Study of Various Prognostic Factors Affecting Successful Myringoplasty in a Tertiary Care Centre

Abstract Introduction Myringoplasty is a commonly performed otologic surgery. Objectives The objective of this study is to evaluate the effect of prognostic factors like - size, site of perforation, status of operating ear, approach, status of contralateral ear, experience of surgeon, primary or revision myringoplasty, and smoking in graft uptake, as well as to evaluate the hearing results after myringoplasty. Methods This is a prospective study. We included in our sample patients aged over 13 years with a Tubotympanic Chronic Otitis Media diagnosis. The patients underwent preoperative evaluation and Pure Tone Audiogram within one week prior to surgery.We performed myringoplasty using temporalis fascia graft with conventional underlay technique. We evaluated postoperative graft uptake and various factors related to the study and did a Pure Tone Audiogram at one year after surgery. Results The graft uptake rate after myringoplasty was 83.1% at one year in 219 patients. Graft uptake with normal opposite ear was 88.2%, and with Tubotympanic Chronic Otitis Media was 75% (statistically significant). We found no statistically significant difference in graft uptake results with other factors. We calculated hearing results of 132 patients with normal ossicular status who underwent myringoplasty. The average Air Conduction Threshold improvement was 11.44dB (p < 0.001) and the average Air-Bone Gap closure was 8.89dB, highly statistically significant (p < 0.001). Conclusion Diseased contralateral ear was a statistically significant poor prognostic factor for graft uptake after myringoplasty. Other factors studied were not statistically significant determining factor for graft uptake. Hearing improves significantly after myringoplasty if the ossicles are normal.

Frequency and effective treatment of ulcers and sinuses in cases of tuberculous cervical lymphadenitis

To investigate the frequency and effective treatment of ulcers and sinuses in cases of tuberculous cervical lymphadenitis [TCL]. Design: Observational cross-sectional study. Place and Duration of Study: Department of ENT, Head and Neck Surgery of Tribhuvan University Teaching Hospital [TUTH], Kathmandu, Nepal, during the period of two years from March, 2000 to February, 2002. Patients and A hundred cases of histopathologically confirmed cases of tuberculous cervical lymphadenitis of more than six weeks of duration were included in the study. Overall frequency of the complication as well as the efficacy of treatment regime was considered. Out of 100 patients, 8 [8%] were found to develop ulcers and/or sinuses during the process of development of TCL which were effectively treated [100% cure rate]. Mode of treatment was surgical excision of ulcers/sinuses along with affected underlying lymph nodes, followed by short course of anti-tubercular chemotherapy. Not a single case recurred during their follow-up period. In this series there was a low frequency of formation of ulcers/sinuses during the process of development of TCL. Surgical excision of ulcers/sinuses along with affected underlying lymph nodes, followed by short course of anti-tubercular chemotherapy is the effective methods of their treatment

experience with sistrunk's operation at Kathmandu

Thyroglossal anomalies are one of the commonest congenital anomalies. The treatment of choice is Sistrunk's operation. The purpose of this study is to describe demographic and clinical profile of the patients presented with these anomalies, findings during Sistrunk's operation and outcome of this procedure post-operatively. This is a descriptive study includes 32 patients who underwent Sistrunk's operation from April 2001 to June 2004 in the Department of ENT and Head and Neck Surgery, Tribhuvan University Teaching Hospital [TUTH] Kathmandu Nepal. Majority of the patients presented in the 1 [st] and 2[nd] decade of life. Most of them were males [75%] and majority were presented with midline neck swelling [87.50%]. Five patients developed continuous/ recurrent discharge following some sort of surgical procedures performed in other hospital of Nepal. The commonest site of lesion was infrahyoid [72%]. None of them had recurrence till the end of this study