Background: Palpable neck swellings include various non-neoplastic and neoplastic lesions of lymph node, salivary glands, thyroid and soft tissue. Fine needle aspiration cytology (FNAC) is the most cost-effective invasive pre-operative investigation, whose simplicity and safety justify its use for "selective" surgery in diagnosing different types of masses. The aim of this study is to evaluate the effectiveness of FNAC as a primary investigation tool in neck masses. The primary objective of the study was to assess the spectrum of head and neck masses and to determine the accuracy of FNAC in detection of various lesions in index medical college hospital and research Centre. Methods: The study included 510 patients presenting with palpable neck swelling in a tertiary care hospital from September 2015 to December 2016. Results:The most frequent cause of neck swelling is lymphadenopathy 58.94%, followed by thyroid swelling 27.36%, soft tissue lesion 10.95% and salivary gland lesions 2.73%. The most common lesion in these patients was non-neoplastic followed by malignant neoplasm. FNAC is an important tool for preoperative clinical diagnosis of non-cystic neck masses with history of more than 3 months. Thus, it helps in planning the surgical management of neck masses and can be confirmed with HPE which is a "gold standard" for diagnosis. Conclusion: Fine needle aspiration cytology is a safe, simple and rapid method that can be done in diagnosing wide range of neck masses.
Aim: To ascertain whether the A-B gap improvement of tragal perichondrial grafting is better than TF grafting in CSOM patients undergoing type 1 tympanoplasty by underlay technique. Methodology: A prospective comparative study was done in CSOM patients presenting to a tertiary health care establishment. 60 patients underwent type 1 tympanoplasty, using TF graft in 30 and tragal perichondrial graft in 30 patients. Both groups of patients were compared in terms of A-B gap improvement following surgery. Results: A-B gap improvement of all the 60 patients were analysed. 8(26.67%) patients had A-B gap improvement </= 15dB in both the tragal perichondrium and TF graft group. Rest 22(73.33%) patients had A-B gap improvement of 16-25dB in either group. In cartilage group, 14 out of 15 patients i.e, 93.33%, while in Fascia group, 10 out of 12 pateints i.e, 83.33% patients who had perforation involving anterior quadrant had A-B gap closure between 16-25dB post- operatively. Therefore, cartilage graft showed better A-B gap closure than fascia graft in anterior quadrant. When both the quadrants were taken into consideration, 11 out 17 i.e, 65% patients in fascia group while 8 out of 13 i.e, 61% patients in cartilage group showed AB gap closure between 16-25dB. Therefore, fascia graft showed better result. Conclusions: This study showed that A-B gap improvement is similar in CSOM patients undergoing type 1 tympanoplasty using either TF or tragal perichondrial graft. Either of these can be good for improving the hearing in CSOM patients but tragal cartilage with perichodrium showed better results with perforation involving anterior quadrants.
Introduction: HRCT temporal bone is the currently widely used investigation for the chronic otitis media patient especially in unsafe disease. Aim: This study was conducted to assess the condition of the middle ear in CSOM by HRCT temporal bone and compare them with intraoperative finding of the middle ear cleft . Method: Study group includes patients of Attico-antral variety of CSOM presenting in ENT OPD in our institution over a period of 18 months who undergone Computed Tomography Temporal bone followed by Surgical Procedure. Results: After study it was observed that CT scan can reliably detect bony & soft tissue changes in middle ear and intracranial complication. It can detect soft tissue in the middle ear but can not differentiate between soft tissue and cholesteatoma. Conclusion: CT scan provides excellent anatomical details and pathological changes of the ear and mastoid. Scanning all the patients is not feasible and justified, so we need to select patients in whom diagnosis and extend of the diseases is in doubt.
A thorough clinical history and a good clinical examination including the findings of inspection and palpation are key factors for near accurate provisional diagnosis but histopathological examination is the only gold standard for confirmation of diagnosis till date for the head neck swellings. It has been observed that there was slightly higher ratio of female patients attending the OPD with complaints of neck swelling. Fine needle aspiration cytology is a quick, convenient, easy to perform, and fairly accurate method for cytological diagnosis on an outpatient basis. Importance of this study, particularly in the context of neck masses, lies in the fact that a preoperative cytological diagnosis of a benign lesion in a high-risk patient may obviate the need of a surgical intervention. Preoperative diagnosis of certain conditions like lymphoma and inflammatory pathology may also escape from unnecessary surgeries. It can be concluded that lymph node swellings are the most common amongst the neck swelling by far and on its cytological examination reactive lymphadenitis being the prevalent one. It can also be said that FNAC is the most reliable method for diagnosing the TB lymphadenitis and thyroid swellings.
Aim: To assess whether patients of NIDDM have a higher incidence of sensorineural hearing loss.Methodology: A cross-sectional study was conducted included 100 participants such that 50 were diabetics and another werenondiabetics. Pure Tone Audiometry was performed on the patient, and the results were assessed by comparing them to the patient'sdiabetes duration. The IBM SPSS version 20 software was used for all data analysis. The tables were created using cross tabulation andfrequency distribution.Results: On comparing the degree of hearing loss between both the groups and the mean hearing threshold of both the ears with durationof diabetes it was found that distribution of degree of hearing loss between the cases and control was significantly different.Conclusion: The study concluded that age had the direct association with the pure tone threshold level which means by increasing theage of the diabetes patients, hearing loss also increases as revealed by the significant p value of <0. 005.
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