ABSTRACT
All penetrating neck wounds are potentially very dangerous and require emergency treatment. The choice of treatment for the stable patient remains controversial, a number of studies encouraging mandatory surgical exploration and a similar number encourage selective surgical exploration. Knowledge of the physical properties of the penetrating object or weapon can help to determine a treatment plan and predict the risk of injury- All tracheal and esophageal injuries with structural damage should be repaired primarily. A case of Gun Shot Wound Neck was air evacuated to Army Hospital R & R Delhi Cantt in a tracheostomised state. Patient was evaluated in detail, he had trachea esophageal fistula. The management of this case is discussed along with principles of management of war injuries.
ABSTRACT
OBJECTIVE: to evaluate hearing in high-risk neonates to find the incidence of congenital and early acquired sensory-neural hearing loss. STUDY DESIGN AND SETTING: The study was designed as a consecutive cases, hospital based study in a tertiary care hospital. PATIENTS: The subjects were 70 normal born neonates and 70 high-risk neonates. The 70 neonates with various high risks included in the study had family history of deafness, prematurity, IUGR, asphyxia, perinatal infections, hyperbilirubinemia, neonatal sepsis, meningitis, ototoxicity and fetal malformations. INTERVENTIONS: The study was conducted over a period of two years from Sep 2000 to Aug 2002. BERA using Octavus neuro-otological computer and a main unit BERA module with integrated pre-amplifier was performed within first 28 days of life and at 6 months follow up. RESULTS: 44 out of 140 neonates showed abnormalities on initial BERA testing. 28 ears out of 67 ears (44 neonates) had losses confirmed at repeat BERA. Wave V was considered to determine the threshold of hearing and was found to be consistently present in neonates and also the wave . Hyperbilirubinemia (18 cases) and prematurity (29 cases) were the most commonly observed. The cases of Hyperbilirubinemia showed raised thresholds, absolute latencies and Wave 1 abnormalities (suggesting affection of eighth nerve). In the cases of Prematurity, 8 ears showed raised threshold at follow up. Asphyxia was found in 5 cases and is known to affect the auditory nerve. Family history of deafness found in 3 cases showed X-linked inheritance in one case and autosomal recessive inheritance in the others. Perinatal Rubella was observed in two cases, which showed hearing loss. Congenital malformations were seen in 7 cases (Waardenberg, Downs, Hydrocephalus and T-O Fistula). Neonatal Sepsis was observed in 3 cases and is known to affect the eighth nerve. IUGR was observed in 3 cases, two had normal hearing while one had no waveforms. CONCLUSION: BERA should be used as a screening tool to test the auditory function in all high-risk neonates.
ABSTRACT
This paper presents an evaluation and results of a study conducted on 62 patients out of 140 cases of chronic headache seen in ENT OPD. 32 patients were taken up for minimal endoscopic surgery. 23 cases (72%) have shown significant relief from headache over a period of 6 months or more. 11 cases showed anatomical / pathological variations at the ethmoidalis infundibulum, the commonest cause being enlarged bulla ethmoidalis followed by minimal polyps/polypoidal mucosa at the frontal recess area. Other causes are hyperplastic sinusitis, high posterior septal deviation, large middle turbinate, paradoxical middle turbinate and concha bullosa.
ABSTRACT
Despite the high human and economic casts involved, conventional warfare is still a harsh reality. This study presents 100 cases of missile injuries of face and neck among service personnel involved in high intensify conflict of recent times. These injuries were caused by fragments of improvised explosive devices/artillery shells (68%), Gunshot wounds (24%) or Mine blast injury (8%). The region wise distribution was face (78%) and neck (22%). These injuries were classified as penetrating (25%) perforating (38%) and avulsive (37%).
ABSTRACT
Sixty head injury patients were evaluated for hearing loss; ten underwent ABER testing. Forty percent of the cases had hearing loss of different degrees. The audiometric pattern was variable in the different types of injuries, although the incidence of conductive deafness was quite low (5%). In most of the cases of sensorineural hearing loss, the end organ was implicated. Recruitment was demonstrated in the ABERs, as well as in the retrocochlear lesions, by studying the IPLs present.
