Fate of middle ear implants.

During the period 1981 through 1993, 613 cases out of a total of 4340 ear operations performed, needed ossicular chain reconstruction. This excludes stapedectomy operations. Out of 613 cases, 371 were cholesteatomatous and the rest were of safe chronic otitis media. Various graft materials used in ossicular reconstruction consisted of autologous ossicles or tragal cartilage, homologous preserved ossicles, cortical bone, human dentine, cadaveric styloid process and gold prosthesis. Results of the study show the extrusion rate of 1.54% with autologous ossicles, 1.43% with homologous ossicles, 1.19% with tragal cartilage, 3.61% with human cadaveric costal cartilage, 5.45% with cadaveric styloid process, 7.14% with dentine and 8.70% with gold prosthesis. These results are largely comparable with other studies. Natural graft materials like autologous and homologous ossicles have been found to have better take-up and long-term acceptance.

Technique of extended transcranial approach for massive nasopharyngeal angiofibroma.

Various surgical approaches have been described to deal with extensive nasopharyngeal angiofibromas. These lesions, particularly those with a large intracranial extension and involving the cavernous sinus, pose a formidable surgical challenge. An extended transcranial approach was employed to resect successfully 2 such lesions.

The styloid process in ossicular chain reconstruction (a pilot study).

Our pilot study reports twenty-six cases of resolved chronic otitis media in which the human, cadaveric styloid process was used as an ossicular graft material. A maximum follow-up of one year is presented in this paper. There was no extrusion or rejection of the styloid processes. Hearing improvement with a closure of the air-bone gap to within 10-15 dB. of the pre-operative bone conduction was found in most cases. So far the styloid process has proved to be an ideal ossicular graft though the long-term results are yet to be seen.

Septilin and geriforte in allergic and vasomotor rhinitis.

Our study comprised 50 patients of allergic and vasomotor rhinitis. Seventeen patients gave history of stress and strain hence they were given Geriforte in addition to Septilin. The results of therapy were judged on following criteria: i) Symptomatic improvement. ii) Appearance of nasal mucosa before and after the therapy. Thirty-nine patients (78%) were cured 100% as they had total relief from symptoms along with change of nasal mucosa from bluish to pink. Eight patients (16%) had about 75% improvement and 3 patients (6%) had only 50% improvement. These patients were advised to continue the therapy for a longer time (6-8 weeks). Of these, 4 patients showed further improvement. In our opinion, Septilin has proved very useful in cases of allergic and vasomotor rhinitis. The patients who have history of stress and strain may also need Geriforte in addition to Septilin.

Transtympanic neurectomies for control of drooling.

Twenty patients of drooling were studied. Of the 20 patients studied, 8 patients underwent bilateral chorda tympani nerve section, and 12 patients underwent bilateral chorda tympani nerve along with bilateral tympanic nerve sections. Bilateral chorda tympani nerve section in combination with bilateral tympanic nerve section is a better and more effective procedure for control of drooling than bilateral tympanic nerve section alone. In both these methods there is immediate stoppage of drooling i.e. on 2nd postoperative day but chances of recurrence of drooling are less in chorda tympani nerve section in combination with tympanic nerve section (17%) than chorda tympani nerve section alone (38%).