Management of tinnitus: oral treatment with melatonin and sulodexide.

The main problem arising from tinnitus is the disturbance it causes in day-to-day life and disturbance in sleep leading to fatigue and general discomfort. We attempted to study the effect of melatonin in conjunction with Sulodexide as a treatment method for tinnitus and evaluate its effectiveness. We studied 102 patients suffering from tinnitus with a Prospective Randomised Controlled Study conducted in a tertiary care ENT department. After randomisation, 34 patients were treated with melatonin and Sulodexide, another 34 were treated with melatonin alone, and the remaining 34 (control group) were managed without therapy in order to evaluate spontaneous variations in quality of tinnitus. Patients were assessed prospectively with Tinnitus Handicap Inventory and Acufenometry both pre-treatment and post-treatment. Among the patients we studied, we found better results with both Tinnitus Handicap Inventory and Acufenometry in the group who received melatonin and Sulodexide as against melatonin alone. Any improvement was noted in the control group. In conclusion, our opinion is that melatonin in combination with Sulodexide is a viable treatment option for patients suffering from central or sensorineural tinnitus.

Management of recurrent otitis media with rapid maxillary expansion: our experience.

UNLABELLED: Management of recurrent otitis media with rapid maxillary expansion: our experience. PROBLEMS/OBJECTIVES: Recurrent otitis media is a frequent problem in the paediatric population. It is commonly associated with adenoid hypertrophy and occasionally with skeletal development syndrome characterised by maxillary anatomical alterations. When this syndrome is present in conjunction with adenoid hypertrophy, surgical management with adenoidectomy and/or myringotomy with ventilation tube positioning does not necessarily ensure a resolution of conductive hearing disorders. METHODOLOGY: We used maxillary rapid expansion in 27 children with a mean age of 7 years affected by recurrent otitis media associated with skeletal development syndrome and adenoid hypertrophy. RESULTS: Rapid maxillary expansion acting directly on the median palatine suture expands the palate and the nasal floor, improving nasal breathing. In addition, maxillary expansion stretches elevator and tensor palatine muscles, helping to restore normal Eustachian tube function, even in the presence of adenoid hypertrophy. CONCLUSION: In our opinion, rapid maxillary expansion results in an improvement in skeletal-facial abnormalities associated with skeletal development syndrome and it can be considered a valid treatment for preventing recurrent otitis media in children affected by maxillary anatomical alterations.

Nasal septal polyps: a report of two cases.

PROBLEM: It is common to see nasal polyps arising from the lateral wall of the nose; however, polyps arising from the nasal septum are rare. Diagnosis of such lesions is usually made by nasal endoscopy and confirmed by computer tomography. METHODOLOGY: Two cases of isolated nasal septum polyps were diagnosed from 150 consecutive functional endoscopic sinus surgeries. Both patients had septal deviation; only one had a history of allergy. The polyps were completely excised in both cases; the septal deviations were not corrected. RESULTS: Both patients remain disease-free after two and three years of follow-up. CONCLUSIONS: Nasal septal deviation does not seem to play an important role in septal polyp development, whereas local nasal inflammatory factors appear to be important for the genesis of septal polyps. Limited resection using a functional endoscopic surgical approach is the best choice of treatment to prevent recurrence of polyps.