Modified quilting sutures: a new technique for hematoma and abscess of nasal septum

This study aimed to analyze the results of a modified continuous quilting sutures technique in a series of patients presenting with hematoma and/or abscess of nasal septum [HANS]. Only patients with a confirmed diagnosis of HANS without co-morbid conditions [which could predispose to a bleeding tendency], were selected. Following incision and drainage, nasal septal flaps were coapted by applying continuous quilting sutures only. The success rate of this technique in terms of recurrence requiring re-exploration and drainage was 100%. Quilting sutures were generally well tolerated with few complaints. Saddle deformity was the most obvious complication of HANS, seen with septal abscess. Quilting sutures can be considered as an alternative treatment option for HANS. The modified technique employed in this study demonstrated impressive results and avoided the morbidity of nasal packing with fewer complications

Clinical comparative study of efficacy of Epley manoeuvre and Semont manoeuvre in benign paroxysmal positional vertigo

To compare the efficacy of Epley manoeuvre and Semont manoeuvre in the management of benign paroxysmal positional vertigo. Randomized controlled trials. ENT Department Combined Military Hospital [CMH] Kharian and Gilgit from March 2005 to February 2010. Hundred cases of benign paroxysmal positional vertigo [BPPV] were selected on Dix-Hallpike test by non probability convenient sampling technique and randomly divided into two groups of 50 cases each. Patients in group-1 were treated by Epley manoeuvre and patients in group-2 were treated by Semont manoeuvre. The patients were examined on first day, 3[rd]30 day, 7[th] day and after 01 month and clinical results were observed. In group-l, 68% cases showed immediate resolution of symptoms, 74% cases on 3[rd] day, 80% cases on 7[th] day and total 82% cases recovered completely after one month. In group-2, 62% cases showed immediate resolution of symptoms, 68% cases on 3[rd] day, 74% cases on 7[th] day and total 78% cases showed complete recovery after 1 month. There was insignificant difference between the two groups regarding recovery at different follow ups. It was concluded that Epley and Semont manoeuvres are equally effective in the management of BPPV

Auricular angiolymphoid hyperplasia with eosinophilia

Angiolymphoid hyperplasia with eosinophilia is an uncommon, benign, angioproliferative cutaneous disorder. Previously, angiolymphoid hyperplasia with eosinophilia and Kimura's disease were regarded as identical conditions, however, recent work identifies them as separate entities. It is clinically manifested by solitary or multiple, red to brown firm papules and nodules, occurring in the head and neck region with a predilection for the peri-auricular area. It usually occurs during the early and mid-adult life. It is more common in Caucasians with equal gender involvement. We report this condition in a 32 years old adult Pakistani male having red-brown papules in left ear

Comparison of locally made phonating device versus oesophageal speech in postlaryngectomy speech rehabilitation

To compare the effectiveness of locally made phonating device with oesophageal speech as a communication method in a laryngectomized patient. Randomized Controlled Trial. Combined Military hospital Lahore from January 2004 to July 2007. Twenty five patients who had undergone total laryngectomy were divided in two groups by random sampling. 13 patients were placed in experimental group and provided with a locally made phonating device El [Electro-larynx, 'BM Talk'] and speech training with this device started between 20th to 30th post-operative day. The results were compared to a Control Group consisting of 12 laryngectomized patients who were provided instruction and training on oesophageal speech for communication. Speech assessment was made at the end of 2nd, 4th and 6th month post-operatively in both the groups. Assessment parameters were defined according to the patient's ability to communicate ten predetermined sentences of Urdu and Punjabi to a team of three speech assessors on each speech assessment day. Speech communication score was fixed at 100 if all the spoken sentences were fully understood by all the three assessors irrespective of character of speech, while it was 0 if none of the sentence spoken could be understood by any of the three assessors. In between the two were different percentages of speech communication scores depending on the number of sentences understood by the speech assessors. The character of voice was assessed by Visual Analogue Score where variation between robotic and normal speech character were divided into ten grades from 1 to 10. At the end of six months, speech communication score was 76.62 with SD 17.29 for EL [Electro-Larynx]; while for control group [oesophageal speech] it was 34.17 with standard deviation of 8.63. Those score was compared by using t test and was highly significant i.e. <0.001 in favor of EL. The character of voice was closer to normal in case of oesophageal speech compared to EL where it was closer to robotic. Locally made EL [Electro-larynx] 'BM Talk' is a useful device for speech rehabilitation in laryngectomised patient. It has added advantage of local availability and cost effectiveness. The character of voice may be robotic and monotonous, nevertheless full sentence can be communicated with relative ease to the listener, which is more important factor in our setup

Tonsillectomy; quality-of-life improvement in school going children

To determine the quality - of - life benefit derived from Tonsillectomy and its specific impacts. A Cross sectional survey. ENT Department, CMH Rawalpindi. Period: From 01 Jan 2004 to 31 Dec 2004. Material and Methods: The Glasgow Benefit Inventory [GBI] was used to quantify the health benefit of tonsillectomy. Data was collected for demographics and antibiotic use, physician visit, and school days missed due to chronic tonsillitis for 12 months before and after tonsillectomy. This study includes the patients who had undergone tonsillectomy alone. A total of 102 patient met inclusion criteria for this study. Sixty five parents returned complete survey of their children. The mean age was 10.3 years [5-15 years]. The improvements in the total score [ +/- 27.1], general health sub score [ +/- 34.7], social functioning sub score [ +/- 14.2], and physical functioning sub score [9.38] were each statistically significant [P<.001], indicating a significant health benefit of tonsillectomy. Statistically significant decreases in mean weeks receiving antibiotics [-7.8 weeks], mean physician visits [-5.4], and mean schooldays missed [-6.3 days] were noted after tonsillectomy [F<.001]. Tonsillectomy provides a significant quality-of-life improvement for children with chronic tonsillitis. Tonsillectomy also affords decreases in medical resource utilization and missed school days after tonsillectomy. Such factors should be incorporated into decision making when considering tonsillectomy