How to cite this article:
Jain S, Singh SP, Upadhyay VP, Dubey AK, Singh HN. Comparative Study of Advantages and Disadvantages of Endoscopic versus Conventional Myringoplasty—A Prospective Study. Int J Otorhinolaryngol Clin 2018; 10 (3):81-86.
Aim: To study, the advantages and disadvantages of the endo- scopic verses microscopic myringoplasty and compare the results of both the technique. Materials and methods: This prospective study was conducted for period of 1 year from November 2016 to August 2017 on 44 patients who under-went myringoplasty. All the patients were divided in two groups. Group A, 26 patients were operated by endoscope technique and Group B, 18 patients were operated by microscope technique. All the patients were followed a 6-month for duration postoperatively. Results: The average postoperative change in air conduction after 6 months in Group A was 8.19 ± 4.94 dB and graft takeup rate was 92.31% where as it was in 10.11 ± 5.07 dB and graft takeup rate was 77.77% in Group B. Conclusion: Endoscope technique has several advantages like less hospital stay and cosmetically excellent as compared to microscopic technique but it could take more operating time and technically difficult. While patients satisfaction and graft take rate are better in microscopic technique but there was no difference in surgeon\'s satisfaction score.
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Goel S, Sood A, Parmar SM. Middle Ear Evaluation in Chronic Suppurative Otitis Media: Otomicroscopy versus Otoendoscopy—A Comparative Study. Int J Otorhinolaryngol Clin 2018; 10 (3):87-90.
Objective: Despite continuous technical advancements, the basic optic principles and their limitations have remained the same over the past few decades. This study was aimed at visualizing and evaluating the middle ear structures with the help of otomicroscope and angled endoscopes in cases of chronic suppurative otitis media. Materials and methods: In this prospective study, 180 patients (200 ears) above the age of 18 years with CSOM were examined by otomicroscopy and otoendoscopy. The visualizations of middle ear structures were compared and statistically analyzed. Results: In all the parameters studied, endoscopy provided a significantly better visualization as compared to microscope. Zero degree was better than microscopy in visualization of round window niche, oval window niche and facial recess even though not statistically significant. 30 and 70 degrees provided good visualization of the round window niche, oval window niche, facial recess, sinus tympani, pyramid, stapedius tendon, long process of incus, incudostapedial joint, stapes suprastructure, eustachian tube opening, hypotympanum and fundus of retraction pockets. Conclusion: Otoendoscopy provides better visualization of all the middle ear structures as compared to otomicroscope. Endoscopy must therefore be more frequently used in the OPD setup, so that more and more cases can be rightly diagnosed thus preventing surprises for the operating surgeon.
Introduction: Pseudocyst or seroma is an uncommon asymptomatic, non-inflammatory swelling of the pinna, characterized by endochondral cyst formation. Various treatments are available such as needle aspiration, curettage following incision and drainage and subsequent contour pressure dressing, deroofing procedure or insertion of a small drainage tube into the pseudocyst with a guide needle. The purpose of this study was to develop a new technique for the treatment of auricular seroma. Materials and methods: In this study 43 patients with seroma of auricle who presented to ENT OPD of AVMC and were treated during the period between August 2015 to August 2018 were included. All cases of seroma auricle were managed with the technique of primary drainage and suturing. Consent was obtained explaining the possibility of change in shape. Sutures were removed on the 10th day. All patients were called for follow-up at 1 month. Results: In our study male to female ratio was 2:1. The common age group was found to be 20–40 years with a total of 28 patients. Sixty-three percent presented with seroma in the right auricle and 37% of patients presented with left ear seroma. Majority of the patients, that is, 75% had no known cause for developing the seroma. Seroma completely disappeared without disfigurement in all patients. Conclusion: Auricular seroma was noted to completely disappear without disfigurement with incision and drainage of fluid with pressure suturing. Our technique is an office procedure and can be carried out under local anesthesia with promising results.
Objective: To evaluate the efficacy of over-underlay graft technique of myringoplasty and compare the results of over-underlay graft technique with conventional underlay myringoplasty. Materials and methods: In this prospective study 40 patients of either sex in age group of 15–50 years with noncholesteatomatous chronic suppurative otitis media (CSOM) were recruited. Patients were initially managed medically to make the ear dry and after that they were operated upon. Twenty patients underwent conventional underlay myringoplasty and 20 patients underwent over-underlay myringoplasty. Follow-up period was at least 3 months. Results: Graft uptake and hearing improvement was comparable in both groups. Although there was 5% lower graft uptake in group underwent conventional underlay myringoplasty (90%) as compared to over-underlay myringoplasty (95%); however, the difference was not statistically significant (P = 0.5). But there was statistically significant difference in gain in hearing threshold (gain in A–B gap) in the conventional underlay myringoplasty (14.5 dB ± 7.236) as compare to over-underlay myringoplasty (18.75 dB ± 5.349 ) (p = 0.04). Conclusion: The over-underlay technique, which is hybrid of both overlay and underlay technique, allows the advantages of both methods. It improves graft uptake rate and hearing improvement in subtotal and large perforations.
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Khokle P, Garud S, Lahane VJ, Mishra S, Prakash NP. Role of Fine Needle Aspiration Cytology in Evaluation of Neck Masses: Our Experience. Int J Otorhinolaryngol Clin 2018; 10 (3):99-105.
Introduction: The neck masses are relatively common problem. The differential diagnosis in a patient presenting with neck mass is often extensive and will vary with age. These neck masses are evaluated by history, clinical examination and investigation like fine needle aspiration cytology (FNAC), ultrasonography (USG), neck, computed tomography (CT) neck and excisional biopsy. Fine needle aspiration cytology is a simple, quick and cost effective method to sample superficial masses in the neck but FNAC is not substitute for histology. Study aims at the clinical spectrum of the neck masses and efficacy of FNAC in the evaluation neck masses. Materials and methods: Prospective study including 100 cases of neck masses studied during the period of January 2012 to June 2013. Patients with acute neck space infection and nonpalpable neck masses were excluded. USG neck was done in all cases prior to FNAC examination. All surgically excised masses were sent for histopathological examination (HPE). FNAC results were compared with corresponding HPE reports. Results: It emerges from our analysis that FNAC is 71.43% sensitive, 100% specific, and 96% accurate in diagnosing neck masses. Conclusion: FNAC is a simple outpatient procedure for diagnosing neck masses with great sensitivity and accuracy and a complementary procedure to histopathological study.
Poonam K Saidha,
Ntaashya H Sima,
Mucor is a saprophytic organism and commonly invades the nose and paranasal sinuses of immunocompromised and diabetic patients. Middle ear involvement is extremely uncommon. Early diagnosis based on strong clinical suspicion with radical debridement in the early setting under amphotericin cover offers a suitable management option.
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Kim Y. Simultaneous Open- and Closed-type Congenital Cholesteatomas in the Middle Ear Removed Using an Otoendoscope and Surgical Microscope. Int J Otorhinolaryngol Clin 2018; 10 (3):110-113.
Aim: Open- and closed-type congenital cholesteatoma in the middle ear can be found at the same time and an ear endoscope can be useful to identify and remove residual cholesteatoma during surgery. Background: Congenital cholesteatoma of the middle ear usually manifests as a single growth. Open- and closed-type congenital cholesteatomas occurring simultaneously in the middle ear on one side are extremely rare. In recent years, the use of endoscopes for middle ear surgery has been gradually increasing. Case description: This report describes the case of a 6-year-old boy in whom we observed both open-type and closed-type congenital cholesteatomas in the right middle ear. The closed-type congenital cholesteatoma extended from the malleus to the posterior wall of the tympanic cavity and had destroyed the long process of the incus and crura of the stapes. An open-type congenital cholesteatoma was observed on the medial side of the malleus, supratubal recess, and attic walls. The cholesteatoma was removed successfully via a transmeatal approach using an ear endoscope and surgical microscope. Using the ear endoscope, we could identify and completely remove the residues of cholesteatoma in the epitympanum, posterior tympanum, and supratubal recess. Conclusion: It is rare for both open-type and closed-type cholesteatomas to exist simultaneously in the middle ear, as in this case. Although the cholesteatomas were more extensive than the single lesion that usually occurs, both could be removed successfully via a transmeatal approach using a surgical microscope and an ear endoscope. Clinical significance: It is important to keep in mind the possibility of simultaneous open-type and closed-type congenital cholesteatomas in the middle ear, and the use of endoscopes can reduce the extent of the surgery and help identify residual cholesteatoma.