Surgical management of otosclerosis- stepedectomy versus stapedotomy

To compare post operative morbidity after stapedotomy with stapedectomy. Quasi-experimental study. Place and Duration of Study: ENT Departments of CMH Rawalpindi and CMH Lahore from Jan 2006 to Jan 2009. Forty eight patients were included in this study and were divided into two groups; 14 patients underwent stapedectomy and 34 patients underwent stapedotomy. Severity and duration of vertigo and hospital stay with stapedotomy were less as compared to stapedectomy. Conclusions: These results demonstrated that postoperative morbidity with stapedotomy was less as compared to stapedectomy

Transpalatal approach- a cosmetically acceptable route for removal of small juvenile nasopharyngeal angiofibroma

To determine frequency of employment of transpalatal route for a cosmetically acceptable outcome in surgically addressing small juvenile nasopharyngeal angiofibroma. Descriptive Study. The study was carried out in department of ENT and Head and Neck surgery Combined Military Hospital Rawalpindi and Combined Military Hospital Lahore from January 2005 - January 2008. Patients age less than 18 years with small juvenile nasopharyngeal angiofibroma [Radkowskis Stage I] were included in the study. These patients were managed surgically. A total of twenty four cases were included in this study, nine [37.5%] were managed by transpalatal route. Four patients had stage la and five had Stage Ib disease. Patients were studied in terms of facial appearance six months post operatively. None of the patients showed any facial deformity. Transpalatal route is novel approach to deal cosmetically with small juvenile nasopharyngeal angiofibroma

Comparison of locally made phonating device versus oesophageal speech in postlaryngectomy speech rehabilitation

To compare the effectiveness of locally made phonating device with oesophageal speech as a communication method in a laryngectomized patient. Randomized Controlled Trial. Combined Military hospital Lahore from January 2004 to July 2007. Twenty five patients who had undergone total laryngectomy were divided in two groups by random sampling. 13 patients were placed in experimental group and provided with a locally made phonating device El [Electro-larynx, 'BM Talk'] and speech training with this device started between 20th to 30th post-operative day. The results were compared to a Control Group consisting of 12 laryngectomized patients who were provided instruction and training on oesophageal speech for communication. Speech assessment was made at the end of 2nd, 4th and 6th month post-operatively in both the groups. Assessment parameters were defined according to the patient's ability to communicate ten predetermined sentences of Urdu and Punjabi to a team of three speech assessors on each speech assessment day. Speech communication score was fixed at 100 if all the spoken sentences were fully understood by all the three assessors irrespective of character of speech, while it was 0 if none of the sentence spoken could be understood by any of the three assessors. In between the two were different percentages of speech communication scores depending on the number of sentences understood by the speech assessors. The character of voice was assessed by Visual Analogue Score where variation between robotic and normal speech character were divided into ten grades from 1 to 10. At the end of six months, speech communication score was 76.62 with SD 17.29 for EL [Electro-Larynx]; while for control group [oesophageal speech] it was 34.17 with standard deviation of 8.63. Those score was compared by using t test and was highly significant i.e. <0.001 in favor of EL. The character of voice was closer to normal in case of oesophageal speech compared to EL where it was closer to robotic. Locally made EL [Electro-larynx] 'BM Talk' is a useful device for speech rehabilitation in laryngectomised patient. It has added advantage of local availability and cost effectiveness. The character of voice may be robotic and monotonous, nevertheless full sentence can be communicated with relative ease to the listener, which is more important factor in our setup