Interval tonsillectomies; comparison of per and post operative complications in patients undergoing early and delayed after peritonsillar abscess

Peritonsillar abscess is a common clinical problem faced by otorhinolaryngologist all over the world. There are different schools of thoughts regarding tonsillectomy after peritonsillar abscess due to its expected complications. This comparative study was conducted to know about frequency of complications in each of the techniques. To compare per and post operative complications in patients undergoing early and delayed interval tonsillectomy after peritonsillar abscess. This was randomized control trial. Department of ENT, Head and Neck surgery, PGMI/HMC, Peshawar. From Jan 2012 to Dec 2013. After taking detailed history, thorough examination, relevant investigations and informed written consent peritonsillar abscess was drained and then interval tonsillectomy was performed. The complications were noted on predesigned proforma. Chi square test was used to compare the complications in both the groups while keeping P < 0.05 as significant. Out of 60 patients males were 38 and females were 22 with male to female ratio of 1.31:1. Average age was 24.7 years + 7.63 SD with a range of 13-45 year in Group-A, while Group B has average age of 23.97 year + 7.07 SD with a range of 13-46 years. Findings of per-operative and post operative hemorrhage showed that there was insignificant difference in both the groups [P=0.601]. However pain and hospital stay in both the groups was significantly different with P value of 0.004 and 0.000 respectively. Early interval tonsillectomy is an easy and safe procedure for peritonsillar abscess

Diagnostic value of fine needle aspiration cytology in diagnosis of non-thyroidal neck masses

To determine the diagnostic value of fine needle aspiration cytology in the diagnosis of non-thyroidal neck masses. This descriptive study was conducted at the Department of ENT, Lady Reading Hospital Peshawar from January to December 2009. Hundred patients with non-thyroidal neck masses fulfilling the inclusion criteria were included in the study. Fine needle aspirations were performed by the same cytopathologist. The findings were TB 31%, metastatic lymph node 19%, reactive lymphadenopathy 9%, lymphoproliferative disease 11%, pleomorphic adenoma 8%, thyroglossal cyst 5%, carotid body tumour 4%, lipoma and branchial cysts were 3% each, sialolithiasis 2% and one case each of dermoid, sebaceous cyst, adenoid cystic carcinoma, Kikuchi's disease and Ewing's tumour. Correlation of FNAC with biopsy was for TB; true positive, 64.5%, true negative 29.03%, false positive 3.22%, false negative 3.22% and for metastatic lymph node true positive 57.89%, true negative 36.84%, false positive 5.26% and no case of false negative. The diagnostic yield of FNAC was for TB, accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 93.54%, 95.23%, 90%, 95.23% and 90% respectively. Metastatic lymph nodes accuracy sensitivity, specificity, positive predictive value and negative predictive value were 94.73%, 100%, 87.5%, 91.66% and 100% respectively. Overall diagnostic value of FNAC in non-thyroidal neck masses with regard to accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 90%, 90%, 77.42%, 90.41%, 90.41%, and 88.89% respectively. Fine needle aspiration cytology for non-thyroidal neck masses has equal diagnostic yield to open biopsy

Factors influencing the success rate of myringoplasty

To know the factors influencing the success rate of myringoplasty. This descriptive study was conducted at Lady Reading Hospital Peshawar, from June to December, 2004. Fifty patients of central perforations in the tympanic membrane with dry ears for at least 6 months and no focus of infection in ear, nose, sinuses or throat were included in the study. Twenty-five patients underwent Underlay technique while in 25 patients Onlay technique was carried out. Graft was taken up successfully in 80% [40/50] cases. Success rate was 84% in patients with underlay technique [21/25] and 76% in patients with onlay technique [19/25]. The graft take up rate was 83.3% where temporalis fascia [30/36] was used and 71.4% where tragal perichondrium [10/14] was used as a graft material. The success rate was 100% in cases of traumatic perforation [6/6] and 77.3% in perforation caused by chronic suppurative otitis media [CSOM] [34/44]; 87.5% in patients with medium sized perforation [14/16] and 83.3% in patients with large central perforation [20/24]; 71.4% in patients with sclerotic mastoid [20/28] and 91% with cellular mastoid [20/22]; 97.5% in patients with good Eustachian tube function [39/40] and 10% in diseased Eustachian tube [1/10]. The success rate of myringoplasty is affected by various factors especially age, nature and size of perforation, the type of graft used, cellularity of mastoid and good functioning eustachian tube. Graft take up was better in cases of traumatic perforation than the perforation caused by CSOM