RESUMO
Microdebrider is a modern powered instrument which is electrically driven with a shaver and a suction. The present study aims to assess the subjective and objective outcome in patients with sinonasal disease after microdebrider assisted endoscopic sinus surgery. A prospective observational study was carried out among 40 patients with symptoms suggestive of sinonasal diseases willing to undergo microdebrider assisted sinus surgery at our tertiary care hospital from January 2019 to December 2019. All the patients underwent microdebrider assisted endoscopic sinus surgery (ESS). Patients were subjectively evaluated using the Lund and Mackay staging system using visual analogue score and objectively using nasal endoscopy by the Lund and Kennedy scoring system preoperatively and post operatively after 6 weeks. 40 patients were included in the study. A mean age of 37 years were noted. All patients showed significant statistical improvement in Lund Mackay scoring system by visual analogue scoring and Lund Kennedy endoscopic scoring postoperatively. Thus, microdebrider offers a better therapeutic approach for patients with sinonasal diseases when compared to endoscopic surgery with the conventional instruments. The advantage of using microdebrider in ESS remains to be proper removal of the pathology, good surgical field and better postoperative outcome.
RESUMO
To compare the effectiveness between topical mometasone furoate nasal spray versus topical fluticasone furoate nasal spray in the treatment of chronic rhinosinusitis. Randomized control trial was conducted involving 70 patients. One group received topical mometasone furoate nasal spray and the other group received fluticasone furoate nasal spray for 3 weeks. All patients were prescribed oral ciprofloxacin for 3 weeks and were subjectively evaluated using the Lund and Mackay staging system and objectively using nasal endoscopy by the Lund and Kennedy scoring system. There was no inter group significance but all patients improved significantly after the administration of either of the steroid sprays. Following administration of steroid nasal sprays, there was clinically significant improvement in the symptoms and signs of chronic rhinosinusitis, but there was no statistical significance between the two study groups. Thus, steroid nasal sprays significantly improve the symptoms and resolution of signs of chronic rhinosinusitis. The choice of drug still remains uncertain to the clinician. However, long term studies with more sample size is needed to arrive at sound conclusions.
RESUMO
The aim of this work was to study the clinical presentation of tracheo-bronchial foreign body aspiration in children for its early diagnosis. This article attempts to address the potential hazards of foreign body inhalation in children and its subsequent management by rigid bronchoscopy. This study was conducted in Department of Otorhinolaryngology, K.L.E.S Dr. Prabhakar Kore Hospital, Belgaum, for a period of 1 year. Children less than 16 years of age with history suggestive or suspicious of foreign body aspiration were screened clinically and radiologically and those patients with high index of suspicion of foreign body were included in the study. All patients were subjected to rigid bronchoscopy under general anaesthesia and the results were analyzed. This study comprises of 29 patients with suspected foreign body aspiration. On rigid bronchoscopy, foreign body was found and successfully removed in 22 patients. Highest incidence was seen in boys between 1 and 2 years age. History of foreign body aspiration was absent in most cases and children presented with combination of symptoms. Obstructive emphysema was commonest chest X-ray finding. There was no significant difference in the site of foreign body aspiration on the right and left bronchus and commonest foreign bodies were vegetative type. Complication rates in this study were low as compared to previous studies. Tracheo-bronchial foreign body aspiration is very common in children. Foreign body aspiration usually presents as an un-witnessed episode and a high index of suspicion by the surgeon, even in absence of a positive history is necessary to prevent morbidity and mortality due to delayed or misdiagnosis. Foreign body aspiration is an emergency and should be removed by rigid bronchoscopy at the earliest to prevent complications.
RESUMO
Vallecular cysts are rare and vary from small cysts to large ones occupying the whole vallecula obscuring the view of the larynx. In the latter situation careful assessment and planning of airway management is required as in our case.
