation (WHO), 2011 report 6 of the 23 districts of West Bengal are higher affected areas [6]. ObjectivesTo study the role of arsenic in development of thyroid disease. MethodsSeven patients with thyroid disease who attended the outpatient clinic of the Department of ENT Head and Neck Surgery of a tertiary teaching hospital were recruited for this study. After obtaining informed consent approximately 0.25 gm hair and nail samples were collected from each patient.
Backgrounds and objectivesIdiopathic sudden sensorineural hearing loss (ISSNHL) is an entity whose diagnosis and treatment remain controversial to date. Various modalities of treatment have been tried with varying degrees of success. Hyperbaric oxygen therapy (HBOT) is a recent modality of treatment for this condition which acts by improving cochlear microcirculation. The objective of this study was to evaluate the effect of HBOT in improving hearing loss and secondary symptoms patients with ISSNHL.MethodsThis prospective study was undertaken over a 6 month period from the Department of Otorhinolaryngology in a tertiary referral hospital in eastern India. 48 consecutive newly diagnosed ISSNHL patients were included in this study. The patients were subjected to HBOT at 2 A.T.A (Atmosphere Absolute) for an hour over 45 days. Hearing status and secondary symptoms as assessed by clinical tests, pure tone audiogram were analysed before and after HBOT.ResultsMales comprised 62.5% (30/48) of our study population, mean age of the population was 49.3 ± 13.4 years. 45/48 patients (93.7%) had unilateral ISSNHL, while 3 (6.3%) had bilateral ISSNHL. Average hearing loss in the affected ear before and after treatment was 79.96dBHL and 62.27dBHL respectively. The most common secondary clinical feature was tinnitus (27/48, 56.3%), followed by vertigo (24/48, 50%), aural fullness (15/48, 31.25%) and nystagmus (5/48, 10.41%). After treatment tinnitus and vertigo were showed marked improvement; (22/27, 81.48%) and (18/24, 75%). 5 out of 15 (33.34%) patients showed reduced aural fullness. There was no improvement in patients suffering from nystagmus.
Functional endoscopic sinus surgery has become the standard of care for chronic sinus disease. However, even with angled endoscopes it is difficult to visualize the entire maxillary sinus and a failure to do so often leads to incomplete disease clearance. This article describes our variation-the Mini Caldwell Luc (MCL) procedure, which we have found effective in disease clearance with minimal morbidity. The advantage of this procedure lies in the fact that the majority or entire procedure may be performed with a 0-degree endoscope and straight instruments. The learning curve is simpler and post-operative cheek swelling and paraesthesia are minimal.
Introduction: Today bacteriological and patho-anatomical considerations too are taken into account while treating a case of tonsillitis. Past decade has seen the rise of resistance amongst the common pathogens, as well as rise in the number of unusual offenders. Determination of the true offending organism and prescribing an antibiotic as per the sensitivity pattern is of utmost importance. Materials and Method: A prospective longitudinal study was conducted in a tertiary care hospital in Kolkata. The study population consisted of patients presenting with recurrent attacks of acute tonsillitis. Determination of throat swab micro flora, ASO titre and core tissue microflora was done and correlated statistically. Result: There was poor correlation between throat swab and core tissue microflora. Positive predictive value of throat swab was 10%. Pseudomonas is the predominant flora harbouring tonsillar core in our study population. Amoxicillin the most commonly prescribed antibiotic stands out to be the most resistant one. No statistical significance could be reached comparing streptococcal tonsillitis with ASO titre. Discussion: The real pathology within the tonsil core is not always reflected in routine throat swab and bacteriology of recurrent tonsillitis may differ in different regions. ASO titre estimation adds up to the economic burden if rheumatic fever is not suspected. Judicious use of antibiotics based on true sensitivity pattern is encouraged. In the era of antibiotics Tonsillectomy still holds an important position in the management of recurrent attacks. Conclusion: Pseudomonas was found to be the most common pathogen in recurrent acute tonsillitis. Core tissue study remains the Gold standard in identifying the pathogenic organism. Oral third generation Cephalosporin was the most efficacious antibiotic for recurrent tonsillitis in our study population.
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