Mastoid Osteoma

Introduction Osteoma of the mastoid region is an uncommon benign tumor of bone. Osteomas may occur in the external auditory canals but are reported to be very rare in the mastoid region, with about 150 cases reported in literature. Case Report A 20-year-old man presented with painless lump behind the right ear since last 2 years. On examination a 3x3 cm tumour was present in the right post-auricular region. HRCT scan showing hyper-attenuating area close to the right mastoid cortex, measuring approximately 3x3cm, spherical, with cleavage areas between the tumour and the mastoid external cortex. Surgical excision was performed on cosmetic grounds. Postoperative period was uneventful. Discussion Osteoma over the mastoid region is rare and mainly asymptomatic with excellent prognosis after complete removal of the lesion

Role of vitamin D3 supplementation in allergic rhinitis: an outpatient department based prospective analytical observational study

Background: Allergic rhinitis is a common disorder characterized by sneezing, rhinorrhoea, nasal congestion, itching and lacrimation which adversely affect quality of life to a substantial degree. Evidence suggests that low serum vitamin D3 has correlation with severity of allergic rhinitis. The objective of the study was to evaluate whether vitamin D3 supplementation has any role to reduce the severity of disease spectrum among allergic rhinitis patients.Methods: This prospective analytical observational study was carried out in 6 months in ENT OPD of Midnapore medical college and Hospital. Only the persistent moderate to severe allergic rhinitis patients as per ARIA-WHO guideline, aged >12 years were included in this study. 64 subjects were randomised into two groups. The test group received oral vitamin D (60000 IU/week for 2 months) along with levocetirizine, fluticasone spray and montelukast while the control group received three drug therapies without vitamin D3. Allergy symptom score (ASS) was assessed at the start and end of the study period.Results: The study population (n=64) was predominantly female (37) and had a mean age of 39.79 years. The ASS score was 14.06±1.01 in Test group and 13.93±1.01 in Control group and the Post treatment ASS score was 2.65±1.12 and 6.06±0.87 respectively. This difference between groups was significant (p<0.001).Conclusions: There was significant reduction in the Allergy symptom score after vitamin D3 supplementation which alters the course of disease towards clinical improvement

Effect of Intratympanic Dexamethasone in Idiopathic Sudden Sensorineural Hearing Loss

Introduction Oral steroids currently represent the standard treatment for idiopathic sudden sensorineural hearing loss The aim of this study is to assess the effectiveness of intratympanic dexamethasone injection for treating ‘Idiopathic sudden sensori-neural hearing loss’ (ISSNHL) not improved with conventional oral steroid. Materials and Methods A prospective study was conducted on 30 patients refractory to oral steroid therapy between June 2017 to May 2018. ‘Intratympanic dexamethasone injection’ (ITDI) was given every week for 3 consecutive weeks. Hearing was assessed by performing pure tone audiogram before every ITDI and also 1 week after the completion of treatment. Results Hearing improvement was found in 19 out of the 30 cases (63.3%).   Conclusions Intratympanic dexamethasone significantly improves the prognosis of ISSNHL and is a safe, inexpensive and effective treatment

An Outcome Analysis of Endoscopic Sinus Surgery in Chronic Sinusitis with Chronic Rhinitis Non-responsive to Medical Therapy

Introduction   Chronic sinusitis with chronic rhinitis affect the patients’ quality of life significantly. Aim of this study is to assess the outcome of Endoscopic Sinus Surgery (ESS) in terms of Quality of Life (QoL) in patient with Chronic Sinusitis with Chronic Rhinitis (CSCR), non-responsive to medical therapy.     Materials and Methods Prospective study was conducted among 75 patients of CSCR non responsive to medical therapy in the age group of 15 to 80 years over a period of 18 months (January 2018 to June 2019). The subjects were randomly grouped into two, namely Group 1- CSCR with Polyp and Group 2- CSCR without Polyp. Subjects were asked to complete SNOT-22 score and Visual analogue scale (VAS) and conventional medical treatment was given for 2 weeks. Those failed to respond as per EPOS guideline were subjected to ESS and followed up at 6 weeks and 12 weeks, re-assessed by SNOT-22 questionnaire and VAS. Data was analyzed by using Paired t- test.   Results Statistically significant (p-value <0.05) improvement in symptom score assessing QoL after Endoscopic sinus surgery.   Conclusion Patients with CRS non- responsive to medical treatment, the decision for surgery should be guided by their pre-operative QoL impairment, as measured by SNOT-22 and VAS

Outcome of Post-Operative Mastoid Cavity Obliteration with Autologous Adipose Tissue

Introduction Mastoid operations have been in practice for over four centuries for suppurative conditions of the ear. Intact canal wall mastoidectomy has the advantage of better functional results while canal wall down mastoidectomy offers excellent exposure for disease eradication and post operative monitoring but is associated with significant cavity problems. In order to overcome the problems associated with canal wall down procedure while retaining its advantages the concept of mastoid cavity obliteration was introduced. This study analysed the outcomes of mastoid cavity obliteration and to assess the outcomes of mastoid cavity obliteration with autologous adipose tissue. Materials and Methods A prospective, experimental, randomized study was conducted over a period of 18 months among patients presenting with active squamous variety of Chronic Otitis Media. The patients were randomly allocated to two groups, A and B. Both groups underwent canal wall down Mastoidectomy followed by obliteration with autologous adipose tissue in Group B . Results In group A, the mean duration required for complete epithelialization was 10.8 weeks. In group B, the average time taken for complete epithelialization was 5.6 weeks. All cases had their graft intact at the end of 12 weeks. Debris was present in group A for a mean duration of 9.47 weeks. In group B, debris was found for a mean duration of 3.33 weeks. Patients from group A complained of discharge from their ears for a mean duration of 7.47 weeks. In group B the same symptom persisted over 3.33 weeks. Conclusion Cavity problems encountered is considerably less in the group obliterated with adipose tissue

Mastoid Osteoma

Introduction Osteoma of the mastoid region is an uncommon benign tumor of bone. Osteomas may occur in the external auditory canals but are reported to be very rare in the mastoid region, with about 150 cases reported in literature. Case Report A 20-year-old man presented with painless lump behind the right ear since last 2 years. On examination a 3x3 cm tumour was present in the right post-auricular region. HRCT scan showing hyper-attenuating area close to the right mastoid cortex, measuring approximately 3x3cm, spherical, with cleavage areas between the tumour and the mastoid external cortex. Surgical excision was performed on cosmetic grounds. Postoperative period was uneventful. Discussion Osteoma over the mastoid region is rare and mainly asymptomatic with excellent prognosis after complete removal of the lesion

Use of Nasal Obstruction Symptom Evaluation Scale in Objective Evaluation of Symptomological Improvement in Post Septoplasty Patients

Introduction The complaint of nasal obstruction or difficulty in nasal breathing is highly subjective. Benefits of Septoplasty, as perceived by the patient, also varies widely with subjective satisfaction ranging from complete alleviation of symptoms to a total failure. Materials and Methods Fifty three patients above 18 years of age, with anatomical deviation of the nasal septum as the sole cause of obstruction and symptoms persisting for more than 3 months, underwent septoplasty. Nasal endoscopy was done for Mladina typing of the nasal septal deviation. Pre and post operative NOSE (Nasal Obstruction & Symptom Evaluation) score were analysed. Results Mean preoperative NOSE score was 11.98 ±1.23. On the 6th and 12th postoperative week follow up NOSE score was 3.13±1.30 & 1.05±0.87 respectively with p value <0.05.  Conclusion Mladina typing along with NOSE score will help in letting the patient know about his or her expected outcome following septoplasty

Effect of Intratympanic Dexamethasone in Idiopathic Sudden Sensorineural Hearing Loss

Introduction Oral steroids currently represent the standard treatment for idiopathic sudden sensorineural hearing loss The aim of this study is to assess the effectiveness of intratympanic dexamethasone injection for treating ‘Idiopathic sudden sensori-neural hearing loss’ (ISSNHL) not improved with conventional oral steroid. Materials and Methods A prospective study was conducted on 30 patients refractory to oral steroid therapy between June 2017 to May 2018. ‘Intratympanic dexamethasone injection’ (ITDI) was given every week for 3 consecutive weeks. Hearing was assessed by performing pure tone audiogram before every ITDI and also 1 week after the completion of treatment. Results Hearing improvement was found in 19 out of the 30 cases (63.3%).   Conclusions Intratympanic dexamethasone significantly improves the prognosis of ISSNHL and is a safe, inexpensive and effective treatment

Vitamin D: A Silent Cofactor for Allergic Rhinitis

Introduction   Allergic rhinitis affects around 50% of atopies in India. Vitamin D is related to both humoral and cell mediated immunity and its receptors are found in inflammatory mediators. This study was conducted to assess any possible association between Allergic rhinitis and serum Vitamin D. Materials and Methods A cross sectional study was conducted amongst 41patients with Allergic rhinitis as per ARIA guidelines attending the Otolaryngology outpatient Department of a peripheral tertiary care hospital. Vitamin D levels were assessed in patients with allergic rhinitis in terms of serum Ig-E level and absolute blood eosinophil count (ABEC). Results Among 41 patients, 31 patients (75.6%) had deficiency of vitamin D with mean Vitamin D level of 14.87±1.56ng/ml (normal vitamin D level-30-100ng/ml and low <20ng/ml), mean serum Ig-E level was 1040±303.83Iu/ml (normal-1.90-170 IU/ml by CLIA method) and mean ABEC 1226.77±397.89 (normal-30-350/ml). Conclusion Low serum Vitamin D is common in Allergic rhinitis patients. Low serum Vitamin D seems to be a significant cofactor in aetiopathogenesis of Allergic rhinitis in most of the cases

Vitamin D: A Silent Cofactor for Allergic Rhinitis

Introduction   Allergic rhinitis affects around 50% of atopies in India. Vitamin D is related to both humoral and cell mediated immunity and its receptors are found in inflammatory mediators. This study was conducted to assess any possible association between Allergic rhinitis and serum Vitamin D. Materials and Methods A cross sectional study was conducted amongst 41patients with Allergic rhinitis as per ARIA guidelines attending the Otolaryngology outpatient Department of a peripheral tertiary care hospital. Vitamin D levels were assessed in patients with allergic rhinitis in terms of serum Ig-E level and absolute blood eosinophil count (ABEC). Results Among 41 patients, 31 patients (75.6%) had deficiency of vitamin D with mean Vitamin D level of 14.87±1.56ng/ml (normal vitamin D level-30-100ng/ml and low <20ng/ml), mean serum Ig-E level was 1040±303.83Iu/ml (normal-1.90-170 IU/ml by CLIA method) and mean ABEC 1226.77±397.89 (normal-30-350/ml). Conclusion Low serum Vitamin D is common in Allergic rhinitis patients. Low serum Vitamin D seems to be a significant cofactor in aetiopathogenesis of Allergic rhinitis in most of the cases