role of various outpatients aural toileting procedures in the treatment of otomycosis

Otomy costs is not uncommon clinical problem requiring a long term treatment and has a recurrence tendency. Meticulous cleansing especially of anterior metal recess is the treatment mainstay. The aim of this work is to determine the clinical presentation and predisposing factors, compare the efficacy of aural toileting procedures and to assess the syringing role as a safe effective procedure for deep meatal recess debris removal. A randomized prospective comparative study conducted on 91 patients [99 ears] in ENT consultation clinic- Sulaimani Teaching Hospital from April 2007 till November 2008. Patients were divided into two groups: group A underwent ear syringing and group B underwent dry suction cleansing. Data entry and analysis carried out by [Statgraphics] software version 15 [2008]. Presenting symptoms were otalgia [94.5%], ear fullness [74.72%], itching [58.24%], hearing impairment [40.65%], otorrhea [20.87%] and headache [14.82%]. Predisposing factors were ear moisture [94.5%], self cleansing habit [62.63%], ototopical agent overuse [36.26%] and dermatophytosis [19.78%]. Dry cleaning showed complete debris removal in 31 [63.26%] ears and incomplete removal in 18 [36.73%] ears while syringing showed complete removal in 38 [76%] ears and incomplete removal in 12 [24%] ears. Dry cleaning adverse effect was 37.37% compared to 12.12% in wet group. There was insignificant statistical differences [Chi-squared, p=0.3411] between the two regimens and both can be used for treatment. However, clinically gentle ear syringing is less time consuming, less complicated and more meticulous in deep recess cleaning

Clinical manifestations in different types of nasal septal deviation

The relationship between nasal septal deviation and sinonasal diseases is well known, but the lack of a single universally accepted classification system for septal deviation makes the study of the influence of various types of septal deviation on the nose and paranasal sinuses, a matter of debates. Determine the sinonasal pathology associated with different types of septal deformities in symptomatic patients according to Mladina's classification and to evaluate clinical data of nasal septum deformities and their manifestations in symptomatic patients. During the period from July 2008-July 2009, 100 patients of nasal septal deviation were identified at the otorhinolaryngology department of Al-Sulamanyia Teaching Hospital. Routine nasal examination, flexible nasopharyngoscopy and rigid nasal endoscopy were done for each patient. Radiological findings were studied in relation to the type of septal deviation. Allergic patients, smokers with chronic sinonasal diseases and patients with sinonasal tumors were excluded from the study. Most of the cases were assigned with particular deviation type ignoring any minor deformity. The male: female ratio was about 1.8:1. [Male 64%, female 36%] with the highest incidence in the age group [21-40] years. The most common complaint was nasal obstruction 84%. The horizontal septal deviation [types 5 and 6] accounted for the majority of the cases [54%]. Deviation of the nasal septum was more prevalent in males and in the age group 21-40 years. Type 5 septal deviation was the commonest type in symptomatic patients