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Shreeya Kulkarni ¹, Kiran S. Burse ¹, Devashri Patil ¹, Chaitanya Bharadwaj ¹, Vandana Sancheti ¹, K. Manu Bharath ¹

Affiliations
1 ENT Department, Dr. Vasantrao Pawar Medical College and Hospital, IN

Abstract

Introduction: Chronic Suppurative Otitis Media (CSOM) is frequently associated with symptoms of inflammation like discharge from the ear or pain. In many cases, patients suffer from hearing loss causing communication problems and social withdrawal. Tubotympanic type of chronic suppurative otitis media is characterized by a perforation of pars tensa, while marginal & attic perforations are pathognomonic of attico–antral variety. The latter category is usually associated with the presence of cholesteatoma. In cases of cholesteatoma, complications like facial nerve paralysis, meningitis, cerebellar abscess, sigmoid sinus thrombosis may develop and potentially threaten the patient’s life. The aim of this study was to retrospectively perform analysis of patients suffering from Chronic Suppurative Otitis Media, visiting our Tertiary Health Centre, Nashik. Materials and Methods: This was a retrospective study, conducted in a tertiary care medical college hospital over a period of 5 years. The study group comprised 528 patients in and around Nashik District and were subjected to Tympanoplasty or Mastoid surgery. Results: Complete data records from 528 patients were available for statistical analysis. Maximum numbers of patients were in age group 21–40. High prevalence of CSOM was found in females. 408 patients had CSOM of Safe type. 97 patients had CSOM of unsafe type, whereas 23 patients had unsafe CSOM with complications. 381 patients underwent Type 1 Tympanoplasty, while 31 patients underwent Modified Radical Mastoid Surgery. 61 patients were operated for MRM with Tympanoplasty and 28 patients were operated for MRM with Myringostapediopexy. 27 patients were operated for revision tympanoplasty. Different methods of tympanoplasty were performed. Simple underlay was done in 123 patients. Maximum patients about 245 were operated by cartilage support method of tympanoplasty. Anterior tucking was done in 40 patients. Myringostapediopexy was done in 28 patients. Ossiculoplasty with tragal or conchal cartilage was done in 61 patients. Graft was not placed in 31 patients. Temporalis fascia was used in maximum patients. In 90.9% of patients temporalis fascia was used. Fascia Lata was used in 3.2% of patients. Conclusion: Retrospective study of patients with CSOM shows: females were affected more than males. Majority of patients were in age group of 21 to 40 years. The reason could be that this age group is socially active and health conscious. 77.3% of patients had safe CSOM while 22.7% of patients had unsafe CSOM. 2.27% of patients had extra–cranial complication, and 2.08% of patients had intracranial complications. 5.1% of patients underwent revision tympanoplasty surgery. Temporal is fascia as a graft material was used for tympanoplasty in maximum patients, and cartilage support method of tympanoplasty was used in majority of patients. Maximum patients were operated in year 2012. This was due to conduction of camps in peripheral areas around Nashik City which shows that CSOM is more common in patients of lower socioeconomic group, overcrowding, sub–standard hygiene and under resourced health care.

Keywords

Chronic Suppurative Otitis Media, Cartilage Tympanoplasty, Modified Radical Mastoidectomy Surgery

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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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