Olfaction and Its Correlates in Allergic Rhinitis: A Case Control Study.

Olfactory dysfunction is frequent in rhinological disease. It has been attributed to nasal obstruction leading to impairment of transport of odorants to the olfactory epithelium or to inflammation in the olfactory cleft. We assessed olfaction in allergic rhinitis and correlated the olfactory score with other variables; in order to elucidate the pathogenesis of olfactory impairment in allergic rhinitis. Forty patients of allergic rhinitis (skin prick test positive) and forty healthy controls were included. The groups were evaluated for olfactory score, nasal airflow, peripheral eosinophilia, and levels of IgE and IL-5 in nasal secretions. The combined olfactory score in the patients was lower than that in controls. The score was better in patients with a better nasal airflow, but no significant association was found between the two. The peripheral eosinophilia and IgE and IL-5 level in nasal secretions was significantly higher in patients but demonstrated no significant correlation with the olfactory score. Allergic rhinitis patients had a decreased olfactory score; which weakly correlated to the nasal airflow. Local IgE and IL-5 were elevated in allergic rhinitis but did not show a significant correlation with olfactory scores. Our study concludes that both factors exist in allergic rhinitis but which factor is significantly responsible for hyposmia is not clear.

Effect of Type 1 Tympanoplasty on the Quality of Life of CSOM Patients.

Chronic suppurative otitis media (CSOM) continues to be an important public health problem despite significant advances in medical science. Ear discharge, pain, discomfort, difficulty in hearing, limitation of routine activities and emotional problems due to CSOM cause a significant impact on the health and general well being of the patient. We have done Type 1 tympanoplasty in tubotympanic type of COM to reconstruct the tympanic membrane and alleviate the symptoms of the patients. This study presents an analysis of the impact of the surgery on the patient subjectively and its correlation with objective outcomes. 45 patients were selected to fill the chronic otitis media-5 (COM-5) questionnaire and underwent pure tone audiometry preoperatively. All the patients underwent Type 1 tympanoplasty by using temporalis fascia graft. The status of the ossicles was checked and documented intraoperatively. Patients requiring ossicular reconstruction or with attico antral disease were excluded. Patients were followed up for a period of 6 months and those with an intact graft after 6 months were included in the study. These patients were again made to fill the questionnaire and undergo pure tone audiometry postoperatively. 37 out of 45 patients (82 %) had an intact graft 6 months after surgery. Marked improvement was observed in subjective scores as documented by the questionnaire, pre- and postoperatively with the mean improvement in total scores being 7.89 ± 4.81 on a Visual Analogue Scale. Also significant improvement was achieved in closure of air-bone gap with the mean improvement being 14.73 ± 8.58 dB. Significant correlation was found between subjective and objective scores in most patients. This study showed that Type 1 tympanoplasty brings about a significant improvement in the quality of life of chronic suppurative otitis media patients. Most patients showed a marked improvement in subjective scores which correlated well with the objective findings of the status of the graft and improvement in air-bone gap. Asymptomatic patients with less preoperative scores showed less improvement in subjective scores which did not correlate with the objective outcomes.

Hemangioma of the oral cavity in a seven year old: a case report.

A rare case of haemangioma of the oral cavity is presented. The lesion was treated using cryo-surgery.

Juvenile angiofibroma: review of a case series and role of embolization.

Here 15 cases of advanced Juvenile angiofibroma are presented. Advantages of wide tumour exposure and preoperative embolization are discussed.

Rhinocerebral invasive aspergillosis.

Here we present 10 cases of rhinocerebral aspergillosis. In this study we included only invasive type of cases. In 4 of these disease had extended into the brain parenchyma and in remaining cases diseases had extended intracranially but dura was not invaded. Details about the operative procedure and followup is presented. Till date only 3 of these cases are surviving.

Benign neoplasms of the tonsil.

Eight rare cases of benign neoplasms of tonsil treated satisfactorily in last 10 years with varied symptomatology are included in this study.

Inverted papilloma of nose and paranasal sinuses -a clinical study.

This study includes details of twentytwo cases of inverted papilloma. It is an uncommon nasal disease. It is treated more radically than other benign conditions of the nasal cavity. The recurrence is frequent and malignant changes are also not uncommon. Histopathological study is important and requires opinion from an experienced pathologist. Rare extension into ear is also observed though the exact mechanism of spread is not understood. Long followup is essential in dealing with recurrences.

Juvenile angiofibroma transpalatal approach for intracranial extensions.

Here we present transpalatal approach for removal of intracranial extensions of Juvenile Angiofibroma (JA) of nasopharynx. Modification of standard transpalatal approach, it is possible to remove extracranial as well as small intracranial tumour. Details of technique, advantages and limitations are presented.

Bera in normal neonates and infants: (Some observations on maturation of auditory pathways).

This study includes eight normal, not at-risk for deafness, neonates and infants of age ranging from 2 days to 1 year. BERA was done at 2 kHz. frequency at 80 dB intensity. In the majority of the subjects, only wave I, II, III and V could be definitely identified. It was observed that latencies of waves decreased as age of neonate/infant increased. Decrease of latency was more marked in first 6 months of life (wave V from 7.2 ms to 6. / ms) as compared to next six months (wave V from 6. 1 ms to 5.9 ms). This could be because of rapid myelination in the first six months of life.

Acoustic biast trauma.

In this study 26 cases of blast injury to ear were studied. Both ears were affected in 9 cases and therefore the number of ears studied being 35. The audiological findings along with the treatment and a followup of 2 years is presented.We found that mixed deafness was commonest and the sensorineural element of the hearing loss started recovering before conductive element, but recovery slowed down later on and was incomplete in most cases. Approximation of torn fragments of tympanic membrane improved its healing. Vertigo lasting for 1-7 days was present in 46.15% of cases. Only one patient had perilymph fistula which was repaired.