ABSTRACT
OBJECTIVES: to evaluate the efficacy of sub mucosal diathermy (SMD) and partial resection of inferior turbinate (PRIT) in the treatment of symptomatic enlarged inferior turbinates. STUDY DESIGN: prospective. METHODS: Forty patients of age group 18 -56 yrs with symptomatic enlarged inferior turbinates had given choices for SMD and PRIT. All the patients had history of failed medical treatment. RESULTS: Each twenty patients underwent SMD (group I), PRIT (group II), five pt of gr. I had to have anterior nasal packing after surgery for bleeding. Three pt complained of excessive rhinorrhoea for first 2 weeks while 3 pt of Group 1 complained of nasal blockage for 1 week even after intervention. In group 2, 5 pt had to have re-anterior nasal packing after pack removal. Both groups followed up for 6 months. Nine patients were lost in follow up, so excluded from the study. Following 6 months of follow up, 6 patient of gr. I had recurrence with nasal blockage and in gr. II none had recurrence. CONCLUSION: PRIT is better than SMD in long course; nevertheless it should be reserved for failed SMD, not as a primary option.
Subject(s)
Adolescent , Adult , Diathermy/methods , Female , Humans , Male , Middle Aged , Nasal Obstruction/pathology , Prospective Studies , Turbinates/pathologyABSTRACT
OBJECTIVE: To compare the efficacy of chemical cautery (AgNo3) and steroid nasal spray against SMD (submucosal diathermy) in the treatment of symptomatic Inferior Turbinate Hypertrophy (ITH). MATERIALS AND METHODS: Patients attending OPD in the department of ENT &HNS at KMCTH with symptomatic Inferior turbinate Hypertrophy were taken with their approval included for the study. Patients were divided into 2 Groups: in the first Group 25 patients were included and treated with chemical cautery (AgNo3) under Local Anaesthesia (LA), followed by steroid nasal spray for 3 months; in the second Group 25 patients were included and were treated with SMD (submucosal diathermy) under General Anaesthesia (GA).They all had history of use of topical nasal decongestant for different time period. Patients were followed up for 6 months. RESULTS: In Group 1, 16 patients complain of burning sensation for first week and 8 patients complain of continuous nasal blockage for 6 weeks.1 patient complain about inosmia for 2 weeks. In Group 2, nasal pain was complained by 17 patient for 2 weeks. 3 patients complain of persistent nasal blockage for 4 weeks. 3 patients complain of anosmia for 4 weeks. After completion of 6 months in Group 1, 20 patient has recurrent nasal blockage, whereas in Group 2, 10 patient has recurrent nasal blockage. Besides these, other symptoms noticed during initial phase did not appear. CONCLUSION: Chemical cautery (AgNo3) and steroid nasal spray is easy to follow, has less complication ,but failure rate is high, whereas SMD is procedure with less failure rate, but has to carried out under GA and has more discomfort postoperatively. For symptomatic inferior turbinate hypertrophy, where topical nasal decongestant has little role SMD is the choice of treatment for longer relief.
Subject(s)
Administration, Intranasal , Adolescent , Adult , Androstadienes/administration & dosage , Anesthesia, General , Anti-Bacterial Agents/administration & dosage , Anti-Infective Agents, Local/therapeutic use , Anti-Inflammatory Agents/administration & dosage , Cautery/methods , Diathermy/methods , Female , Humans , Hypertrophy/therapy , Male , Middle Aged , Nasal Obstruction/therapy , Silver Nitrate/therapeutic use , Treatment Outcome , TurbinatesABSTRACT
Necrotizing fasciitis (NF) of head and neck is a fulminant infection associated with necrosis of connective tissue which spreads along the fascial planes with high mortality rate. It is usually polymicrobial, odontogenic and occurs more frequently in immunocompromised patients. Because of the rarity of the disease, early diagnosis and early management is often delayed. We present a diabetic patient who developed NF of head and neck following tooth extraction. Because of vigorous teamwork he could be saved from the fatal disease but required extensive plastic repair. Every clinician should be aware of such a disease, particularly in immunocompromised patients and necessitates earliest diagnosis and intervention to save their life. Keywords: Necrotizing fasciitis, necrotizing soft tissue infections.
Subject(s)
Adult , Fasciitis, Necrotizing/etiology , Focal Infection, Dental/complications , Head , Humans , Male , Neck , Tooth Extraction/adverse effectsABSTRACT
OBJECTIVE: the aim of this study is to describe the extension of unsafe middle ear disease in the sinus tympani and to review the methods of surgical access to remove the disease from this area. METHODS: Of the 164 operated ears with unsafe chronic suppurative otitis media 64(39%) ears had variable disease extension into the sinus tympani and were included in the study. Sixty two ears underwent canal wall down (CWD) procedure while remaining two underwent tympanoplasty with bone work. RESULT: Five operated ears had deeper extension of the disease into the sinus tympani. And despite of different maneuver the complete removal of the disease could not be confirmed. Six ears (9.4%) had recidivism. CONCLUSION: The study emphasizes on the greater incidence of this disease extension into this difficult anatomical area and their complete removal may not be always possible. But one should require thorough knowledge and surgical expertise to work in this difficult area of posterior mesotympanum.
Subject(s)
Adolescent , Adult , Aged , Child , Cholesteatoma, Middle Ear/pathology , Female , Humans , Male , Middle Aged , RecurrenceABSTRACT
Oncocytic tumors of salivary glands are rare. Diffuse oncocytosis is the rarest lesion among 3 principal groups of oncocytic lesions as classified by WHO. Only seven cases have been previously reported in the literature. We report a case of diffuse hyperplastic oncocytosis of the parotid gland in a 63-year-old male with a brief review of literature. To the best of our knowledge this is the first case from Indian subcontinent.
Subject(s)
Adenoma, Oxyphilic/pathology , Humans , Hyperplasia , Male , Middle Aged , Oxyphil Cells/pathology , Parotid Gland/pathology , Parotid Neoplasms/pathologyABSTRACT
Post kala-azar mucosal leishmaniasis (PKML) is relatively rare in the Indian subcontinent. We describe an ulcerative variant of PKML with nasal involvement in a Nepalese adult male. He had ulcerated plaque over the upper lip with extensive involvement of nasal columella and septum. He came from endemic area for kala-azar and had a previous history of kala-azar. There were plenty of LD bodies in microsections and FNA of submandibular lymph node.