Coblation adenoidectomy our experience

Aim of our study is to compare the efficacy and safety of coblation adenoidectomy versus conventional cold steel adenoidectomy. The study design included 40 children between age groups 4 – 8. Twenty of these children underwent coblation adenoidectomy while the othergroup of 20 underwent conventional cold steel adenoidectomy. The parameters taken into consideration for comparison included Post operative pain, operating time, intraoperative bleeding and presence of residual adenoid tissue 6 weeks after surgery.In this study the coblation group demonstrated less post operative pain, less intraoperative bleeding and more complete removal of adenoid tissue. Operative time was found to be significantly higher in coblation group when compared to conventional cold steel adenoidectomy group.

Editorial

Otolaryngology online

Extra cranial Schwannomas of Head and Neck

Schwannomas are benign slow growing tumors that arise from the Schwann cells ofany nerve (peripheral, cranial or autonomic). It also called nerilemmona,neurinomaspindle cell tumor etc. Extra cranial Head and Neck schwannomas usually present assolitary and well demarcated lesions. The lesion can cause secondary symptoms such as nasal obstruction,dysphagia and hoarseness, depending upon the location of the lesion.All patients with head and neck schwannomas treated in our department from April 2008 to dec.2010 were reviewed. Most of cases (3 cases) presented with neck swelling. Pre-operative diagnosis may be aided by FNA,computed tomography and MRI. The main stay of treatment is complete intracapsulor excision with preserving the nerve of origin.

Congenital hypothyroidism: follow up of a case for 13 years.

Background/objectives: Congenital hypothyroidism is one of the most common preventable causes of mental retardation in children. The prognosis of infants detected by neonatal screening and started on treatment early is excellent, with intelligence quotients similar to sibling or classmate without the disease.Setting: Department of ENT, Head and Neck Surgery, KVG Medical College, Sullia.1Case report: A 15 year old boy came with history of head ache, generalized body ache and lack of concentration in school. He was a case of congenital hypothyroidism and was on irregular treatment for the last 13 years.Intervention: The patient was advised strictly to continue the oral l-thyroxine 100μg one hour before food and come for regular follow-up.Conclusion: Definite intellectual deterioration is seen if oral l-thyroxine is not started within 50 days of life and the deterioration is irreversible. So in India newborn screening programs should be implemented as a national program as it is very important to diagnose and treatcongenital hypothyroidism as soon as possible and to treat it effectively.

Coblation an overview

The term coblation is derived from “Controlled ablation”. This procedure involves non-heat driven process of soft tissue dissolution using bipolar radiofrequency energy under a conductive mediumlike normal saline. When current from radiofrequency probe pass through saline medium it breaks saline into sodium and chloride ions. These highly energized ions form a plasma field which issufficiently strong to break organic molecular bonds within soft tissue causing its dissolution. This article attempts to provide a broad overview of the technology and its uses in the field ofotolaryngology.

THE CORRELATION BETWEEN DERIVED NASALANCE MEASURES AND PERCEIVED NASALITY IN CHILDREN WITH REPAIRED CLEFT LIP AND PALATE

Context: Velopharyngeal dysfunction (VPD) is one of the associated condition reported in individuals with repaired cleft lip and palate (RCLP) leading to hypernasality. Nasality can be assessed by nasometer through nasalance values. But, mean nasalance values (N) found to be overlapping betweenindividuals with RCLP and normals. To overcome these limitations Nasalance Distance (ND) and Nasalance Ratio (NR) are derived based on nasalance range.Aims: The study is aimed to evaluate, correlate and compare acoustical (N, ND & NR) and perceptual measures of nasality between the children with RCLP and control group.Settings and Design: Institutional setup and standard group comparison designMethods and Material: The study included fifteen children with RCLP ranging from 6 to 11 years and the control group consists of age and gender matched 15 typically developing children. Four point standard rating scale was used to rate the hypernasality by three speech language pathologists (SLP’s)and Nasometer was used to measure the mean and derived nasalance scores for vowels and sentences in Kannada.Statistical analysis: SPSS, Cronbach’s Alpha test, multivariate analysis and Pearson’s product movement correlation were used to analyze the data.Results: Significant increase in the mean nasalance value and NR was seen in children with RCLP than the control group, whereas ND was contrary. ND was highly correlated with perceived nasality than N. The NR of sentences shows high negative correlation.Conclusions: The measures based on range of nasalance can be adapted to the routine clinical examinations for better correlation with perceived nasality.

ODONTOGENIC CYST - CASE REPORT AND REVIEW

ABSTRACT                                                                                                                                                    Introduction:  Odontogenic cysts are defined as epithelial cell lined cysts. Maxillary sinus is closely related to the upper premolar and molar teeth. Any infection / pathology involving the root of these teeth will also have its effect on the maxillary sinus.                                                                                                                                                                       Case report: To present a case of Odontogenic cyst in the left maxillary sinus following history of trauma. Patient complained of swelling. The swelling was bony hard. CT revealed a lesion in the left maxillary sinus with breach in its anterior wall.  All routine investigation normal. The swelling was excised via Caldwell luc approach and sent for histopathological examination. Histopathological finding came as odontogenic keratocyst.                                                                                                                                       Conclusion: Odontogenic cysts are difficult to diagnose with clinical findings alone and a combination of clinical,radiological and pathological input will help in proper diagnosis. Most of these odontogenic cysts are defined by their position than by their histology

PLEOMORPHIC ADENOMA OF LATERAL WALL OF NOSE – A RARE PRESENTATION

The aim of the article is to present a rare case of pleomorphic adenoma arising in lateralwall of nose. Pleomorphic adenoma arises mainly in the major salivary glands (65%), especiallyin the parotid and, less frequently, in accessory salivary glands (35%). Rare cases have beenreported in the lip, the hard and soft palate, the lacrimal gland, and the external auditory canal. Itis extremely rare to find these in the respiratory tract. The incidence is even lower in the upperrespiratory tract, such as the nasal cavity, maxillary sinus and nasopharynx. In that approximately80% of intranasal pleomorphic adenomas are found in the septum. Only about 20% are found inthe lateral wall or turbinate. They are essentially benign but prolonged duration; incompleteresection may lead to recurrence and increased chances of malignant transformation. So, theyshould be diagnosed early by using fine needle aspiration, ultrasonography and removed in theirentirety with its pseudocapsule and surrounding margins.

INTERNAL JUGULAR VEIN PHLEBECTASIA PRESENTING WITH HOARSENESS OF VOICE

Internal jugular phlebectasia presents as a soft cystic mass in the neck that appears on straining.We present case of a 7 year old girl who presented with a painless soft cystic mass in the neck associated with hoarseness of voice. Based on clinical examination and CT image diagnosis of right internal jugular phlebectasia was made.

The Outcome of Shield Graft Tympanoplasty: A Single Center Descriptive Study at KAMC

Cartilage has proven to be a favorable graft material to close tympanic membrane perforations.Objective: In this study we describe our experience with cartilage shield graft tympanoplasty in reconstruction of tympanic membrane perforations.Study Design: A retrospective review was done on 42 patients. The male to female ratio was 19:23 and the age range 11-72 years. Cases varied between Chronic Otitis Media with Dry Perforation and Ossicular Discontinuity and were treated with cartilage shield graft tympanoplasty type I or III, respectively. The correspondingauthor performed all operations over a period of 2 years at the department of Otolaryngology Head and Neck Surgery at King Abdullah Medical City, Makkah, Saudi Arabia.Methods: Patient and disease information were collectedretrospectively and analyzed. Results: Graft take was achieved in 42 patients (100%).No statistically significant association between the postoperative pure tone average – air bone gap results and age, sex, or type of tympanoplasty was observed (p>0.05).The overall mean preoperative pure tone average – air bone gap was 27.0±10.5 dB, and it decreased to 14.9±7.0 dB 3 months postoperatively. A statistically significant improvement was observed (p<0.001). Conclusion: Excellent graft take results wereachieved and hearing outcomes were satisfactory. Therefore, shield cartilage graft is a valid alternative in all tympanoplasty procedures.