More than half of patients with oral cancer recur even after multimodality treatment and recurrent oral cancers carry a poorer prognosis when compared to other sites of head and neck. The best survival outcome in a recurrent setting is achieved by salvage surgery; however, objective criteria to select an ideal candidate for salvage surgery is difficult to frame, as the outcome depends on various treatment-, tumor-, and patient-related factors. The following is summarizes various tumor- and treatment-related factors that guide our decision-making to optimize oncologic and functional outcomes in surgical salvage for recurrent oral cancers. Short disease-free interval, advanced tumor stage (recurrent and primary), extracapsular spread and positive tumor margins in a recurrent tumor, regional recurrence, and multimodality treatment of primary tumor all portend worse outcomes after surgical salvage. Quality of life after surgical intervention has shown improvement over 1 year with a drastic drop in pain scores. Various trials are underway evaluating the combination of immunotherapy and surgical salvage in recurrent head and neck tumors, including oral cavity, which may widen our indications for salvage surgery with improved survival and preserved organ function.
<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media attributes to 71.6% of hearing impairment in which most of them only have central perforations without any ossicular erosion or middle ear pathology. There are insufficient explanations to conclude which technique is better for type 1 tympanoplasty. Hence the study was conducted to compare and analyze the endoscopic technique with conventional microscopic technique for performing type 1 tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> This prospective study was done at Basaweshwara teaching and general hospital attached to MR medical college, Kalaburagi from December 2015 to June 2017 after obtaining institutional ethical clearance. Patients were selected according to inclusion and exclusion criteria and randomly posted for surgery by either endoscopic or microscopic technique and results were analyzed. </p><p class="abstract"><strong>Results:</strong> There were 60 patients in the study between 11-65 years with mean age of 28.85±10.87 years in which were 28 females and 32 were males. All patients were divided into 2 groups in which 30 underwent endoscopic and 30 underwent microscopic type 1 tympanoplasty. In this 46.7% of the patients had left ear conductive hearing loss whereas 31.7% of patients had right ear conductive hearing loss and 21.7% of the patients had bilateral conductive hearing loss which included 22 small perforations, 33 medium size perforations and 5 large perforations of pars tensa.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that endoscope can be a better alternative for microscope in type 1 tympanoplasty as it provides a wide panoramic view, less operating time and hospital stay with negligible scar post operatively.</p>
Background:Inferior turbinate hypertrophy is one of the most common causes of nasal blockage for patients to seek an otorhinolaryngologist, who is often seen in cases of allergic rhinitis, nonallergic rhinitis with eosinophilic syndrome, or iatrogenic rhinopathy. Although most cases of ITH can be managed medically but surgical intervention sometimes becomes necessary in certain non-responding patients which are managed by Submucous Inferior Turbinate Reduction (ITR) surgery. Large variation in surgical techniques available denotes lack of consensus on optimal technique. With advent of Microdebrider to Rhinosurgery by Setliff et al., many surgeons have recently started using microdebrider for the same indication.Aim: To compare the outcome following submucosal Inferior turbinate reduction using microdebrider and diathermy. Methods and results: A prospective interventional comparative clinical study between Submucosal inferior turbinate reduction using microdebrider (SITRM) and submucosal inferior turbinate reduction using diathermy (SITRD) was conducted. A total of 150 patients were included in the study. Patients were evenly randomized into Pool A and Pool B by chit allocation technique. Patients in pool A underwent SITRD and in pool B underwent SITRM. Comparisons were made between pre and post-operative NOSE score, endoscopic inferior turbinate size and mucociliary transit time and possible complications from both techniques and result were statistically significant in SITRM. Conclusion:To conclude submucosal resection with microdebrider produce better results in the treatment of inferior turbinate hypertrophy, both in the short term and long term compared to the submucosal diathermy, where the latter produce comparable results in the early postoperative period. Limitation of this study was that different etiological causes for inferior turbinate reduction were not taken into consideration and ITH due to any cause were included in the study irrespective of its cause. Another limitation of this study was that objective method of nasal patency assessment like rhinomanometry were not used due to cost restrains. A more elaborate larger randomized studies with use of rhinomanometry would definitely be helpful to confirm or refute the same.
<p class="abstract"><strong>Background:</strong> Rabies is a zoonotic disease caused by lyssavirus and spread through saliva of rabid animal bite. This study was taken to compare primary closure versus non-closure of animal bite wounds.</p><p class="abstract"><strong>Methods:</strong> This is a prospective randomized study. Patients were divided into 2 groups. Group A consisted of patients with non-closure of wounds and group B with primary closure of wounds. Patients were followed up for wound healing time, infection and cosmesis. </p><p class="abstract"><strong>Results:</strong> This study consists of 540 patients (323 males and 217 females). The common age group was paediatric and geriatric age. Most common animal bite was from dogs. The average healing time in non-infected wound in group A versus group B with Lackman’s I and II grading was 10.5±1.25 and 12.5±1.5 days versus 7±1.25 and 8.5±1.5 days respectively. There were 19 cases in group A and 17 cases in group B with infection which subsided with antibiotics in 24 hrs. Cosmesis graded on VSS was better in group B (average 4.03±1.5) as compared to group A (average 2.44±0.185). Only one patient from group A with Lackman’s grade II contacted rabies died 2yrs after the bite.</p><p class="abstract"><strong>Conclusions:</strong> Animal bite wounds over head and neck were found to be more common in paediatric and geriatric population who are more vulnerable. Infection and spread of rabies virus through these wounds can be prevented by thorough debridement and cleaning whereas primary suturing helps in achieving early wound healing and better cosmesis producing a socially and functionally acceptable scar.</p><p class="abstract"> </p>
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.