ABSTRACT
Two patients one male of 25 years the other a girl of 10 years old presented to us with purulent ear discharge, severe hcadache and nausea/vomiting and amastoid abscess in one of them of few days duration. Otoscopy revealed purulent foul smell discharge filling the ipsilateral ears with X-ray mastoid showing a cavity due to bone erosion. Incision and drainage of mastoid abscess followed by radical mastoidectomy in one and radical mastoidectomy straight away in the other were performed with complete eradication of disease and chlesteatoma was achieved clinically. But within 16 hour in the young girl and after 12 days in the 25 years old male again both cases presented in emergency with sever headache, nausea/vomiting and disorientation. CT scan of both the cases revealed right temporal lobe abscess. The girl was already in ICU and the male was re- admitted for the drainage of abscesses under care of neurosurgeon and follow up was done in both the departments for four months
ABSTRACT
Dissection and diathermy are commonly used techniques of Tonsillectomy with quite satisfactory results with either of the two, for which a number of studies have been made many a times all over the world. However, at our end, another analysis of the results of these techniques was done to find out a procedure which has least preoperative and postoperative morbidity. A study towards that end was conducted at the departments of Ear, Nose and throat and Head Neck Surgery, Jinnah post Graduate Centre [from June 1998 to June 2000] and continuation of the study at Baqai Medical University Hospital [from June 2000 to July 2006] Patients of ages between 13 years and 50 years were selected from the outpatient departments of both setups in a randomized fashion. Sample size was 200 patients. For uniformity sake, one tonsil was dissected followed by ligature homeostasis and the other tonsil of the same patients was removed by diathermy. It was found that the difference in results between the two techniques was statistically insignificant [P<0.001] in terms of intra operative blood loss and time taken for surgery. Regarding postoperative hemorrhage and post-operative pain, the difference between the two was statistically significant [P=0,234] in favour of dissection method. Hence it is concluded that tonsillectomy with diathermy was a better technique compared to dissection method in terms of intra operative blood loss and time taken for surgery. However it is associated with painful recovery and significantly higher risk of postoperative hemorrhage and therefore can have morbidity higher than the dissection method of tonsillectomy
ABSTRACT
A 40 years old female presented with left nasal obstruction, sneezing and watery discharge for the last three months. Clinically left proptosis and widening of the nasal bridge was obvious while the left nasal cavity was full of multiple greyish grapes like polypoid masses which were painless and did not bleed on manipulation. CT scan revealed soft tissue mass occupying the left nasal cavity, maxilla, infra temporal fossa, ethmoid, sphenoid and the orbit. The mass was excised in toto through left Lateral Rhinology approach and histology examination revealed it to be a transitional cell carcinoma