RESUMO
To propose a classification of anatomical variation of the caudal septal deviation and propose strategy for the management of caudal septal deviation by septo-rhinoplasty and to evaluate the efficacy of treatment of different types of caudal septal deviation in terms of aesthetic and functional outcome. The study is a retrospective review of 124 cases with significant anterior caudal deviation causing aesthetic and or functional problems, treated by septo-rhinoplasty within a 5 year period from December 2014 to December 2019, with a minimum follow up of 6 months. Visual analogue scale, photographic evaluation and subjective assessment were used for postoperative outcomes. Significant improvement in the treatment of nasal obstruction was achieved, with mean visual analogue scale score of 7.83 preoperatively to 3.56 postoperatively, Subjective assessment showed marked satisfaction in 96 patients, moderate satisfaction in 21 and no improvement in seven patients of total 124 patients. The rate of revision was (4%). A novel classification of anterior caudal septal deviation is proposed with surgical technique directed for individual deformity and we have achieved very good results.
RESUMO
To evaluate various factors that affects the auditory outcomes in pediatric patients with bilateral profound sensorineural hearing loss who underwent unilateral cochlear implantation. 50 prelingually deaf pediatric patients aged between 1 and 6 years with bilateral profound sensorineural hearing loss who underwent unilateral cochlear implantation between January 2016 and June 2018 at our tertiary centre were included in this study. Auditory performance was measured using revised categories of auditory performance score at 1 year post cochlear implantation. A Statistical analysis of several factors was performed to reveal any significant relation with outcomes of cochlear implantation. The results of the study showed that patients with younger age at implantation, patient who used hearing aid prior to surgery and patients with normal cochlear morphology had better auditory outcomes post cochlear implantation than their counter group and are the factors which have positive effect on the cochlear implantation outcomes, whereas factors which did not showed any significant relation with the auditory outcomes of cochlear implantation are gender, consanguinity and birth hypoxia. Age at implantation, use of hearing aid prior to surgery and cochlear morphology are the factors with direct impact on the outcomes of cochlear implant.
RESUMO
To study use of ultrasonic wave bone cutting technique (piezotome) in cochlear implant surgery by veria technique. The Piezoelectric device is a bone cutting tool that transmits ultrasonic high frequency vibrations through a metallic tip to selectively cut bone while sparing the surrounding soft tissues. We have used the piezo tools instead of the perforator in over 50 cases of Cochlear Implant by the non mastoidectomy Veria technique [which uses a specially designed hand piece perforator with a guide (Kiratzidisa et al. in ORL J Otorhinolaryngol Relat Spec 64:413-416, 2002)]. These tools are helpful in: straightening the posterior bony canal wall, making the well for Implant bed, making space for excess electrodes and removing bone tissue close to dura without risk of injury to dura. Though use of Piezo tools in various otologic surgeries has been described but we feel the piezo tools will be an important tool in a CI surgeon's armament.
RESUMO
Tympanoplasty is surgical reconstruction of tympano-ossicular system and includes-Canalplasty, Meatoplasty, Myringoplasty and Ossiculoplasty. To analyse and compare the intraoperative and postoperative aspects and the outcomes of conventional postauricular microscopic tympanoplasty and permeatal endoscopic tympanoplasty this study was conducted on 50 patients undergoing type I tympanoplasty (25 patients divided into two groups; group A-microscopic tympanoplasty and group B-endoscopic tympanoplasty). Advantages, disadvantages and results were compared between the two groups. Success rates and hearing improvement were comparable in both groups while intraoperative ease, postoperative morbidity and operative time was seen superior in endoscopic group. Although, endoscopic technique being minimally invasive yet has disadvantages such as single handed difficult instrumentation, frequent cleaning of scope and thus a steep learning curve. In conclusion permeatal endoscopic tympanoplasty can be considered as a good alternative to the conventional microscopic tympanoplasty.
