Endoscopic transnasal dacryocystorhinostomy versus conventional external dacryocystorhinostomy a comparative study

Epiphora is very common in medical practice and constitutes an important portion of the practice of the lacrimal ophthalmologist [Song et at. 1993]. Obstruction to the outflow of tears may be due to displacement or obstruction of the lower punctum or obstruction of the lower canaliculus. lacrimal sac or nasolacrimal duct [Lyle et at. 1968]. Thirty patients suffering from epiphora. chronic dacryocystitis and having lacrimal obstruction distal to the common canaliculus were achieved by dacryocystorhinostomy [DCR]. This was carried out by either endoscopic transnasal approach [15 patients] or by conventional external approach [15 patients]. Both techniques were performed as a team effort. Otolaryngologist and Ophthalmologist. With a follow up ranging from 6 to 12 months endoscopic transnasal DCR successfully relieved all symptoms of lacrimal obstruction in 12 of 15 patients [80%] while external DCR cured 11 of 15 patients [73] There were some intraoperative difficulties that may explain surgical failures in both sides. The choice of the method of DCR to be performed should be determined by the type of the case, the pathology found and the available equipments

Thermal myringotomy versus Grommet's tube insertion in management of childhood secretory otitis media

Recently thermal myringotomy has been recommended for the treatment of secretory otitis media [Lau et al., 1985]. In this research work we have studied the effectiveness of this form of surgical treatment by comparing it with the conventional myringotomy and grommet tube insertion in the opposite ear in 50 children having bilateral secretory otitis media during a 3 month follow up period. All thermal myringotomies were healed within 6 weeks. Recurrence of middle ear fluid was evident in 10 cases [20 percent] treated by thermal myringotomy during the three month follow up period while there was no recurrence of fluid in the grommeted ears in the same interval. Thermal myringotomy was found to be more easier, safer and with less complications and costs than the classic myringotomy with grommet tube insertion but still the latter procedure is more effective especially when long-term aeration of the middle ear is needed

effect of cigarette smoking on hearing

In the present study, an audiological evaluation was done for 400 male Egyptian subjects aged between twenty and sixty years. Detailed smoking histories were taken and complete general and otorhinolaryngological examinations were done followed by audiological assessment using pure tone audiometer [Amplaid 208]. Smoking was found to adversely affect hearing ability in a dose related manner in both current and previous cigarette smokers. Among previous smokers, improvement in hearing was related to the time elapsed since the cessation of smoking. These data suggest that smoking causes a long-term, but reversible, adverse effect on hearing

Investigations of the maxillary sinus in cases of primary atrophic rhinitis

Primary atrophic rhinitis is not uncommon disease in Egypt [Girgis, 1966]. Its exact aetiology is not yet well established [Barton and Sibert, 1980]. The condition of the maxillary sinus in cases of primary atrophic rhinitis is not clear. The aim of this work was to throw some light on the condition of the maxillary sinus in cases of primary atrophic rhinitis. This study included 30 patients, Sinoscopy was used to examine the mucous membrane of the sinus and to study the efficiency of its mucociliary transport mechanism. Radiological, Bacteriological and histopathological examinations of the nose and the maxillary sinus were also done. 22 patients [73%] showed thick bony walls during piercing by the sinoscope and the antrum was found to be small in size in almost all cases. The mucociliary function is only affected very late in the disease. The mucosa of the sinus shares the same histopathological changes as the nasal mucosa. However, in well established cases and before fibrosis the sinus mucosa showed compensatory hyperplasia of goblet cells. In 43.3% of cases the maxillary sinuses were found to be sterile and the commonest organism detected in both the nose and the sinus was staph. aureus and there was no relation between the type of the isolated organism and the atrophic changes. Opacification of the maxillary sinus by radiogical examination was found to be due to thickening of the walls and not due to infection