Salivary Gland Lesions: A Clinico-Pathological Correlation.

To study the usefulness of clinical features, histopathological and radiological features in diagnosis and management of salivary gland lesions. Prospective study conducted at the department of ENT of a tertiary care centre in central India. A total of 162 patients who were treated over a period of 2 years for salivary gland lesions were studied with regards to correlation between clinical diagnosis, cytological examination and radiological features with histopathological diagnosis. Mean age group was 23.94 (± 15.43) years. There was slight male preponderance. Commonest presenting complaint was swelling. The most common gland involved was minor salivary glands followed by parotid gland. Sensitivity of clinical diagnosis, USG and FNAC for neoplastic lesions was found to be 80%, 95.65% and 79.61% respectively. Specificity of clinical diagnosis, USG and FNAC for neoplastic lesions was found to be 100%, 100% and 97.23% respectively. At the end of the study we concluded that combination of thorough clinical examination, radiological and cytological examination help in proper diagnosis, but it should always be confirmed on histopathology because some surprises are expected with regards to the nature of salivary gland lesions.

Comparative Study of Various Techniques of Mastoid Obliteration following Canal Wall Down Mastoidectomy.

The primary objective of mastoid obliteration is the eradication of the disease and prevention of its recurrence. We intend to evaluate the impact of mastoid obliteration using autologous materials on the achievement of a dry mastoid bowl and frequency of maintenance care and hearing outcome of the operated ear. This was a hospital-based, non - randomized, prospective study. The study was performed over a period of 2 years. The study was performed in the Department of ENT of a tertiary care teaching hospital. Patients of chronic otitis media - squamosal type underwent canal wall down mastoidectomy and patients were divided into 2 groups of obliterated and non-obliterated. The canal wall obliterated patients were further compared in 3 groups based on the technique of mastoid obliteration used - bone dust, musculo-periosteal flap and cartilage graft. 6 months post-operative mastoid cavity epithelisation based on oto-microscopy and hearing outcome based on pure tone audiometry findings were compared. Majority of patients at 6-months follow-up found that epithelization was most common status of mastoid cavity with musculoperiosteal flap and discharge was commonest with cartilage graft. Mastoid obliteration with autologous materials is a safe and effective method to achieve a dry, safe and useful ear. In this study, musculo-periosteal flap being significantly better in terms of a well epithelized cavity and hearing outcome.

Fascial Arthroplastic Ossiculoplasty - A New Technique of Ossicular Reconstruction.

OBJECTIVE: Ossicular reconstruction with autologous materials has been practised for a long time, but the procedure may lead to stiffness of joints and bony ankyloses thus hampering the sound conduction mechanism. This paper describes a novel technique of creating joint capsule around the reconstructed joints with temporalis fascia strips hoping a firm and movable union with full functional restoration. MATERIALS & METHODS: This study is a prospective study of 35 patients requiring tympanomastoid surgery with ossicular reconstruction and were studied over a period of 2 years. The newly reconstructed ossicular joints were wrapped with temporalis fascia strips. Post-operatively air-bone gap closure were studied and statistically analysed. RESULTS: A significant air-bone gap closure was achieved in 23 patients, while moderate improvement was seen in remaining cases. Only 1 patient had tympanic membrane graft failure and rest all had well healed tympanic membrane. CONCLUSION: Fascial arthroplastic ossiculoplasty is a simple and safe procedure and the results are reproducible and more predictable. It provides an ossicular assembly which is near to normal in its physiological functions.

A Prospective Clinical Study of Foreign Bodies in Ear, Nose and Upper Aerodigestive Tract - Our Experience.

A foreign body is an object foreign to location where it found. Foreign body (FB) in ear, nose and aerodigestive tract are common problem seen in children and adults. This study aims to know foreign bodies in terms of type, age, site, gender distribution and method of removal. This prospective study was performed in tertiary care centre from 2020-2022. A total 185 patients with foreign bodies in ear, nose and aero digestive tract who were presented to casualty and OPD were included in study. Their demographic data, age of presentation, clinical presentation, foreign bodies types, site of lodgement and management were included in study. Out of 185 patients, 99 were male [53.51%], 86 were female [46.48%]. FB were found to be maximum in ear (44.32%) followed by nose (37.29%), aerodigestive tract (18.37%). The foreign bodies were removed with or without local anaesthesia in 155 patients and under general anaesthesia in only 30 patients. In some patient foreign bodies like coin, small ear ring was expelled out spontaneously. Left Ear FB (51.21%) was seen most commonly than right ear [45.12%] & both ears (3.67%). Right Side of nasal cavity was frequently involved (69.56%) than left nasal cavity [28.99%] & in both nasal cavities (1.45%). In aerodigestive tract, FB most commonly seen at cricopharynx level [38.23%]. The early childhood group had highest number of patients. Foreign bodies in ENT can be easy as well as difficult at times. Thorough and timely clinical and radiological examination helps in diagnosing and subsequent timely intervention.

Limited Granulomatosis With Polyangiitis of Nose and Paranasal Sinuses - a Case Report.

Granulomatosis with polyangiitis is a rare disease with involvement of multiple organ system. It classically affects the upper respiratory tract, lower respiratory tract and kidneys. 90% of patients present with upper respiratory diseases like rhinosinusitis, nasal polyposis, nasal septal perforation, serous otitis media, impaired hearing and stridor due to subglottic stenosis. Disease manifests in two forms as limited disease i.e. without renal involvement and generalized disease i.e. with renal involvement. It needs to be differentiated from chronic granulomatous diseases like tuberculosis and delay in the treatment should be prevented. Here we present a case with disease limited to Nose and Paranasal sinuses.

Role of Intraoperative Cytology in Head and Neck Lesions: A Prospective Study.

To study the technique of intra-operative imprint cytology for intraoprative diagnosis and management in cases of Head and Neck malignant lesions and to compare its result with postoperative histopathology. Prospective study conducted over 2 yrs period at the Department of ENT of a tertiary care centre in central India. A total of 60 patients who were operated for Head and Neck malignant lesions were studies with regards to intraoperative diagnosis, marginal status and lymphnodal status and compared with postoperative histopathology. Mean age-group was 47.70 (± 13.7) years. There was male preponderance. Bucco-aveolar complex lesions constituted the majority followed by Tongue and thyroid lesions. Intraoperative cytology technique showed a sensitivity of 92.98%, 80.60% and 92.30% as regards the intraoperative diagnosis, marginal clearance and nodal metastases respectively; while the specificity was 100%, 90.09% and 83.33% respectively. At the end of the study we conclude that intra-operative cytology is a good technique for intra-operative evaluation in Head and Neck lesions, where facilities for frozen section are not available. It can be used as a simple, non-expensive and rapid alternative to frozen section. A larger and longer study can validate its routine use in surgical setups where high-end pathology setup is not available.

Ossiculoplasty: a prospective study of 80 cases.

INTRODUCTION: The use of ossicular graft material in ossicular chain reconstruction has significantly improved hearing results hearing after tympanoplasty and tympanomastoid surgery for chronic otitis media. Today, otologists have a wide array of tools from which to choose, but may find it difficult to know which middle ear implant works best. MATERIALS AND METHODS: A prospective study of 80 patients who underwent ossiculoplasty was performed in the ear, nose, and throat (ENT) department at a tertiary health care facility from 2011 to 2013. Patients with chronic suppurative otitis media with an air-bone gap (ABG) of >25 dB with ossicular involvement were included in the study. Total ossicular replacement prosthesis (TORP), partial ossicular replacement prosthesis (PORP), and refashioned incus were used. Success was defined as ABG <25 dB on postoperative Day 90. RESULTS: The majority patients were of middle age with moderate conductive hearing loss. Incus was the most susceptible ossicle. Overall success rate in this study was 80.0% with an average change of 15.76 dB in ABG. CONCLUSION: With continuing advances in our understanding of middle ear mechanics, the results of ossiculoplasty are improving and results can be very rewarding in experienced hands. Severity of preoperative ear discharge, preoperative mastoid cellularity, presence of disease, and surgical procedure proved to be significant prognostic factors. Autograft incus and PORP fared better when the malleus handle was present while TORP gave better results when the malleus handle was eroded.