Peritonsillar cellulitis and quinsy, clinical presentation and management

The study was done to find the various clinical presentations and compare the out come / prognosis of peritonsillar cellulites and guising. A Descriptive study. Department of ENT and Head and Neck surgery Jinnah Medical and Dental College and Fatima Hospital, Baqai Medical University Karachi, from May 2001 to June 2006. This is a retrospective study of the treatment and their out come of 102 patients, 73 [71.6%] had peritonsillar abscess or quinsy while 29 [28.4%] had peritonsillar cellulitis who were treated indoor over a period of five years. The main modality of treatment was incision and drainage of pus in 73 [71.6%] patients and needle aspiration in 29 [28.4%] cases which resulted with 3 positive 26 negative and 5 false negative aspirates. Antibiotics given in combinations with an average stay of 5 to 8 days in the ward. Within 2 to 5 months 12 [11.7%] cases had recurrence, while none had bilateral quinsy. Tonsillectomy was done in 35 [34.3%] patients after 6 weeks. In peritonsillar infections needle aspiration is useful to differentiate between the two entities. Cellulitis usually resolves by intravenous antibiotics, when an abscess is suspected incision and drainage remains the gold standard treatment which is followed by antibiotics and tonsillectomy in selected cases

Retrosternal goitre, presentation and treatment outcome

To assess the clinical presentation, surgical out come and complications of retrosternal goitre [RSG]. A descriptive retrospective study. Departments of Ear Nose Throat and Head and Neck Surgery, Fatima Hospital Baqai Medical University and Civil Hospital Dow University of Health Sciences Karachi, between January 2002 to March 2008. Twenty seven patients of both gender and different ages of retrosternal goitre who under went for thyroidectomy between January 2002 to March 2008 were studied regarding their clinical presentation, and surgical outcome. Only two [7.4%] of our patients were presented with acute air way obstruction. Six [22.2%] patients were complained of dsypnoea only in supine posture, dysphagia and hoarseness were noticed in 3[11.1%] and 1 [3.7%] patients respectively while fifteen [51.5%] were asymptomatic apart from the obvious neck swelling. Total thyroidectomy was performed in twenty two [81.4%] cases and lobectomy with isthemectomy was done in five [18.1%] patients. CT scan was done in seven [25.9%] cases. Majority of our cases i.e. twenty five [92.6%] were benign while malignancy was noted in only two [7.4%] cases. Complications noted was haematoma formation in one [3.7%], recurrent laryngeal nerve injury in four [14.8%], hypoparathyroidism [transient] was recorded in three [11.1%] patients, and wound infection was observed in two [7.4%] patients. There was no mortality pre and post-operatively and no case of permanent hypoparathyroidism was noted where as only one patient had permanent unilateral recurrent laryngeal nerve injury. Retrosternal goitre is often asymptomatic and thyroidectomy is the treatment of choice with very low mortality and morbidity

Inverted papillomas of the nose and sinuses: clinical presentations, surgical treatment and outcome

To find the outcome of surgical management of inverted papillomas of the nose and paranasal sinuses. Case series. At Fatima Hospital Baqai Medical University and Usman Memorial Hospital Karachi, from June 2000 to July 2006. A total of 17 cases of inverted papillomas presented to us during the last six years, were managed and the outcome of their surgical treatment was reviewed retrospectively. Out of 17 cases 13 were male and 4 females. All the cases presented with unilateral nasal obstruction. Lateral rhinotomy and medial maxillectomy were the standard surgical procedure adopted for complete excision of the lesion. Two cases had wound infection, one with depressed ipsilateral facial deformity. In two cases recurrence occurred in the post-operative period. Wide surgical excision is the primary treatment modality of inverted papilloma to minimize the incidence of recurrence. Radiation therapy should only be considered in patients with incompletely respectable lesions, multiple recurrent lesions and tumours associated with malignancy

study of hearing levels in children of rural and urban setups

To assess the hearing levels of children belonging to two different environmental set ups. A Comparative analysis. ENT department Fatima Hospital, Baqai Medical University June 2006 to Nov. 2006. Study includes 100 students of Saleemullah Fahmi Primary School and equal number of Cadets of Baqai Cadet College Gadap. Hearing levels of these two groups of children were assessed and recorded with the help of pure tone audiometer [PTA]. It was found that the hearing levels of the students of Baqai cadet college were noticeably better i.e. 59/100 having normal hearing, hearing grade-I, and 41/100 having mild loss, hearing grade-Il, than the students of Saleemullah Fahmi primary school where 41/100 having mild loss i.e. hearing grade-I and 58/1 00 moderate loss hearing grade-Il and only 01/100 having severe bilateral loss i.e. hearing grade-III. The hearing assessments of 200 sample students from rural and urban background [divided into two equal groups] were found to have different levels of hearing without any detectable pathology in their hearing apparatus