RESUMEN
Diseases of adenoids are commonly observed in children. It indirectly leads to pathology in the middle ear cleft. It has been demonstrated both by radiological techniques and middle ear pressure studies that adenoids can and do obstruct the Eustachian Tube. The Adenoid-Nasopharyngeal Ratio (ANR), can offer a simple arithmetic measure of nasopharyngeal obstruction. Coupled with tympanometry, it also predicts the degree to which the middle ear is affected. Multicentric study done at two centres in India. 230 patients were studied. Children were in the age group of 5-14 years. The nasopharyngeal and adenoid dimensions were measured separately using the Fujioka method. The adenoid-nasopharyngeal ratio was derived by the arithmetic method. All patients were also subjected to tympanometry. ANR decreased from 0.728 to 0.663 with an increase in age from 5 to 12 years. ANR between 0.701-0.800 had maximum number of Type B (140) and Type C (71) Tympanogram whereas between 0.801 and 0.900, all Tympanogram were found to be of Type B or Type C with none belonging to Type A. Using ANR and Tympanometry, the effects of the adenoids on the middle ear can be quantified indirectly. Both these modalities are easily available, economical, safe and can be performed at the Out Patient Level. This aids in timely and appropriate management thus preventing discomforting symptoms caused by the adenoids locally and also the morbidity caused to the middle ear in the long term.
RESUMEN
In a country such as India, popularly known for its rich diversity and traditions, chewing tobacco and its many other forms is a commonly practised entity. The resultant of this leads to oral submucous fibrosis (OSMF) which causes permanent morbidity in the form of trismus and also can lead to potential possibility of oral cancer. Intra oral injections of steroids such as hyaluronidase and placentrex have been postulated by many studies. But this study was done to evaluate the efficacy of both these commonly used treatment modalities. A 1 year hospital based study was performed over 30 patients diagnosed to be having oral submucosal fibrosis. They were randomly given injection hyaluronidase and injection placentrex. In addition to this, routine haemogram was done and the inter incisor distance was measured before and after the treatment along with histopathological study of the oral lesions. With a prevalence of 0.31%, the males out numbered females. Majority of the patients were in their third decade. All patients chewed tobacco in one or the other form and 90% of them presented with burning sensation in the mouth. The mean inter incisor distance in our patients was 3.1%. A third of the cases were anaemic and two thirds had an elevated erythrocyte sedimentation rate and serum globulin level. More than half the cases had an elevated absolute eosinophil count. All 30 biopsy specimens showed atrophic oral mucosa with subepithelial dense collagenised fibrous tissue. The group of patients who were treated with injection placentrex showed slightly better results than corticosteroids. The results were not statistically significant although clinically they were noteworthy. Being a silent, chronic disease, oral submucosal fibrosis affects the most productive population fraction of our country causing morbidity and also acts as precursor for oral cancer. Since the etiological agent is chewing areacnut in one form or the other, considerable efforts have to be made in sensitizing the workforce of the nation at the community level in understanding the ill effects of chewing tobacco. Understanding the associated conditions such as anaemia, elevated erythrocyte sedimentation rate, serum globulins and absolute eosinophil count should prompt the otolaryngologist in treating these patients holistically. Though injection placentrex yielded better improvement in the inter incisor distance, the results with steroid injection was also comparable with no statistical significance. Hence, keeping the premalignant nature of the disease, screening the patients promptly and treating them on time would lead to considerable reduction in the morbidity caused by the disease. Coupled with health education, the results could be even more encouraging.
RESUMEN
To investigate the viability of the implanted crushed and uncrushed auricular cartilage graft with intact perichondrium with respect to macroscopic and microscopic parameters. Cartilage grafts from 8 white New Zealand rabbits were harvested from the right auricle, with intact perichondrial layers. There were two categories Pre implant and Post-implant and two types, mildly crushed and uncrushed cartilage graft. The cartilage grafts were implanted into the subcutaneous pockets over the right upper paraspinal area. At the end of 2 months, implanted grafts were retrieved and examined histopathologically. There was a difference among the both types of cartilages in both the categories with respect to chronic inflammation, fibrosis, cartilage mass viability and vascularization. The mildly crushed auricular autologous cartilage with intact perichondrium does not lose the viability and maintains the structural integrity and thus increasing the clinical predictability for cosmetic correction of nose in rhinoplasty.