ABSTRACT
Chronic Rhinosinusitis (CRS) is a common health problem with an estimated prevalence of 6.8% in Asia. The treatment of CRS involves an initial course of maximal medical therapy followed by Functional Endoscopic Sinus Surgery (FESS). Here, we are assessing the outcomes of FESS on CRS using most recent Sino Nasal Outcome Test (SNOT-22) questionnaire, for quantifying changes in symptoms and predicting extent of postoperative improvement. 75 patients who reported in the tertiary health care centre in Department of ENT, MGM Medical College & M.Y. Hospital, Indore and were diagnosed with CRS that did not relieve on medication were selected on the basis of inclusion and exclusion criteria. The selected cases were asked to answer the SNOT-22 questionnaire before the surgery. FESS was done and after three months, the patients were again subjected to the SNOT-22 questionnaire. There was 83.67% overall improvement in postsurgical SNOT-22 evaluations, which was statistically significant (p value < 0.00001). Most common SNOT-22 symptom was the need to blow nose, which was seen in 28 (93.34%) cases, while ear pain was found in 10 (50%) patients and was the least common SNOT-22 symptom. FESS seems to be effective treatment of CRS patients. We observed SNOT-22 to be very effective and reliable in assessing the Quality of Life in CRS patients and to measure the improvement after FESS.
ABSTRACT
To study the specific effects of smoking on laryngeal mucosa and voice using video-stroboscopy, subjective and objective voice analysis. This cross-sectional and observational study was carried out in the Department of Otorhinolaryngology, M.G.M. Medical College & M.Y. Hospital, Indore on 103 subjects with dysphonia (49 smokers and 54 non-smokers), between October 2018 to October 2020. After detailed history and general examination, all the cases underwent video-stroboscopic analysis and voice analysis by simple parameters-Maximum Phonation Time (M.P.T.) & s/z score. The cases answered the Voice Related Quality Of Life questionnaire (V.R.Q.O.L.). The observations between smokers and non-smokers were compared. Statistically significant (P < 0.05) associations were observed between smoking and various vocal fold pathological characteristics. There was statistically significant association of smoking with overall possibility of benign vocal fold lesions (P = 0.0129). Significant association was noted of smoking with specific lesions like leukoplakia (P = 0.02), erythema (P = 0.0161) and Reinke's edema (P = 0.322). The mean M.P.T. was 9.5 s in smokers and 11 s in non-smokers. We observed statistically significant relationship between smoking and abnormal s/z ratio (P = 0.0165). This study shows the observable effects of smoking on vocal fold micro-anatomy and voice. Dysphonia was primary complaint in both groups, but all observations were worse in smokers, indicating harmful effects of smoking.
ABSTRACT
Management of aspirated foreign bodies in children becomes very challenging in absence of most appropriate instruments. Rigid bronchoscopy has evolved in the long course of history. The advent of Hopkins rod telescope and optical forceps has enhanced the efficacy as well as the safety of removing tracheobronchial foreign bodies. Total 36 children of age less than 16 year with confirmed diagnosis of airway F.B. were included in the study. Two types of forceps were used: (1)Optical forceps combined with Hopkins rod lens telescope[n = 25] (2)Standard forceps [n = 11]. Most common age group was 1-5 year [n = 26] with male preponderance [n = 20]. Most common site was right bronchus in 13 cases (RMB-11, RBI-1, RLLB-1) followed by Left main bronchus in 11 cases, trachea in 10 cases, bilateral bronchus and sub-glottis each in 1 case. Vegetative F.B. were found in majority of cases [n = 26]. Mean grasping attempt, Mean bronchoscopic insertion and Mean time taken from insertion of forceps to removal of F.B. were less in optical forceps as compared to standard forceps with significant p-value. Optical forceps have advantage of high resolution & magnified view of airway, spring action in handle and better tactile sensation. These helps in correctly identifying the type, size and site of tracheobronchial foreign body. Precise grasping attempts with optical forceps reduces the chances of complications. Optical forceps have given the new dimension to the Rigid Bronchoscopy and proved to be the real boon for surgeons, residents and patients with F.B. aspiration.
