A Comparative Study Between Coblation-Assisted Tonsillectomy and Conventional Dissection and Snare Tonsillectomy.

Background Tonsillitis is a vastly prevalent disease, accounting for the majority of outpatient visits. The dissection and snare method has been the predominant approach for tonsillectomy for centuries. Coblation-assisted tonsillectomy offers advantages such as faster healing, shorter surgery duration, minimal blood loss, and fewer postoperative complications. Therefore, a study was conducted to evaluate the distinctions and compare the efficacy of traditional dissection and coblation-assisted tonsillectomy. Materials and methods Patients were divided into two groups: Group I was operated on using the conventional method, and Group II was operated on using the coblation method. Both groups were then assessed for intraoperative time, intraoperative bleeding, postoperative pain, and postoperative complications. Results Coblation-assisted tonsillectomy patients had a significantly shorter mean duration for the procedure and significantly lower blood loss in comparison to the conventional method. There were no statistically significant variations in the incidence of postoperative complications. Coblation-assisted tonsillectomy patients experienced considerably higher pain scores on various postoperative days. Conclusion Coblation-assisted tonsillectomy had the added advantage of reduced intraoperative blood loss, shorter surgical time, and faster recovery postoperatively. Coblation-assisted tonsillectomy can be considered an effective alternative to conventional methods. However, it's important to consider factors such as cost-effectiveness and surgeon experience. Further research involving larger sample sizes and longer follow-up periods could yield more insightful knowledge of the outcomes of these two tonsillectomy techniques.

The Assessment of Auditory Function in High-Risk Neonates and Infants Using Brainstem-Evoked Response Audiometry (BERA).

Introduction Hearing impairment in neonates and infants is a critical concern due to its potential to impede language acquisition, cognitive development, and overall quality of life. Brainstem-evoked response audiometry (BERA) stands out as a valuable diagnostic tool. The early detection of hearing impairments is paramount in neonatal care. Hearing loss during infancy can impede speech and language development, social interaction, and academic achievement. High-risk neonates, including those born prematurely or with low birth weight, have a heightened susceptibility to hearing impairment due to various factors such as exposure to ototoxic medications, mechanical ventilation, and complications associated with prematurity. Methods A hospital-based prospective study was conducted in the department of otorhinolaryngology; the study focused on high-risk neonates and infants from the outpatient department and inpatient department. The study was conducted from October 2022 to March 2024. A sample size of 70 patients was taken, including high-risk neonates and infants. Healthy term neonates and healthy infants were excluded from the study. Results In the current study, there were 40 males and 30 females. Among the infants surveyed, prematurity was the most prevalent risk factor, followed by perinatal asphyxia. Low birth weight was observed in 43% of cases, while hyperbilirubinemia and neonatal sepsis were the next. Among the 70 infants assessed, 50% were found to have normal hearing. Mild hearing loss was observed in 23% of cases, while 14% had moderate hearing loss. Severe and profound hearing loss were less common. Conclusion Our study highlighted the importance of early and routine auditory screening using BERA in high-risk neonates and infants, revealing a significant prevalence of hearing loss linked to various risk factors such as premature babies, low birth weight, hyperbilirubinemia, neonatal intensive care unit stay, perinatal asphyxia, and ototoxic drugs during pregnancy. Prematurity is the most common risk factor. For language development, early diagnosis and intervention were crucial. If babies have profound sensorineural hearing loss, they can go for a cochlear implant.

Clival Osteomyelitis in an Adult Patient: A Case Report.

Clival osteomyelitis is an uncommon skull base infection that mostly affects elderly diabetics and is frequently caused by malignant otitis externa or paranasal sinus infections. It manifests as severe otalgia, fever, auditory fullness, and purulent otorrhea. Clinical history, physical examination, test data, radiographic findings, and pathogen identification all contribute to a diagnosis. Treatment consists of extended intravenous broad-spectrum antibiotics, with severe cases necessitating surgical debridement. We present a case of a 20-year-old girl with bilateral ear discharge, nasal blockage, and purulent rhinorrhea, as well as a dull neck ache increased by extension. An MRI revealed osteomyelitis in the clivus and right atlanto-occipital joint. The clival abscess was drained transnasally using endoscopic techniques. Microbiological tests revealed Streptococcus intermedius. The post-operative recovery was uneventful, with extended antibiotic therapy. Early identification and treatment are critical for preventing serious consequences, as illustrated in this case, where surgical and antibiotic care improves patient outcomes.

Modified Circular Knife in Two-Handed Endoscopic Ear Surgery: A Technical Note.

With the introduction of endoscope to middle ear surgery, certain modifications are required in the middle ear instruments to reach the nook and corners of the middle ear without compromising vision and leading to cross-over of instruments. In this manuscript we describe and discuss the modified circular knife and enumerate its advantages and applications during two handed endoscopic ear surgery.

A Comparative Study of Outcomes of Submucosal Diathermy Versus Inferior Turbinoplasty in Patients With Deviated Nasal Septum With Inferior Turbinate Hypertrophy.

Introduction Nasal obstruction due to deviated nasal septum (DNS) and inferior turbinate hypertrophy (ITH) is a common problem necessitating surgical intervention. Submucosal diathermy (SMD) and inferior turbinoplasty (IT) are two commonly performed procedures aimed at improving nasal patency. Methods A prospective comparative study was conducted on 56 patients with DNS and inferior turbinate hypertrophy, divided into SMD and inferior turbinoplasty groups. Preoperative and postoperative assessments included symptom assessment using the 22-item Sinonasal Outcome Test (SNOT-22) questionnaire. Results Both procedures led to significant improvements in nasal symptoms and quality of life. Inferior turbinoplasty showed slightly better outcomes in symptom improvement compared to submucosal diathermy. Conclusions Inferior turbinoplasty appears to offer slightly better outcomes in improving nasal symptoms compared to SMD in patients with DNS and inferior turbinate hypertrophy. However, both procedures are effective and safe options for surgical management. Individualized treatment decisions should consider patient preferences and surgeon expertise.

A Rare Presentation of Malignant Melanoma of the Face: A Case Report.

Melanoma is a malignant neoplasm of melanoblasts, which are the precursors of the melanocytes arising from the neural crest cells. Melanomas can occur at various sites like the skin, eyes, upper esophagus, and meninges due to the migration of neural crest cells. Usually, the prognostic factors are decided based on the Breslow index. This case report describes a 61-year-old female who presented with the complaint of pinkish irregular swelling over the left side of her face for six months. The patient had a surgical resection, and the condition was determined to be invasive melanoma following confirmation by magnetic resonance imaging (MRI) and histological examination. Through our case report, we aim to shed light on the existing protocol for managing malignant melanoma while also exploring new aspects of presentation and multidisciplinary action.

Improvement in Pulmonary Function Tests After Septoplasty: A Longitudinal Study.

Introduction The relationship between the nasal and pulmonary systems is rooted in the shared anatomy and physiology of the upper and lower respiratory tracts. Our study objective was to assess the improvement in pulmonary function tests (PFTs) after septoplasty in patients with a deviated nasal septum (DNS). Methods A longitudinal study was conducted at a tertiary care center from October 1, 2022, to March 31, 2024. Patients aged 18-55 years with chronic nasal obstruction due to an isolated DNS were included in the study. Patients under 18 or over 55 years of age, those undergoing combined nasal surgeries, and those with comorbidities such as hypertension, diabetes, chronic smoking, chronic obstructive pulmonary disease, bronchial asthma, turbinate hypertrophy, chronic sinusitis, or nasal polyposis were excluded. Pre-operative assessments included detailed ear, nose, and throat examinations, routine blood investigations, X-rays of the chest and paranasal sinuses (Waters' view), PFTs (spirometry), the Sino-Nasal Outcome Test-22 (SNOT22) questionnaire, and the six-minute walk test (6MWT). Post-operative assessments included repeated spirometry, a 6MWT at three weeks post-surgery, and the SNOT22 questionnaire for subjective symptom assessment. Results Participants included 30 males and 30 females, with a mean age of 35.6 ± 8.2 years. Significant improvements (p < 0.05) were observed in PFT parameters (forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, peak expiratory flow), exercise capacity (6MWT distance), and symptom severity (SNOT22 scores) post-septoplasty. High levels of patient satisfaction and notable improvements in quality of life were reported. The average hospital stay was 2.5 days. Conclusion Septoplasty in patients with DNS significantly improves pulmonary function, exercise capacity, and symptom severity, with high patient satisfaction and minimal complications.

A Rare Presentation of Cysticercosis in the Sternocleidomastoid Muscle.

Cysticercosis is a rare condition associated with the development of cysticercus (larval form) of Taenia solium (pork tapeworm), within an intermediate host. Accidental ingestion of infectious eggs is most likely the cause of humans becoming intermediate hosts. The most common site for larval cysts is the central nervous system followed by vitreous humor of the eye, striated muscle, and, in rare cases, subcutaneous and other tissues. Isolated muscular involvement with nonspecific symptoms makes this condition challenging to diagnose. We present an unusual case of cysticercus in the sternocleidomastoid muscle diagnosed with ultrasonography and contrast-enhanced scans, which was subsequently treated with surgical excision and a short course of anthelmintics.

Cavernous Hemangioma of the Tongue in an Adult.

Hemangiomas are benign tumors characterized by the proliferation of dilated blood vessels, typically capillaries and veins. They primarily occur in infancy and childhood, with the majority affecting the head and neck region. Oral hemangiomas, though relatively rare, can affect areas such as the lips, tongue, buccal mucosa, and palate. Despite their benign nature, managing vascular malformations is crucial due to potential functional loss and lifelong aesthetic concerns. This case report involves a 76-year-old woman presenting with a soft reddish-blue mass on the dorsal aspect of her tongue, causing functional impairment. While various treatment options exist for oral vascular malformations, including sclerotherapy and cryosurgery, surgical excision was chosen in this case, considering the patient's age and the associated risks of the condition.

Dentigerous Cyst in a Pediatric Patient: A Case Report.

One of the most prevalent types of odontogenic cysts is a dentigerous cyst, which is usually connected to the crown of an immature tooth. We report the case of an 11-year-old boy, who had a swelling over his left cheek, which was determined to be a dentigerous cyst by radiological imaging and clinical examination. Over the course of two months, the peanut-sized mass grew to 3x2 cm. A massive, well-defined cystic lesion connected to an unerupted premolar tooth was found on a CT scan of the left maxillary alveolar arch and sinus floor. Under general anesthesia, the patient had a Caldwell-Luc surgery to remove the cyst. In order to avoid difficulties related to cyst formation, which can invade surrounding tissues and even result in cancer if left untreated, early detection using radiological imaging is essential. Complete excision of the cyst is the treatment, particularly for big lesions, in order to limit morbidity and lower the likelihood of aggressive behavior. This case emphasizes the necessity of thorough examination and surgical intervention when necessary, underscoring the significance of early identification and adequate therapy to minimize potential problems related to dentigerous cysts. In cases of dentigerous cysts, early intervention, and appropriate surgical procedures are critical to reducing morbidity and improving patient outcomes.

Nanocrystalline silver for the treatment of otitis externa.

Objective: To study the efficacy of nanocrystalline silver in treating otitis externa. Methods: This is a retrospective study constituting 50 patients of 18 to 60 years, studied from July 2022 to February 2023, conducted in the outpatient clinic of a tertiary healthcare centre. Clinically diagnosed otitis externa patients were treated with fragmented gel foam coated with nanocrystalline silver gel and the response to this treatment was noted. Results: This study analysed a total of 50 cases of otitis externa in which the majority of patients fell between the age group of 30 to 45 years. Of the 50 patients included in the study, 30 were male and 20 were female. Pseudomonas aeruginosa was isolated in 50% of the patients followed by staphylococcus aureus in 36% of the patients. Among the 50 patients, 32 responded early to treatment (early responders), 15 were partial responders, and 3 did not respond to treatment (non-responders). Conclusion: Out of 50 patients, 32 responded early to treatment, 15 were partial responders, and 3 did not respond to treatment. The antimicrobial and anti-inflammatory properties of silver, particularly when used in the nanocrystalline form, have been shown to be highly effective in managing this condition. Further research is warranted to fully explore the potential of nanocrystalline silver in treating otitis externa and other related conditions.

Early clinical exposure: Dynamics, opportunities, and challenges in modern medical education.

INTRODUCTION: Applications of early clinical exposure (ECE) are wide-ranging and reflect the important role that ECE plays in medical education. This review article aimed to highlight the dynamics, opportunities, and challenges of ECE in medical education. STUDY METHODOLOGY: This review article was conducted through a comprehensive search of electronic databases including PubMed, Scopus, Web of Science, and Google search engine. The keywords used for the search were "early clinical exposure," "medical education," "clinical skills," "patient contact," and "medical students. The inclusion criteria for selecting the articles were that they should be written in English, peer-reviewed, and provide insights into the dynamics, opportunities, and challenges of ECE in medical education. RESULTS: ECE allows students to gain a deeper understanding of the patient experience, and to develop empathy and a patient-centered approach to care. ECE can also help to improve recruitment and retention of medical students, by providing a more engaging and rewarding learning experience. CONCLUSION: ECE is a promising teaching method that has the potential to improve clinical skills and patient outcomes. However, it also poses some challenges that must be addressed to ensure its effective implementation.

Nanocrystalline Silver for the Treatment of Otomycosis: A Retrospective Study.

Introduction: Otomycosis is a common fungal ear infection usually found in tropical and subtropical countries where infections arise due to hot and humid conditions. Also, these infections have a high recurrence rate with limited therapeutic options, which makes their management difficult. There is a long history of applying various antiseptic agents consisting of silver specifically for these broad-spectrum infections. Silver nanoparticles (AgNPs) are futuristic nano-size products for controlling the microbial infection. The study aimed to determine the antifungal properties of nanocrystalline silver in patients with otomycosis. Materials and Methods: The study was conducted in Pune (India) in the department of Ear Nose Throat & Head at the Dr. D.Y. Patil Medical College, Hospital and research center, Pune (India) for a period of one year (2019 -2020). Our study included 100 patients (58 male and 42 female) with clinically diagnosed otomycosis, which was treated by applying nanocrystalline silver gel-soaked Gelfoam. Results: Our study had patients of 18 to 60 years, with the highest prevalence in males (58%) aged 30 to 45 years. A large number of infection cases were reported at the hospital, i.e., 62 cases during the wet season as compared to 38 cases during the dry season. Commonly found fungi belonging to the genus Aspergillus (55%), followed by Candida (45%). Improvements in symptoms were observed in 89% of the patients (70% within 5 to 6 days and 19% from 7 to 14 days). Conclusion: Applying nanocrystalline silver cured most of the patients (89%) within 14 days. Treating otomycosis patients with nanocrystalline silver demonstrated beneficial results. Further studies with larger samples should be conducted to validate the benefits of nanocrystalline silver.