Tympanic membrane perforations secondary to blast traumaan experience of 74 affected ears

Objective: To determine the rate of spontaneous healing in different size of perforations and to analyze associated findings in cases of tympanic membrane perforations secondary to blast trauma

Study design: Retrospective Observational study

Place and duration: Department of ENT CMH Peshawar from 1[st] January 2009 to 31[st] December 2010

Patients and methods: Data of all patients diagnosed asblast induced 'tympanic membrane perforation' presenting from 1[st] January 2009 to 31[st] December 2010 was retrieved and analyzed. Depending upon size of perforation ie small, medium and large, cases were divided into three groups. All cases were managed conservatively for 3 months. Rate of Spontaneous healing, any surgical intervention and its outcome were analyzed in these three groups

Results: Fifty three patients with tympanic membrane perforation due to blast injury fulfilled the criteria to be included in this study. 32 [60.38%] patients had unilateral perforation and 21[39.62%] had bilateral perforation thus the total number of ears included in study was 74. Age range was 10 to 55 years with mean age 29.07+-8 years. Spontaneous healing was 94% in small perforations, 70.83 % in medium and 12.9 % in large perforations in three months' time

Conclusion: Further studies are required to find out the optimum time of surgical intervention to achieve best results in medium and large perforations

Review of 300 cases of hoarseness of voice and its management in ENT department unit I, allied hospital Faisalabad

Objective: Aim of the study was to determine the prevalence and various management options of Hoarseness

Place and Duration of Study: 300 patients were selected from ENT OPD and casualty department of Allied Hospital, Faisalabad during January, 2013 to June, 2014

Materials and Methods: 300 patients were selected for study. The patients were assessed and a treatment plan formulated. Treatments were given depending on patients symptoms, vocal requirements and clinical findings

Results: In our study, majority of the cases, 116 patients [38.66%] were found to be suffering from Acute and Chronic Laryngitis, as the leading cause of Hoarseness. Acute Laryngitis was found in two peaks of age groups, one below 10 years of age, then the 2nd peak was found in age group between 10 to 20 years. In our study 46 patients of Tumors [15.33%] were the 2nd highest cause of Hoarseness. Tumors were found to be maximum in age group of 50 to 60 years. 49 patients were found to be suffering from Vocal Nodules [16.33%]. Vocal Nodules were found to be maximum in the age group between the 30 to 40 years. Vocal Cord Paralysis was found in 33 patients [11%]. Trauma, Blunt or Iatrogenic [injury to Recurrent Laryngeal Nerve following Thyroidectomy] was found in 27 patients [9%] as a cause of Hoarseness. Trauma was common in the age group between 10 to 20 years. 18 patients [6%] were found to have Vocal Polyps and the maximum age group was found to be between 30 to 40 years. Diphtheria was found in 8 patients [2.67%] and the maximum age group was below 10 years. All improved by timely ADS, Antibiotics and tracheostomy. Laryngeal Web was found in only 3 patients [01%] and the age group was again below 10 years

Conclusion: Our study concludes that acute and chronic laryngitis is the leading cause of hoarseness [42% of cases] and management plan varies according to its etiological cause from conservative voice rest and speech therapy to surgical intervention

Review of 300 cases of epistaxis

Objective: Aim of the study was to determine the etiology and management options of epistaxis admitted through emergency in our ENT Ward of Allied Hospital, Faisalabad

Place and Duration of Study: This study includes 300 cases of epistaxis admitted through emergency in our ENT Ward of Allied Hospital, Faisalabad from January, 2013 to September, 2014

Materials and Methods: All the patients in this series were admitted through Emergency of ENT Department, Allied Hospital, Faisalabad. Detailed history and thorough examination was done in all the patients. Investigations to measure Hemoglobin, total and differential Leucocyte Count, Platelet Count, Random Blood Sugar, Electrolytes and Serum Creatinine. Bleeding parameters like, Bleeding Time / Clotting Time [BT/CT], Prothrombin Time and Activated Partial Thromboplastin Time [APTT] should also be requested

Results: In our study of 300 cases, 56 cases [18.67%] were of the maximum age group [51 to 60 years] and the minimum 30 cases [10%] were of age group between 1 to 10 years. 180 cases [60%] were males and 120 [40%] were females. Hypertension was the leading Etiological Factor in 83 cases [27.67%] in our study. Next was the Idiopathic group in 67 cases [22.33%]. Regarding treatment Anterior Nasal Packing was found to be sufficient in 123 cases [41%] in our study. 94 cases [31.33%] were required to be done Nasal Cautery. Only 09 cases [3%] required Posterior Nasal Packing. Arterial ligation or endovascular embolization was not required in any case

Conclusions: Our study concludes that hypertension is the leading cause of Epistaxis [27.67% of cases] in the age of group of 51 to 60 years [19% of cases]. Whereas, the most effective treatment is Anterior nasal packing [41% of cases]