Unilateral Meniere's disease; intra tympanic injection of low dose gentamicin in the treatment

ABSTRACT: Meniere's disease is chronic progressive disease with unclear idiopathic etiology and symptomatic improvements with treatment

Objectives: To analyze the efficacy of low dose intratympanic injection of gentamicin for vertigo control in unilateral Meniere's disease. Study Design: Quasi experimental study. Settings: Department of ENT, PIMS, NESCOM and IMDC Islamabad

Materials and Methods: Gentamicin was used intra tympanically in this multicentre study of 75 patients over a period of 8.5 years between 1[st] January 2005 to 30[th] June 2013 in definite Meniere's disease according to the 1995 Document of American academy of otolaryngology- Head and Neck Surgery [AAO-HNS].All these centers followed same criteria and procedures. Single dose of 1 ml Gentamicin solution 40 mg/ml was instilled in the middle ear through the grommet under microscope and followed up for 3 months and two years. The staging of disease [hearing thresholds] the degree of disability [frequency of attacks per month] and the functional level were assessed before and after treatment

Results: Among 75 patients, 41 were female and 34 were males between age ranges of 25 to 70 years. Most of the patients in the study had stage 2 [23/75] and stage 3 [41/75] Meniere's disease. About 68[91%] patients were having good control of vertigo at the end of two year of intratympanic gentamicin without any loss of hearing

Conclusion: A single Low dose intratympanic gentamicin is effective in controlling vertigo in patients with Meniere's disease with no further deterioration in hearing for at least two years follow up

Association of smoking with lymph node metastasis in early stages of squamous cell carcinoma of tongue

To determine the relationship of lymph node metastasis with smoking in T1 and T2 staged squamous cell carcinoma [SCC] of tongue. An analytical study. ENT Department of Pakistan Institute of Medical Sciences, Islamabad, from 1st January 2001 to 31st December 2002. A total of 60 patients of T1 and T2 of SCC of oral tongue were selected. These patients were divided into two groups on the basis of history of smoking. Also these patients were clinically examined for lymph node metastasis and FNAC done for the confirmation of diagnosis. Odds ratio [OR] and p-value were statistically determined to asses the association between lymph node metastasis and smoking. The odds ratio for patients with history of smoking to develop lymph node metastasis was 1.896 but association was statistically insignificant [p = 0.24]. This study indicates that although smoking increases the risk for lymph node metastasis but the association is insignificant in T1 and T2 staged SCC of tongue

Role of cryosurgery in chronic non-infective rhinitis

Cryosurgery is the therapeutic application of cold at profoundly low temperatures [below 0 ring above C] for tissue destruction. This is a simple, conservative, painless and time saving procedure. There is favourable healing less scar formation with little or no blood loss. Recurrence rate of 10% is recorded in the literature for cryo-treated benign lesions of head and neck. This series of 188 patients [male-96, female-92] is presented, who were treated with cryosurgery during the period may, 1986 to may, 1991

comparison of tragal perichondrium with or without cartilage with temporalis fascia for tympanoplasty

A comparative study of 160 patients who had tympanoplasty performed at Pakistan Institute of Medical Sciences, Islamabad, between the periods of Oct. 1987 and Oct. 1990 is presented. Two types of grafting materials were used in the repair of the tympanic membrance, viz; temporalis fascia and tragal perichondrium with or without cartilage. Results of 99 patients with tragal perichondrium-cartilage vs. 61 patients with temporalis fascia are presented. All these cases were followed up for at least one year. Tragal perichodrium with or without cartilage was found to be superior to temporalis fascia