Comparative Study of Surgical Outcome in Endoscopic-Assisted Versus Conventional Septoplasty Using Nasal Surgical Questionnaire (NSQ): A Randomized Control Trial.

Deviated nasal septum (DNS) causes nasal obstruction, secretions, decreased sense of smell, bleeding, headache and snoring. This study aims to compare endoscopic-assisted septoplasty versus conventional septoplasty in terms of surgical outcome and intra- and post-operative complications. A prospective study was done on 50 patients aged between 18 and 41 years of which, 41 (82%) cases were males and 9 (18%) were females who had DNS based on clinical examination and diagnostic nasal endoscopy. Patients were randomized by simple randomization into two groups. Functional outcome was assessed using nasal surgical questionnaire (NSQ) prior to and after surgery for 3 months post-operatively and complications associated with the surgery were compared between two groups. In this study, most of the patients had anterior dislocations, present in 37 cases (74%). Improvement in pre- to post-operative visual analogue scale (VAS) for nasal obstruction was significantly better in endoscopic-assisted than conventional septoplasty (p < 0.001*). Pre-and post-operative differences in 4-point likert scale for other nasal symptoms like decreased sense of smell, snoring, secretions, headache and crusting were better in endoscopic-assisted septoplasty (p < 0.001*). Complications in endoscopic-assisted septoplasty were less common compared to conventional septoplasty (p = 0.05). In endoscopic-assisted septoplasty patients, pre-to post-operative NSQ (Nasal Surgical Questionnaire) VAS improvement for nasal obstruction, likert scale change from pre-to post-op were better and complications were lesser compared to conventional septoplasty. This suggests endoscopic-assisted septoplasty has better surgical outcomes and fewer complications and posterior deviations, spurs and inferior deviations can be corrected with ease and fewer complications.

Alterations in cochlear function after exposure to short term broad band noise assessed by otoacoustic emissions.

BACKGROUND: Sudden or chronic exposure to sound alters the functioning of cochlea. This results in temporary or permanent alteration of functioning of cochlear cells. Alteration of functioning of outer hair cells (OHC) of cochlea following exposure to noise can be assessed by measurement of transient otoacoustic emissions (TEOAE). Such a measurement is of great clinical importance in early detection of the damage to the OHC. AIM: In this study we aim to study effect of noise on outer hair cell function by studying the changes in TEOAE's amplitude following exposure to short term broad band noise in healthy volunteers. MATERIALS AND METHODS: Twenty volunteers' ten males and ten females participated in the study. They underwent pure tone and impedance audiometry to rule out ear pathology. Then pre-exposure TEOAE's were recorded. After that they were exposed to broad band noise for two minutes. After gap of five minutes again TEOAE's were recorded. Pre and post exposure amplitude of TEOAE's was analysed statistically.s RESULTS: There was statistically significant difference between pre exposure and post-exposure amplitude of TEOAE's. Pre and post exposure values for A & B amplitudes showed p-value of 0.0001 whereas values for A-B amplitude showed p-value of 0.0001. CONCLUSION: Measurement of TEOAE's can detect early changes in the functioning of outer hair cells which cannot be picked by routine pure tone audiometry. Thus they can be used in assessing early changes in cochlear function following exposure to noise in individuals exposed to sudden noise or working in noisy environments. Thus preventive methods to reduce the noise induced hearing loss in such individuals can be implemented.

To Study the Level of Awareness About Complications of Chronic Suppurative Otitis Media (CSOM) in CSOM Patients.

INTRODUCTION: Chronic Suppurative Otitis Media (CSOM) is one of the most common diseases in clinical practice. It affects large number of people. Disease causes disability and mortality because of its ability to cause complications. Patients develop complications because of lack of awareness about the disease, scarce availability of qualified otologists at peripheral areas and economical constraints. This study was conducted to study the awareness about CSOM and its complications. MATERIALS AND METHODS: Patients suffering from CSOM attending outpatient department of Ear, Nose and Throat Department were included in this study. After taking proper history and examination to confirm the diagnosis patients were given structured questionnaire to assess their knowledge about CSOM and its complications. RESULTS tabulated and compared with literature. RESULTS: Majority of our patients (77.6%) were from low socio-economic status group. Maximum number of patients was from 3(rd) and 4(th) decade of life. Only 29.5% patients understood perforation in Tympanic Membrane (TM) as a cause for continued discharge. 94% patients did not differentiate between safe and unsafe CSOM. 52.2% had knowledge about entry of water in ear as cause for recurrence of discharge in CSOM. 44.7% said CSOM can be cured by surgery. Only 7.4% said infection can spread to brain, 23.3% knew about collection of pus around ear, 11.9% said it can cause vertigo, but none of them recognized facial nerve palsy as complication of CSOM. 38.8% took self medication and 16.4% consulted qualified ear nose throat (ENT) doctor. CONCLUSION: Although CSOM is a major disease affecting large number of people, awareness regarding disease and its complications is still poor. Mass education programs aimed at educating people about CSOM are need of the hour.