Journal of ENT and Allied Sciences

Aim: This study was undertaken to compare the proximal and distal facial nerve exploration approach during superficial parotidectomy. Materials and Methods: A retrospective analysis of patients who underwent superficial parotidectomy at our tertiery referal center was conducted. Cases were divided into those who underwent superficial parotidectomy using distal facial nerve exploration and those who underwent standard proximal facial nerve exploration. Statistical comparisons of intraoperative blood loss and margin status (negative, focally, positive) were conducted between these two approaches. Results: A total of 42 patients underwent superficial parotidectomy at our Tertiary referal center between May 2015 and April 2019. The technique used in most of the cases was conventional proximal nerve exploration technique (30 cases). Distal exploration of the buccal branch was undertaken only in 12 cases, on account of difficulty in locating the main trunk intraoperatively due to the presence of postinflammatory fibrosis. The average patient age was 38 years with a female preponderance (64%). Distal nerve exploration technique consumed almost average operative time less than 2 hours (1.6 hrs) and average intraoperative blood loss 25 ml but in proximal nerve exploration technique have average operative time more than 2 hours (2.2 hrs) intra operative average blood loss 70 ml was recorded. No significant difference in surgical margin status was noticed between the two techniques (p > 0.05). Conclusion: Both the techniques are efficient without compromising the surgical margins, but the average intraoperative blood loss and surgical operative time are less in distal facial nerve exploration technique.

Keywords: Distal; Facial nerve; Proximal; Superficial parotidectomy

Background: Adenoid, also termed as nasopharyngeal tonsil, Lushka’s tonsil, is located at the junction of roof and posterior wall of the naso-pharynx. Infections like recurrent rhinitis, sinusitis, tonsillitis can cause chronic Adenoid infection and hypertrophy which can be diagnosed by a postnasal mirror examination, rigid nasal endoscopic examination. Objectives: To relate adenoid hypertrophy by performing x ray nasopharynx lateral view for soft tissues anddiagnostic rigid nasal Endoscopy. Methodology: It was a prospective study conducted among patients visiting tertiary care institute both pediatric and adult group both in patient and out -patient departments of ENT. Patients were selected as case material, with clinical features of Nasal obstruction, Nasal discharge, Sinusitis, Epistaxis, Voice change, Aural symptoms like Tubal obstruction etc were selected. A detailed clinical examination is done. SPSS 21 was used for analysis. Nonparametric test and correlation value were computed. Results: 50 patients were studied as the sample size, all of whom were subjected to both the modalities of investigation, after entering the results in a master charta statistical analysis was done. Value calculated showed a result of +0.795, which is approximating to +0.8, that is very much nearer to +1, showing very strong and positive relation between X-ray and Rigid endoscopic grade which means that x-ray nasopharynx lateral view for soft tissues is nearly as reliable as Rigid endoscopy and thus can beused as reliable tool in diagnosing Adenoid hypertrophy. Conclusion: Even in this endoscopic era, x –ray nasopharynx lateral view for soft tissue can be useful and as reliable as a diagnostic tool for the diagnosis of adenoid hypertrophy, which may the only available investigation in the absence of rigid nasal endoscopic equipment.

Keyword: Adenoid hypertrophy; Nasal endoscopy; Airway obstruction; Nasal discharge; Sinusitis; X-ray nasopharynx.

Chronic rhinosinusitis (CRS) is a frequently encountered condition in clinical practice. Diagnostic endoscopy and Computed Tomography (CT) are imperative in the evaluation of CRS. The reliability of each of these to predict the operative findings in chronic sinusitis is important. Method: Cross sectional study in which 30 patients of CRS were included. 20 patients needed bilateral surgery. Hence, a total of 50 procedures were done. Results: Diagnostic endoscopy findings correlated very well with the operative findings for all parameters without any false positives or false negatives. Sensitivity of CT was found to be good for almost all the parameters except for anterior ethmoids. The specificity of CT was found to be good for all the parameters except maxillary sinus. Conclusions: Systematic diagnostic endoscopy is the best way forward to evaluate and objectively confirm CRS with CT scan being supplemented only in cases where gross anatomical/ pathological disease restricts visualisation of the disease.

Keywords: Chronic rhinosinusitis; Diagnostic nasal endoscopy; Computed tomography.

Objectives: To observe the surgical outcome of myringoplasty in children in terms of graft uptake and improvement in hearing. Materials and Methods: The prospective study was conducted on 30 children of either sex upto the age of 15 years both from urban and rural population irrespective of socioeconomic status and was conducted in Department of ENT, Government Medical College and Rajindra Hospital, Patiala. All the patients had central perforation and dry ear having duration of atleast 6 weeks. The myringoplasty was performed under either general anesthesia or local anesthesia, using either per meatal or post auricular approach Patients were followed up in post operative period at 4th, 8th and 12th weeks for any complication, assessment of graft status and audiological evaluation. Results: Out of 30 patients taken for myringoplasty, 17 (56.7%) were males and 13 (43.3%) were females. 70% of the patients were from rural background and 30% were from urban area. The mean age was 13.6 ± 1.49 years with majority (76.66%) of the patients in 13–15 years age group, while 7 patients (23.33%) were in the 9–12 years age group. In this study, successful graft uptake was seen in 24 (80%) cases while 6 (20%) cases had graft rejection and all successful patients had improvement in hearing ranging from 20dB to 30dB. Conclusion: Myringoplasty is safe and effective and can be performed in pediatric population regardless of age, location and type of perforation.

Keywords: Chronic otitis media; Myringoplasty; Central perforation.