Pathological findings of chronic supparative otitis media in tertiary care hospital

Objectives: To see the clinico-pathological pattern of findings in the chronic supparative otitis media [CSOM] during surgery

Study Design: A prospective observational study

Place And Duration: This study was conducted in Karachi Medical and Dental College and Abbasi Shaheed Hospital during the period of October 2006 to October 2010

Methodology: For this study, 288 patients were selected. After complete history, examination and relevant investigations surgery was performed and intra-operative findings of middle ear cleft were noted

Results: Total number of patients selected were 288, in which female were dominating slightly with 54.1%. Maximum incidence was noted between the ages of 16-30 years of age in 180 patients [62.5%]. 140 cases [48.61%] had no ossicles damage while 148 cases[51.38%] had one or more ossicles damage. Granulation tissue found in 99 patients [34.37%], while cholesteatoma found in 77 patients [26.73%]

Conclusion: Pathological changes varies from simple mucosal edema to extensive destruction of the middle ear cleft

Pattern of ossicular damage in chronic supparative otitis media

The aim of this study is to determine pattern of ossicular damage in chronic supparative otitis media. Prospective study. This study and was conducted in Karachi and Medical and Dental College and Abbasi Shaheed Hospital during the period of October 2006 to October 2010. 288 patients were selected in this study and intra-operative findings of ossicles were noted. Total numbers of patients was 288, in which female was slight domination with 54.1%. Maximum incidence was noted between the ages of 16-30 years of age which was 180 patients. 209 patients presented with central perforation. 140 cases had no ossicles damages of ossicles damage. Ossicles damage can be prevented by early diagnosis and proper management

Comparison of three different ceruminolytic agents [soda-bicarbonate, almond oil and normal saline] with respect to their efficacy

To compare the efficacy of three ceruminolytic agents for cerumen impaction with respect to its ease of complete removal via suctioning or probe. A comparative prospective study. This study was conducted carried out at the outpatient department of ENT, Abbasi Shaheed hospital, Karachi from November 2010 to March 2011. A comparative prospective study of 75 adult patients with cerumen impaction in either or both of the ears carried out at the outpatient department of ENT, Abbasi Shaheed hospital, Karachi. The study was done after taking the consent of the patients. All the adult patients of age 18 years or greater, of either sex with the symptoms in the ear[s] because of cerumen which was hard/dry and difficult to remove were included in the study. Those of age less than 18 years and not having any symptomatology because of the cerumen or with soft wax which was easy to clear were not included in the study. The study was carried out from November 2010 till March 2011. the patients with problematic, difficult to remove cerumen or cerumen impaction with symptoms were divided in to three groups: Groups A, Group B and Group c; all having equal number of cases that is 25 each. In group A they were given soda-bicarbonate in glycerin based ear drops; in group B almond oil and group C the normal saline for instillation in ear. The doses and timings for drops were equal in all the group and it was 3 drops in the affected ear every 6-hourly for 1-week. They were councilled that the dose should not be missed and they have to lay down for 5 minutes so that drops are absorbed and does not come out of the ear. After one week they were called in the OPD, was compared with completeness of removal of impacted cerumen for the three groups. Ease and completeness of cerumen removal was 80% in group A, followed by 60% for group C and 20% for group B. We found soda-glycerin to be superior to almond oil and normal saline as ceruminolytic agent

Role of antibiotics in the pre and post tonsillectomy period in reducing the morbidity associated with tonsillectomy

The aim of the study is to see the role of pre and post operative antibiotic used in the cases for which tonsillectomy was planned as a primary surgical procedure with or without adenoidectomy, for effects on peroperative blood loss, ease of surgery, postoperative fever and pain, incidence of secondary heamorrhage and return to activities of daily living [ADL]. Department of ENT and Head and Neck Surgery, Abbasi Shaheed hospital, Karachi, from June 2006 - December 2006. Prospective, double blind study. The cases which were selected for tonsillectomy were included in this study. Their full informed and written consent was obtained prior to their inclusion in the study. Two groups were made each consisting of 50 patients. In group I [intervention group] preoperatively antibiotic was used for a period of 3 days and continued for another 5 days postoperatively. The antibiotic used was Amoxicillin-Clavulanic acid according to the weight of the patients [50mg/kg/day]. In the group II [control group] no preoperative or postoperative antibiotic was used. Analgesia was given on the need and demand basis in both the groups. Pain for adult was categorized by using a pain rating scale by the British Pain Society and pediatric age group the modified Toddlers Preschooler Postoperative Pain Scale [mTPPPS]' was used. The questionnaires were given on daily basis to them for 5 days postoperatively, results recorded and then compared. Both of these groups were not aware of each other. The parameters monitored were amount of peroperative blood loss, ease of surgery, whether or not the patients had postoperative fever, secondary heamorrhage rate, pain status and return to activities of daily living. The method for tonsillectomy used was dissection method [cold steel dissection method with ties for hemostasis]. There was a significant reduction in the amount of peroperative blood loss and early return to daily activities in group land also there was an ease of surgery because of less friability of tissue and less infection and bleeding as compared to group II where the patients had a significant amount of bleeding peroperatively and delayed return to activities of daily living with a bit difficulty experienced in dissection. The incidence of post tonsillectomy [secondary] heamorrhage was not found to be of significance suggesting that there might be some other factors that may lead to this complication despite the fact that antibiotics was used in group I in comparison to group II. The level of pain experienced post operatively was not affected in either group suggesting that antibiotics do not help in decreasing or alleviating it, Fever occurred in 3 in group I while 6 had fever in group II. Seeing the results of this study we would recommend the use of pre and post operative antibiotics for the tonsillectomy patients