To Study the Efficacy of Coblation in the Endoscopic Surgery of Sinonasal and Skull Base Masses.

Objective: To study the efficacy of coblation in the endoscopic surgery of sinonasal and skull base masses. Study Design: Prospective Interventional Study. Method: 100 patients with signs and symptoms of nasal obstruction were enrolled for 14 months. On the basis of diagnosis they underwent endoscopic sinus surgery using coblator and their intra-operative blood loss, operation time, post-operative pain threshold using VAS(Visual analogue scale) were enlisted. Result: 80% had Sinonasal polyp followed by Inverted papilloma in 8%, Angiofibroma in 5%, Hemangioma in 3%, Esthesioneuroblastoma in 2% and Rhinosporidiosis in 2%. The Minimum blood loss was 50 ml and Maximum was 600 ml. 30% patients had no pain, 60% had Mild pain and 10% had Moderate pain post procedure. Mean Operation time was 112.86 min. Conclusion: Coblation has proven to have reduced operation time, blood loss and faster wound healing. It has now established itself as an essential tool for advance tumours in nasal surgeries.

Clinical Manifestations and Treatment Outcome of Laryngopharyngeal Reflux on Larynx and Symptom-Sign Correlation.

To evaluate various clinical signs and symptoms of Laryngopharyngeal reflux on the Larynx along with treatment outcome and to establish symptom-sign correlation. Prospective interventional study. 50 patients with symptoms and signs of LPR were enrolled in the study and were followed up for 9 months. Patients were evaluated with a 70° Hopkins rigid laryngoscope and the Reflux Symptom Index and Reflux Finding Score scales were used to grade the sign and symptoms and to diagnose LPR and to compare pre and post-treatment conditions. Patients were given treatments including PPI and diet modification. The most common laryngeal symptom based on the RSI score was sore throat (40%). Other common symptoms were hoarseness of voice (30%) and cough (20%). The most common laryngeal sign based on RFS (Reflux finding score) was Posterior Commissure Hypertrophy (40%). The other common signs were Pseudosulcus (30%), Vocal cord oedema (20%), and Granulomas (10%). Out of the 50 patients, 21 patients (42%) had an RFS score of less than 7. Rest 29 patients (58%) had RFS scores of more than 7. Out of these 29 patients, 19 patients (65.52%) had partial relief from symptoms after 3 weeks of treatment and were advised to take treatment for 3 more weeks, and rest 10 (34.48%) patients were completely unresponsive to treatment. The improvement in symptoms does not always manifest in improvement in signs and there is no correlation between the symptoms and signs of LPR.