Non-Users and Limited Users of Cochlear Implants in Pediatric Patients: A Retrospective Cross-Sectional Study.

To determine the prevalence of non-use and limited use of cochlear implants. To find out the reasons for the same. This study was carried out among the paediatric patients who underwent cochlear implantation under the SHP* scheme in Civil Hospital, Ahmedabad between 2013 and 2020. STUDY DESIGN: Retrospective cross-sectional study. STUDY SETTING: Civil Hospital Ahmedabad. SAMPLE SIZE: 150 paediatric patients. Patients were selected based on a random number generator. The data was collected through a telephonic interview based upon a preformed questionnaire. The study indicates that out of a total 150 participants, 109 (72.7%) used their cochlear implant regularly while 41 (27.3%) did not. Major issue faced by the participants was in the external device -damage to the device and monetary issues for its repair. The participants who have dropped the usage of their implants faced issues mostly after 2 years of usage. The age group of less than 3 years showed 15.6% of non-usage, while the age group of 3-6 years showed an increase to 34.5% of non-users. The age group of more than 6 years showed an even higher proportion (41.3%) of non-users. It is recommended that the government ensures the follow-up of the patients undergoing cochlear implantation for at least 2 years after the surgery. The proportion of non-users in the consecutive increasing age groups saw a rise in number. Therefore, it is recommended to divert the resources towards lower age groups to facilitate a better outcome.

An Unusual Case of Parapharyngeal Desmoid Fibromatosis - A Rare Case Report.

Desmoid fibromatosis (DF) is a rare locally aggressive, connective tissue malignancy developing in musculoaponeurotic tissues with an incidence of 2-4 per million population. We presented a case of a 3-year-old patient with a left parapharyngeal mass, histopathological examination suggesting DF, who underwent complete surgical excision without recurrence or requirement of cardiac resynchronization therapy.

Comparative evaluation of early versus late tracheostomy for reduction of the length of ICU stay, incidence of nosocomial pneumonias, risk of laryngeal injury and mortality of mechanically ventilated patients at a Tertiary Care Hospital in Western India.

Introduction: Tracheostomy is a very common procedure performed in ICU as it offers significant advantages over prolonged endotracheal intubation. It facilitates weaning by decreasing the work of breathing in patients with limited reserve by decreasing the dead space area, decreases the requirement for sedation, and may allow for earlier patient mobilization, feeding, and physical and occupational therapy as compared to prolonged intubation along with lesser oral and oropharyngeal ulcerations, improves pulmonary toileting, and lowers incidence of pulmonary infections. Tracheostomy, however, is not devoid of risks. Complications may include hemorrhage, stoma infections and granulations, pneumothorax, subcutaneous emphysema, tracheal stenosis, tracheomalacia, and rarely death. Hence, performance of tracheostomy should be considerate to outweigh benefit-risk ratio. Aims and objectives: To evaluate the early versus late tracheostomy for reduction of the length of ICU stay, incidence of nosocomial pneumonias, risk of laryngeal injury and mortality of mechanically ventilated patients. Materials and methods: We conducted a retrospective study from May, 2019 to April, 2021 of patients being tracheostomized in medical ICU at Civil Hospital, Ahmedabad, who were previously intubated endotracheally and were on mechanical ventilation. The decision to tracheostomize would be taken by physicians in their routine rounds in ICU. Results: Incidence of endolaryngeal complications like laryngotracheal stenosis, stomal granulations, fistula as well as nosocomial infections have lower incidence in early tracheostomy as compared to with late. Mortality remains same in both the groups as well as hospital and ICU stay.

Balloon dilation laryngoplasty for acquired subglottic stenosis at a tertiary center in India.

To evaluate outcomes of balloon dilation laryngoplasty for laryngeal stenosis. It is a retrospective study done at Civil Hospital Ahmedabad from Feb 2017 to Jan 2019. All patients treated with laryngeal balloon dilation with acquired subglotticstenosis with normal vocal cord mobility. Stenosis severity, Measured using the Cotton and Meyer classification, and McCaffery grading system. A total of 10 patients of acquired subglotticstenosis ranging in age from 16-64 y (5 [50%] with grade II stenos is, 3 [30%] with grade I stenosis, and 2 [9%] with grade IIIstenos is) were included. A total of 10 balloon dilation laryngoplasties were performed, and 9 (90%) were deemed successful. Four of the 5 patients undergoing primary dilation (90%) had successful outcomes, and in the other 1 [10%], outcomes were unsuccessful and required either laryngotracheal reconstruction or tracheotomy. Five balloon dilations were performed as a secondary procedure after recent open surgery; all of the procedures (100%) were successful, and thus surgical revision was avoided. After balloon dilatation,among 7 tracheostomised patients, 6 patient got decannulated. Balloon dilation laryngoplasty is an efficient and safe technique for the treatment of both primary and secondary acquired laryngotrachealstenosis. Minimal intervention with maximum results.