Cochlear Dysfunction in Chronic Otitis Media and Its Determinants.

INTRODUCTION: Long-standing chronic otitis media (COM) may lead to sensorineural hearing loss (SNHL). The present study aimed to evaluate the factors affecting the sensorineural component to counsel patients regarding the risk of SNHL at the event of untreated COM. MATERIAL AND METHODS: A time-bound cross-sectional study was conducted in the Department of Otorhinolaryngology at a tertiary care hospital. The study population included the study group comprising 137 patients with chronic suppurative otitis media (CSOM) and the control group which consisted of 137 individuals with the same age range and gender as the case study group. Moreover, the hearing was assessed using a pure tone audiogram and special tests of hearing. RESULTS: Based on the findings of the present study, the SNHL was found in 71.4% of CSOM cases with an ear discharge duration of more than 5 years. The SNHL occurred in 55.2% and 44.7% of the cases with pars flaccida and of pars tensa perforations, respectively. In the case of pars tensa perforation, greater perforation size resulted in a steady increase in the odds of developing SNHL. Patients with subtotal and total perforations were at higher risk of developing SNHL. CONCLUSION: Patients with longer duration of disease, squamous type of disease, and larger size of pars tensa perforation had greater susceptibility to develop SNHL. Therefore, eradication of the disease from the middle ear and early reconstruction of the hearing mechanism during the course of the disease result in reducing the burden of SNHL.

Aspiration and Steroid Injection-An Effective Approach for Auricular Seroma.

INTRODUCTION: Auricular seroma is a benign condition of the pinna usually following blunt trauma. This condition which presents with a simple swelling of the pinna is occasionally associated with pain and may result in permanent disfigurement of the pinna owing to delay in diagnosis or mismanagement. Various techniques have been proposed and practiced over the years to treat this uncomplicated condition. However, since this condition is notorious for its recurrence, it has always posed a challenge to the ear, nose, and throat surgeons. Therefore, a simple technique known as aspiration and intralesional steroid injection was proposed in this study for the treatment of auricular seroma. MATERIALS AND METHODS: A total of 30 patients with a clinical diagnosis of auricular seroma were studied over a period of six years at a tertiary care hospital in Mangalore, India. The seroma was aspirated with a 22 gauge needle followed by intralesional injection of Triamcinolone acetate (40 mg/1 ml). The patients were followed up strictly for two weeks, one, three, and six months, as well as one year, and thereafter at yearly intervals as long as possible. No recurrence was observed as the main outcome of treatment for at least one year. RESULTS: None of our patients had recurrence at the end of one year. In total, 15 patients followed up for at least two years. In addition, four patients are continuing follow-ups at the moment (i.e. six years post-treatment). CONCLUSION: Aspiration and intralesional steroid injection is a simple, minimally invasive, cost-effective, and a promising treatment modality which avoids recurrence.

Orthodontic Microimplants Assisted Intrusion of Supra-erupted Maxillary Molar Enabling Osseointegrated Implant Supported Mandibular Prosthesis: Case Reports.

Loss of mandibular molars, when not replaced in time, are usually associated with overeruption of maxillary molars. To provide prosthetic replacement for missing lower posteriors, over erupted maxillary teeth have been intruded in past with great difficulty in adults with conventional orthodontics, along with associated problems of root resorption. Currently orthodontic microimplants provide stable intraoral anchorage, allow predictable maxillary molar intrusion enabling reestablishment of functional posterior occlusion with mandibular implant supported prosthesis, thereby reducing need for prosthetic crown reduction in maxillary arch. The added advantage of microimplant is it enables use of sectional appliance in area of concern instead of full arch bracketed appliance which an adult may not accept. The case reports demonstrates, overerupted maxillary molars were intruded using orthodontic microimplants to enable prosthetic rehabilitation of mandibular dentition by osseointegrated implant supported prosthesis. The second case report also demonstrates use of CBCT scan in planning and execution.