Rushika Patel ¹, Sumeet Kaur Ghai ¹, Shreeya V. Kulkarni ¹, Chaitanya Bharadwaj ¹, Vandana Sancheti ¹, K. S. Burse ¹

Affiliations
1 Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN

Abstract

Background: Ossiculoplasty is defined as reconstruction of the ossicular chain using various graft materials and techniques. Aim: Audiological analysis with Pure Tone Audiometry (PTA) of results of ossiculoplasty in cases of safe and unsafe csom and its correlation with preoperative middle ear status using Kartush’s Middle Ear Risk Index (MERI). Methodology: Non randomized prospective study conducted over 2 years in 34 patients with CHL; ossiculoplasty conducted with cartilage, remodeled autologous incus or malleus, malleostapediopexy and PORP; preoperative and 3 months postoperative PTA done. Kartush’s MERI to correlate preoperative middle ear status with postoperative hearing results done. Out of 34 patients operated: 10-cartilage ossiculoplasty, 6-autologous incus, 2-autologous malleus, 4-PORP and 12-malleostapediopexy. Results and Conclusion: Hearing improvement was seen in all types of osssiculoplasties using various materials and techniques. However, there was no significant statistical difference between the various types in relation to the postoperative hearing improvement. Kartush’s MERI was found to be an indicator of postoperative hearing improvement. It was found that as the value of the index increases, the postoperative hearing improvement decreases.

Keywords

Chronic Suppurative Otitis Media (CSOM), Middle Ear Risk Index (MERI), Ossiculoplasty, Pure Tone Audiometry.

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Rohan Vijay Gupta ¹, Shreeya Vinay Kulkarni ², Kiran Burse ³, Chaitanya Bharadwaj ⁴, Vandana Sancheti ⁵, Rushika Patel ⁶

Affiliations
1 Former PG Resident, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 Professor, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
3 Professor and Head, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
4 Associate Professor, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
5 Senior Resident, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
6 Assistant Professor, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN

Abstract

Background: Chronic suppurative otitis media is a common otological condition in India causing hearing loss for which patients seek advice from an otolaryngologist. The perforation seen in chronic suppurative otitis media may be the only sequel remaining when the pathological process in middle ear cleft has healed. Tympanoplasty, the procedure for repairing the perforations of the pars tensa, can be done using a variety of graft materials. In this study two different types of graft materials, fascia lata and temporalis fascia, which can be used in tympanoplasty will be studied. The study will help to know which is better in terms of graft uptake as well as improvement in hearing. This will help in a better understanding of which grafts can be used in tympanoplasty in the future. Aims and Objectives: To compare hearing gain and graft uptake rate between temporalis fascia and fascia lata in tympanoplasty and to study the postoperative morbidity/complications associated with the 2 modalities. Materials and Methodology: The study was conducted on 42 patients divided in 2 groups of 21 each. The 1st group underwent tympanoplasty type 1 by endomeatal approach using fascia lata graft and the 2nd group by a post aural approach using temporalis fascia graft. Regular follow ups and otoscopic examination was done on the patients to check the graft uptake. Pure tone audiometry was done after a minimum period of 2 months post-surgery and was compared with the preoperative audiometry to assess the hearing improvement in hearing. Results and Conclusions: This study compared both temporalis fascia and fascia lata as graft materials used in tympanoplasty. Graft uptake results and gain in hearing were better with temporalis fascia as compared to fascia lata. Temporalis fascia was also associated with lesser post-operative complications. So this study finds that tympanoplasty done by postaural technique using temporalis fascia is better in terms of graft uptake, hearing improvement and postoperative complications when compared to tympanoplasty done by fascia lata.

Keywords

Endomeatal, Fascia Lata, Postaural, Temporalis Fascia, Tympanoplasty

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Saloni Raisoni ¹, K. S. Burse ², S. V. Kulkarni ³, Chaitanya Bharadwaj ⁴, Vandana Sancheti ⁵, Rushika Patel ⁶

Affiliations
1 Former PG Resident, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 Professor and Head, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
3 Professor, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
4 Associate Professor, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik-422003, Maharashtra, IN
5 Senior Resident, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik-422003, Maharashtra, IN
6 Assistant Professor, Department of ENT, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik-422003, Maharashtra, IN

Abstract

Background: Functional Endoscopic Sinus Surgery (FESS) is a physiological and also well accepted surgical treatment for chronic sinus disease that is unresponsive to medical treatment. The most frequent intraoperative complication is bleeding. Various methods are being tried to reduce the bleeding during FESS. But, none of these methods consistently provide the desirable bloodless field for the surgeons. Blockage of Pterygopalatine Fossa (PPF) through the greater palatine foramen is an alternative approach to reduce blood loss during ESS, which is an easy procedure, associated with little complication. Pterygopalatine Fossa Block (PPFB) along with general anaesthesia is effective in patients undergoing FESS surgery. Aims and Objectives: To assess the effect on and the difference in heart rate and blood pressure after pterygopalatine fossa block during FESS surgery. Materials and Methodology: 25 Patients with bilateral nasal pathology undergoing FESS were selected from ENT wards after a written informed consent. The PPFB was done only on one side, while the opposite nostril acted as control, thus each case acted as their own control. Various vital parameters like – heart rate (HR), blood pressure [(BP) systolic and diastolic] were calculated every 15 mins and their average noted. Surgery on the first side was completed and then followed by surgery on the second side. Applying paired-t Test, results were obtained. Results and Conclusion: There was a significant fall in heart rate and blood pressure. There was a positive correlation between these factors. “p value” was found to be highly significant in both the parameters tested. Pterygopalatine fossa block is an effective adjunct to general anaesthesia for controlling heart rate and blood pressure during FESS surgery.

Keywords

Blood Pressure, FESS, Heart Rate, Pterygopalatine Fossa

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Chaitanya Bharadwaj ¹, Rushika Patel ², Shreeya Kulkarni ³, Kiran Burse ⁴, Vandana Sancheti ⁵, Preeti Dudhe ⁶

Affiliations
1 Associate Professor, Department of Otorhinolaryngology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Adgaon Nashik, Nashik – 422003, IN
2 Assistant Professor, Department of Otorhinolaryngology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Adgaon Nashik, Nashik – 422003, IN
3 Professor, Department of Otorhinolaryngology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Adgaon Nashik, Nashik – 422003, IN
4 Professor and Head, Department of Otorhinolaryngology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Adgaon Nashik, Nashik – 422003, IN
5 Senior Resident, Department of Otorhinolaryngology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Adgaon Nashik, Nashik – 422003, IN
6 Former PG Resident, Department of Otorhinolaryngology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Adgaon Nashik, Nashik – 422003, IN

Abstract

Introduction: Fibrous Dysplasia (FD) is a fibro-osseous lesion of the osseous structures of the body. The exact etiology is not known. Monostotic (when one bone is involved), polyostotic (when multiple bones are involved) and craniofacial are the three subtypes of craniofacial dysplasia. When the lesions are limited to contiguous bones of the craniofacial skeleton, it is termed as craniofacial dysplasia. McCune Albright syndrome is the triad of polyostotic fibrous dysplasia, Cafe aulait spots and endocrine pathology. Case Report: This case describes craniofacial dysplasia in a 30 year old female patient who had unusual presentation on the right side of the face involving maxilla, sphenoid, ethmoid and orbit. The clinical features, radiological findings and treatment have been discussed.

Keywords

Craniofacial Fibrous Dysplasia, Maxilla, Monostotic, Polyostotic

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