Patterns of cholesteatoma extension in chronic otitis media

To analyze the patterns of extension of cholesteatoma during surgery for chronic otitis media. A retrospective review was made of all cholesteatoma surgery in otology center within 6 years. Data included demographic data and the patterns of extension of cholesteatoma. One hundred sixty six patients, 86 [51.8%] males and 80 [48.2%] females, who were admitted with clinical diagnosis of chronic suppurative otitis media, with cholesteatoma. Analysis of the patterns of extension of cholesteatoma, showed that the tympanic cavity was involved in [91.6%], mastoid cavity in [74%] and Eustachian orifice in [42%] of our patients. In the Tympanic cavity, oval window [46%] and sinus tympani [40%] were involved. The most common patterns of extension included tympanic cavity. Attic and antrum involvement were greater than attic only. This study showed that despite decrease in chronic otitis media cases; still there is extensive extension of cholesteatoma in various part of temporal bone in different patients

Maxillary Sinus mucormycosis mimicking sinus malignancy

Mucormycosis is an opportunistic fulminant fungal infection in diabetic and immunocompromised patients. The infection is acquired in the nose and paranasal sinuses by the inhalation of the fungal spores. We report of a case of maxillary sinus mucormycosis in a 32-years-old non diabetic woman. She had right side facial pain, headache, unilateral right side nasal obstruction, and post nasal discharge [PND] for five years. Nasal endoscopy revealed pus and granulation tissue, and semi-black middle turbinate in right side nasal cavity. Computed tomography showed bone erosion and a large soft tissue mass similar to sinus carcinoma in maxillary sinus with extension into the ethmoidal sinus. She underwent functional Endoscopic sinus surgery. Macroscopically, the specimen consisted of multiple tissue fragment 0.8-1 cm. Microscopic findings included an inflammatory cells and deposited fungal elements [mucormycosis]. So in the paranasal sinus and nasal cavity mass, mucormycosis should be included in the differential diagnosis, especially in the non diabetic and young patients

Unilateral choanal atresia in adults

Choanal atresia usually is a congenital anomaly; it can be unilateral or bilateral. Bilateral choanal atresia is always diagnosed in newborn infants. But unilateral choanal atresia sometimes missed and symptoms appear later. In a six years period eleven patients were referred to our clinic with unilateral nasal discharge, snoring and nasal blockage. No history of trauma and no complaints were there which could clearly point to the diagnosis. On investigation [nasal catheterization, choanography and CT scan], unilateral choanal atresia was seen on one side and semi stenosis on other side was seen.Seven female and four male [ages ranges from 11-15 years]. Three of them underwent Transpalatal approaches [William incision] and eight endoscopic transnasal techniques. All have done well with follow up ranging from 9 months to 6 years and no complication. Otorhinolaryngologist should be alert to the diagnosis, particularly in patients with a unilateral nasal discharge and unilateral nasal blockage in adults

Closure of septal perforation by split-thickness skin graft and cartilage

To evaluate a technique for Closure of large Septal Perforation [SP] by Split- Thickness Skin Graft and Cartilage. In this prospective study carried out from March 2000 to March 2005, 15 patients with large SP [>/= 2[cm2]] underwent closure of SP with split thickness skin graft and cartilage. The most common symptoms were nasal obstruction [66.7%] and crusts [46.7%]. In our technique, the success rate of closure was 86.7%. In two patients, closure was incomplete which was thought to be due their old age and long duration of SP. Our technique is easy, with good exposure, high success rate and is low in cost. We recommend this technique for perforation >/= 2[cm2]

Frenuloplasty with A splitthicknes skin graft

Experience with frenuloplasty differs in different centers and there are many techniques in this regard. The purpose of this study was to investigate the severity of presenting symptomatology in patients with ankyloglossia and to assess the surgical results of patients undergoing frenuloplasty with split thickness skin graft. During a 4 year period from September 1998 through September 2002, 19 patients of ankyloglosia underwent frenuloplasty with a split thickness skin graft. All skin grafts were taken from arm. There were 11 males and 8 females. The average length of the lingual frenulum was 3.5 mm. Twelve children were over 4 years old and were primarily operated with this technique. In the 7 patients, Z plasty had been performed previously but failed and cicatrisation caused ankyloglosia. There were two minor postoperative complications, one hematoma, and other graft dehiscence with cicatrisation. The mobility of the tongue after one year was excellent. There were no complications in donor site. Frenuloplasty with split thickness skin graft is the best and easy procedure with good results for children over 4 years and those who fail primary closure