Cigarette smoking and its effect on gastro-pharyngeal and gastro-esophageal refluxes

Ciastro-pharyageal reflux appears to be associated with various otolaryngological complaints Cigarette smoking is known to affect adversely the defense mechanisms against reflux of gastric acid into the esophagus. To study the relationship between gastropharyngeal as well as gastroesophageal refluxes and cigarette smoking, fifteen subjects underwent 24-hour double - probe pH monitoring while smoking their daily amount of cigarettes. The percentage of time the PH was below 4 during the smoking period was significantly higher than the percentage of time the pH was below 4 during the non-smoking period, proximal, at the level of the upper oesophageal sphincter, as well as distal above the lower oesophageal sphincter. in conclusion, this study demonstrated and concluded that smoking increases both the gastropharyngeal and gastroesophageal refluxes by affection on the defense mechanisms against reflux of gastric acid or increased gastric acidity. Thus, smokers with disorders and / or complaints caused by reflux should, therefore, be advised to stop smoking in order to reduce reflux of gastric acid into the oesophagus and pharynx

Comparative study between hearing results of tympanic membrane grafting with autograft cartilage and fascia

The objective of this study was to investigate the hearing results after primary cartilage tympanoplasty and compare them with those after primary tympanoplasty with temporalis fascia. Only primary cases, in whom the ossicular chain was intact and no mastoid surgery was performed, were included in this study. Indications for surgery included tympanic membrane perforation, retraction and cholesteatoma. Pre- and postoperative speech reception thresholds and air-bone gaps at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz were compared. Eleven patients comprised the cartilage study group [I] and compared with eleven cases with tympanoplasty with temporalis fascia [group II]. The mean improvement in speech reception threshold for both the study group I and group II was 10 dB. The majority of patients in both groups had air-bone gap closure to within 10 dB at all frequencies examined. There were no statistically significant differences in speech reception threshold improvement or air-bone gap closures between the two groups

comparative study between microbipolar dissection tonsillectomy VS. traditional knife dissection/snake with suture tonsillectomy and VS. knife/suction cautery tonsillectomy in children and adults

In this study, a newly described technique for tonsillectomy and adenoidectomy T and A [microbipolar dissection [MBPD]] was compared with knife dissection with suction cautery and snare and suturing of bleeding vessels [KDSC] in a study of 129 children and adults aged 6-21 years. The patients were randomly assigned and stratified by age group into one of three treatment groups. Intraoperative and postoperative measures of T and A effectiveness relative to complications and patient recovery rate were studied and recorded. The preliminary data focused on the reliability of the measures and the potential clinical relevance of the findings with a confirmation of these results. Thus, it appeared that the postoperative bleeding rates were significantly reduced, the recovery rate was improved and return to normal activities was better in the MBPD patients

Chronic otitis media treated orally with ciprofloxacin or topically with tobramycin

To evaluate the efficacy of ciprofloxacin compared with tobramycin and placebo ear drops in the treatment of chronic suppurative otitis media without cholesteatoma, 60 ears in 51 patients were randomly divided into three treatment groups; oral ciprofloxacin hydrochloride, tobramycin ear drops and placebo [1% aluminum acetate solution served as a control group]. All ears were treated for three weeks. Each patient in group 2 and 3 received a small numbered bottle and was instructed to instill five drops three times daily for three weeks and in group 1 received 500 mg oral ciprofloxacin twice daily for the same period. The final clinical and bacteriologic assessment was done after three weeks. The results of this study demonstrated that the organism, which was most commonly isolated from the ear discharge, was Pseudomonas aeruginosa. Its sensitivity to ciprofloxacin and tobramycin was 94.2% and 70.6%, respectively. The clinical response was 78.9%, 72.2% and 41.2% in the ciprofloxacin group, tobramycin group and the control group, respectively

Value of prophylactic antibiotic ear drops in decreasing post-tympanostomy otorrhea

To evaluate the effectiveness of prophylactic polymyxin B sulfate neomycin sulfate-hydrocortisone drops in decreasing the incidence of post tympanostomy otorrhea, a randomized controlled study from ENT department at Al-Zahraa University Hospital. Ninty-nine patients undergoing tympanostomy tube placement [including those undergoing tonsillectomy, adenoidectomy, or both] were randomized into three groups. Patients in group [I] received no antibiotic drops: group [2], received a single dose intra-operatively, and group [3], received an intraoperative dose followed by a 5-day course. A statistically significant decrease was observed in the incidence of post tympanostomyotorrhea between the control [GI] [16.4%] and treatment groups [G2, 8.3%, G3, 8.1%] [P=.01]. A single dose of antibiotics ear drops was effective when patients with middle ears were dry or had serous effusions. A 5- day course was indicated for those patients whose ears had either mucoid or mucopurulent or purulent contents. Thus, from this randomized controlled study, we conclude that antibiotic ear drops are indicated in all patients. A single dose is as effective as a 5-day course but our data support a longer course in certain subgroups