Prospective randomized comparison of mitomycin C application in endoscopic and external dacryocystorhinostomy.

The aim of the study is to compare the subjective (relief of symptoms) and objective (endoscopic visualization of ostium patency at the time of syringing) outcomes at the end of two procedures-Endonasal DCR versus External DCR with Mitomycin C and to assess the role of Mitomycin C in maintaining patency of nasolacrimal drainage system. Prospective randomized comparative study was performed. Thirty-five patients were enrolled in each endoscopic and external dacryocystorhinostomy groups with Mitomycin C (MMC) application. The 37 eyes underwent endonasal DCR (28 unilateral primary eyes + 1 bilateral primary eyes + 5 unilateral revision eyes + 1 bilateral revision eye) while 35 eyes underwent external DCR (34 unilateral primary eyes + 1 unilateral revision eye). Mitomycin C 0.2 mg/ml was applied intra-operatively for 5 min to the ostium site at the end of endonasal or external DCR procedure. Objective assessment by syringing at the end of 1 year in the endonasal group showed 35 eyes (94%) were patent, 1 (3%) was partially blocked and 1(3%) was completely blocked; while in external group all 35 eyes (100%) were patent. Endoscopic visualization of the ostium at the time of syringing showed only one eye (3%) in the endonasal group was blocked while all the other eyes in both groups were patent. Both groups had a mean follow-up of 6-36 months. No complications were associated with use of Mitomycin C. In conclusion, intra-operative use of Mitomycin C in both endoscopic DCR and external DCR is safe and effective in increasing the success rate.

The prevalence of otological manifestations in children with cleft palate.

AIMS: i) To determine the prevalence of the various otological manifestations that occured in children aged between 1 to 5 years, presenting to the Departments of ENT and Plastic Surgery with overt cleft palate. ii) To evaluate the possibility of the association of the different otological manifestations in relation to the various types of cleft. MATERIALS AND METHODS: A cross sectional study was performed on children with cleft palate presenting to the Otorhinolaryngology and Plastic Surgery OPDs of KLE Society's Dr. Prabhakar Kore Hospital and MRC (KLESPKH & MRC) (a tertiary referral centre), Belgaum between February 1, 2007 and January 31, 2008. Data was collected by clinical ear examination and evaluation of tympanometry reports. RESULTS: Prevalence of external ear abnormalities in the studied population was 13%. More than 55% of the participants' ears were diagnosed clinically with OME. There was no statistically significant association between type and side of cleft with the presence of OME. CONCLUSION: External ear deformities are more prevalent in the cleft palate population than the general population. There was a high prevalence of OME in concordance with previous studies. The prevalence of other otopathology was rare. There was no association of the type or side of palate cleft with OME.

A rare case of Proteus syndrome.

INTRODUCTION: We report a rare case of Proteus syndrome which presented with dysphagia due to unilateral tonsillar hypertrophy. CASE REPORT: Our case had involvement of multiple organs in addition to bony deformities, namely, enlarged right parotid gland and right testis, verrucous naevus, varicose veins and abdominal lipoma. The features unique to this case were a larger right optic disc and expansion of the inner table of the skull. DISCUSSION: A literature review revealed less than 100 bona fide, published cases which fit the revised diagnostic criteria proposed by Turner. SUMMARY: The ENT manifestations of Proteus syndrome are high arched palate, gingival hypertrophy, malocclusion and overcrowding of teeth, hyperostosis of the external auditory meatus, and low nasal bridge. Our patient had a unilateral enlargement of the tonsil causing dysphagia, which was relieved by tonsillectomy.