Tonsillar Surface Micro Flora: Does it Truly Represent Pathological Tonsillar Flora?

OBJECTIVE: To determine the best method of identifying core tonsillar flora. STUDY DESIGN: Quasi-experimental study. PLACE AND DURATION OF STUDY: ENT Department, Combined Military Hospital, Lahore, from September 2013 to October 2015. METHODOLOGY: Eighty-seven patients of recurrent tonsillitis undergoing tonsillectomy were included. All the patients, after being anaesthetised, had surface swabs taken from the tonsillar surface followed by tonsillar aspiration with a 5cc syringe. Following tonsillectomy, the tonsils were sent for culture of core flora. All three specimens from each patient were cultured according to established criteria. RESULTS: The patient population had 33 (37%) female and 54 (62%) male patients. Flora of 12 (13.8%) surface swabs and 68 (78.2%) tonsillar aspirates matched the flora cultured from core of the tonsils. Chi-square test showed this difference to be significant (p-value <0.001). CONCLUSION: Tonsillar aspiration gave a much more realistic picture of the tonsillar core flora as compared to surface swabs.

Atorvastatin in the management of tinnitus with hyperlipidemias.

OBJECTIVE: To determine the role of atorvastatin in management of tinnitus in patients with hyperlipidemia. STUDY DESIGN: Quasi-experimental study. PLACE AND DURATION OF STUDY: ENT Department, Combined Military Hospital, Rawalpindi, from July 2011 to August 2012. METHODOLOGY: Ninety eight patients of tinnitus with sensorineural hearing loss having hyperlipidemia were included in the study. Their pre-therapy serum cholesterols were measured, and tinnitus scores were recorded on a 'Tinnitus handicap questionnaire'. They were administered tablet atorvastatin 40 mg once daily with low fat diet for 8 months. After 8 months of therapy, patients were purposefully divided into responsive and unresponsive group depending on serum cholesterol levels. Post therapy serum cholesterol levels and tinnitus scores were also recorded after 8 months and compared with pre-therapy records. RESULTS: Serum cholesterol came to within normal limits in 51 (52%) patients (responsive group), while it remained high in 47 (48%) patients (unresponsive group). Improvement in tinnitus score in the responsive group was seen in 36 (70.5%) patients and in 2 (4.2%) patients of the unresponsive group. Improvement in tinnitus scores was compared in the two groups using Fisher's exact test and were found to be statistically better in the responsive group (p < 0.001). CONCLUSION: Tinnitus, in patients having hyperlipidemia, can be successfully dealt with by treating hyperlipidemia with lipid lowering agent atorvastatin.