Fungal spectrum in otomycosis at tertiary care hospital.

Introduction: Otomycosis is a superficial mycotic infection of the external auditory canal that is caused by opportunistic fungi. It is a common fungal infection of the ear that is worldwide in distribution. The infection usually characterized by inflammation, pruritus, trauma to external auditory canal, scaling and severe discomfort such as suppuration and pain. We have tried to clarify the different causative factors & predisposing factors for otomycosis in our environment. Material & Methods: In this study we were including 100 patients (53 female and 47 male) with presumptive diagnosis of otomycosis. We performed mycological analysis on swab or fungal ball from external auditory canal of 100 patients. The diagnosis was confirmed micro biologically by direct microscopy (10% KOH mount) and fungal culture methods. Results: Otomycosis was more common among females as compared to males & also common in age groups of 20-35 yrs. The most common fungal pathogens isolated were Aspergillus niger (75.82%) followed by Aspergillus fumigatus( 13.19 %), Candida albicans ( 7.69 %) & Aspergillus flavus ( 3.3 %). while bacterial co infection/ super infection was detected in 6 cases. Conclusion: In this study we observe that otomycosis is unilateral condition more common in young age housewives and farmers particularly during summer and rainy season.

A comparative study of ossiculoplasty by using various graft materials.

Introduction: The use of ossicular graft material in the ossicular chain reconstruction has significantly improved the results in the hearing after the tympanoplasty and tympanomastoid surgery for the chronic otitis media. The ossicular chain transmits the vibration of tympanic membrane to the inner ear with impedance matching function failure to which results in > 50dB hearing loss of conductive variety. Material and Method: A Prospective study of 76 patients who underwent ossiculoplasty was done in the department of ENT & Head and Neck Surgery , Sir T. Hospital ,Bhavnagar, Gujarat between May 2007 to June 2009.Only patients with conductive hearing loss were included in study and underwent ossiculoplasty with using various graft material and assessment done by post operative closure of air bone gap. Most available graft material used are auto graft, cartilage and bone, and various biosynthetic materials like gold,Teflon,plastipore,titanium etc. Results: Majority of patients are middle age group with moderate conductive hearing loss. The comparison of hearing improvement between various graft materials at 2 month and 5 months post operatively were studied in the relation to the postoperative air bone gap closure shows that auto graft and gold prosthesis are cost effective with comparable results obtained as by expensive titanium and plastipore prosthesis. Discussion & Conclusion: The ossiculoplasty materials produce varying results. The titanium and plastipore are rather expensive for the Indian patients , particularly for the government hospital poor class patients. We have tried to evaluate the results using the economical and readily available graft materials like cartilage, bone and gold prosthesis for ossiculoplasty and compared its results with costly plastipore and titanium prosthesis. prosthesis