KTP laser debulking of recurrent nasal polyps: a preliminary report

Surgery for recurrent nasal polyposis is a challenging task. Although surgical lasers were introduced more than 30 years ago, their use and popularity in nasal and sinus disease have been limited. This study was conducted in a prospective manner with the aim of reporting the results of the endoscope assisted KTP laser in debulking recurrent nasal polyps. 25 Patients with recurrent nasal polyps complaining of nasal obstruction refractory to medical therapy were subjected to KTP laser debulking of these polyps under local anesthesia. Five patients were lost in the follow-up period. Subjective assessment of the patients symptoms revealed improvement of all patients at 3 months and of 90% of the patients at 6 and 12 months. Endoscopic examination revealed no polyps at 3 months. Recurrent polyps were detected in 4 patients [20%] at 6 months, 2 of them were symptomatic, so they were subjected to further laser debulking of these polyps. None of our patients had recurrent polyps at 12 months. KTP laser has proved to be an effective tool in debulking recurrent nasal polyps with minimal complications, excellent patients tolerability and recurrence rate which is comparable to conventional endoscopic techniques

Intratympanic gentamicin injection in unilateral meniere's disease: effects on vertigo attacks and hearing level

It is generally accepted that there is no specific therapy to cure Meniere's disease. The use of intratympanic gentamicin appears to be quite popular and may replace vestibular surgery. To evaluate the use of intratympanic gentamicin injection in eliminating incapacitating vertigo, while preserving hearing in Meniere's disease. 18 patients [11 males and 7 females] diagnosed as definite unilateral Meniere's disease, in accordance with the 1995 AAO-HNS guidelines, were selected. Each patient had 3 successive intratympanic gentamicin injections with one week interval. Patients evaluation was done pre-treatment and 1, 3, 6, 12, 18 and 24 months posttreatment regarding level of functional disability, vertigo control, hearing level, tinnitus and ear Fullness. 2 patients were lost during follow-up, so they were excluded from the study. Based on the 1985 AAO-HNS guidelines, vertigo control was complete in 12 patients [75%], substantial in 3 patients [18.75%] and insignificant in 1 patient [6.25%]. After exclusion of 2 additional patients with dead ears, hearing was not changed in 10 patients [71.43%], improved in 2 patients [14.28%] and worsened in 2 patients [14.28%]. No functional disability was encountered in 10 patients [62.5%], mild disability in 5 patients [31.25%] and moderate disability in one patient [6.25%] two years post-treatment. Intratympanic gentamicin injection is an excellent alternative to invasive surgical procedures in cases of Menicre's disease that resist medical treatment. It is an easy, effective office-based procedure, but with variable degrees of hearing level affection