Tonsillar fossa steroid injection for reduction of the post-tonsillectomy pain.

Fifty patients (26 males and 24 females) who underwent tonsillectomy were then treated with injection of the long acting steroid (Kenacort-A) into the right tonsillar fossa after the operation. The left side was used as the control. Post-operative pain was assesed by the patients and was graded and recorded daily as mild, moderate, and severe pain on both sides of the throat for 2 weeks. A significant reduction of pain in the tested side (right side) was noted in the majority of the patients. The duration of pain was shorter in the right side than the left side. It seemed to significantly reduce the post-tonsillectomy pain. Because of its simplicity, cost effectiveness, and no complications, the technique should be used for pain-free tonsillectomy in non-contraindicated cases.

Nasolacrimal duct injury from microscopic sinus surgery: preliminary report.

Nasolacrimal duct injury is a well established complication of functional endoscopic sinus surgery. In 1992, Bolger reported an incidence of nasolacrimal duct injuries in endoscopic sinus surgery of up to 15 per cent, but there is no documentation in microscopic sinus surgery. Fluorescein instillation into the lacrimal system via the punctum was done to determine the incidence of nasolacrimal duct injuries in 16 patients who underwent 32 microscopic sinus procedures. Only one patient exhibited nasolacrimal duct injury intraoperatively on the left side (0.3%). He had complete healing of the nasolacrimal duct at 2 months and no postoperative epiphora developed.

Upper aerodigestive tract burn: a case report of firework injury.

The case of a 46 year-old German man with upper aerodigestive burn by firework was reported. He presented with the symptoms and signs of upper airway obstruction. Tracheostomy was done and direct laryngoscopy with microscopic examination revealed swelling and denudation of the mucosa of the oral cavity and supraglottic area. Intravenous steroids and antibiotics were administrated for treatment. It is suggested that proper management needs an understanding of the mechanism and effect of the corrosive agent. Careful airway management resulted in a good outcome in this patient.

Lingual osseous choristoma: report of three cases.

Osseous choristoma represents the dense, mature, bony tissue in an abnormal location. We reported three cases of lingual osseous choristoma, herein, a year after the report of eight cases in 1998. All three lesions were at or close to the foramen caecum. The lesions were smooth, round or lobulated and pedunculated in shape and stony hard in consistency. All of them were preoperatively diagnosed, based on the above unique clinical findings without any radiography. The lesions were simply excised without local recurrence.

Comparison of ofloxacin otic solution with oral amoxycillin plus chloramphenicol ear drop in treatment of chronic suppurative otitis media with acute exacerbation.

The efficacy and safety of 0.3 per cent Ofloxacin otic solution (OFLX) 6 drops twice daily was compared with those of oral Amoxycillin 500 mg three times daily plus 1 per cent Chloramphenicol ear drop at 3 drops three times daily (AMOX + CRP) in a two-week treatment of chronic suppurative otitis media (CSOM) with acute exacerbation. 80 adult patients were enrolled in a prospective, randomized, investigator-blind study at the outpatient ENT service of Chulalongkorn University Hospital. The most common pathogens isolated at the pretreatment visit were Staphylococcus aureus (30.3%) and Pseudomonas aeruginosa (24.7%). The susceptibility of all the pathogenic isolates to ofloxacin, amoxycillin and chloramphenicol were 96.4, 57.1 and 51.8 per cent respectively. The overall response expressed as an improvement or cure of otalgia, otorrhea and middle ear mucosal inflammation was recorded. It revealed that the improvement rate of the OFLX-treated patients was better than that of AMOX + CRP-treated, but was not statistically significant. However, the cure rate was significantly better in OFLX-treated than in AMOX + CRP-treated groups in terms of painless (p = 0.05) and dry (p < 0.001) ears. Ototoxicity was assessed by an elevation in bone conduction threshold (BC) and/or speech reception threshold (SRT) of greater than 5 dB or a presence of high tone hearing loss resulting from treatments. A significant decrease in BC and SRT was revealed in OFLX-treated ears (p < 0.0001; p = 0.002 respectively) but a significant elevation of BC was found in AMOX + CRP-treated ears (p = 0.007). The ototoxic rate was significantly higher in AMOX + CRP-treated than in OFLX-treated ears whether assessed by BC (p < 0.001) or SRT (p = 0.03). In conclusion, OFLX was more effective and safer than AMOX + CRP in the treatment of CSOM with acute exacerbation.

Myringoplasty: a simple procedure for out-patients.

The standard treatment of tympanic membrane perforation is myringoplasty. We describe a new myringoplasty technique requiring only a partial removal of skin on the ear drum remnant followed by lateral placing of fascia and free skin graft. The overall cure rate in our series is 97 per cent. The hearing gains for the overall cases are 13.9 dB (p < 0.001) for the AC, 13.6 dB (p < 0.001) for the air bone gap closure, 13.1 dB (p < 0.001) for the SRT and 4.2 per cent (p = 0.005) for the SDS. Minor complications are observed in only 14 per cent. Our technique is simple, effective and can be performed on an out-patient basis.

Loss of heterozygosity for chromosome 11 in Epstein-Barr-virus associated nasopharyngeal carcinoma.

In order to demonstrate and define possible tumor suppressor gene loci on chromosome 11 associated with NPC, we used 7 STR to test for LOH on 25 NPC samples. LOH was detected in 46 per cent of cases. Most LOH loci were clustered on the long arm. Further study demonstrated 22 per cent and 45.5 per cent of cases with LOH on 11q13 and 11q23 respectively.

Microsatellite instability in Epstein-Barr virus associated with nasopharyngeal carcinoma.

The result reported here represents the first human genomic screen for MSI in Epstein-Barr-Virus associated NPC. The analysis revealed the incidence of MSI only 1 of 23 cases (4%) which indicates that MSI is less common in NPC development.