Comparison of complications of septal surgery with and without use of intra-nasal splints

To compare the adhesion formation and post-operative pain with and without intranasal splints in patients undergoing septal surgery with inferior turbinectomy. Comparative study. The study was carried out in CMH Rawalpindi from April2005 to Oct 2005. Total 60 patients undergoing septal surgery were randomly divided into two groups. In Group A intranasal splints [made from plastic infusion bottles] were placed with paraffin gauze packing and in Group B, paraffin gauze packing was done without intranasal splints. Follow-up was carried out at 48 hours and 01 week after surgery for assessment of pain scores, while adhesion formation was monitored for two months after surgery. Mean age of patients in Group A [with splints] was 26.43 years and of Group B [without splints] was 25.77 years. There was marked difference of pain scores at 48 hrs after surgery between two groups and difference was found highly significant [p value 0.001]. The p-value of pain score for data at one week was 0.022, still significantly different but lesser than the one at 48 hrs. Only two patients both without splints were found to have adhesions [p value 0.150]. It is concluded that intranasal splints increased post-operative pain significantly and there was no significant benefit in reducing the post-operative adhesion formation with splints

Total inferior turbinectomy for hypertrophied inferior turbinates: postoperative results in 135 patients

The surgical treatment of hypertrophied inferior turbinate remains controversial. A wide variety of surgical procedures have been performed with universally unsatisfactory results. The objective of our study was to evaluate the efficacy and safety of total inferior turbinectomy in relieving nasal obstruction caused by hypertrophied inferior turbinates. The study was conducted at the Departments of Otolaryngology Combined Military Hospital Kharian and Peshawar, over a period of 5 years [January 1997 to December 2001]. Three hundred and twenty two patients suffering from chronic nasal obstruction due to enlarged inferior turbinates underwent total inferior turbinectomy. Out of these, 135 were followed for one year postoperatively and included in the study. Postoperative evaluation was done by formal questionnaire and clinical examination. One hundred and twenty eight patients described marked improvement in their nasal breathing, 4 had mild improvement, and 3 had no change. Three patients developed postoperative bleeding which was controlled by anterior nasal packing only. No blood transfusion was required. Asymptomatic adhesions were found in 8 patients and none developed atrophic rhinitis. We conclude that total inferior turbinectomy is safe and very effective in relieving chronic nasal obstruction caused by hypertrophied inferior turbinates and does not require expensive instrumentation

Sensitivity and spectrum of bacterial isolates in infectious otitis externa

To determine the spectrum and antibiotic sensitivity pattern of organisms from aural swabs taken from cases of infectious otitis externa. Design: Descriptive study. Place and Duration of Study: Department of ENT, Combined Military Hospital, Peshawar, from May 2002 to April 2003. Subjects and One hundred and twenty-four patients, diagnosed clinically as infectious otitis externa without concomitant suppurative otitis media, perforated tympanic membrane or otomycosis, were selected for the study. Samples of pus from external auditory canal were taken on sterile cotton swabs and were cultured on blood agar and MacConkey Agar for 24 to 48 hours. Sensitivity was tested and interpreted by Kirby-Bauer disc diffusion method of grading zones of inhibition. One hundred and twenty four subjects were cultured. Sixteen samples showed no growth. One hundred and eight specimens yielded growth of bacteria. No specimen revealed multiple organisms. Staphylococcus aureus was found in 38%, and Pseudomonas aeruginosa was found in other 38%. Others included Proteus, Enterococci, Klebsiella, and E. coli. Majority of organisms were resistant to co-trimoxazole, amoxicillin and erythromycin, while 100% were sensitive to imipenem. Sensitivity to enoxacin was 96%, Ninety-two% were sensitive to ciprofloxacin and ofloxacin. Pseudomonas aeruginosa and Staphylococcus aureus were the most common bacterial isolates. Both were sensitive to fluoroquinolones. The latter can be used empirically for treatment of acute infectious otitis externa