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.

Plasma Dissection Versus Tissue Dissection in Adenoid Surgery.

Aim is to compare coblation versus conventional adenoidectomy, to evaluate whether this approach is adequate, safer and could be a coblation a good alternative of conventional adenoidectomy? It is a prospective randomized controlled study done at Civil Hospital Ahmedabad from January 2016 to January 2017 with 70 patients. The study includes children between age groups 5-11 years divided into Group A (38 children underwent coblation adenoidectomy) and Group B (32 children underwent conventional adenoidectomy) with an average follow-up period of 10 days, 1 month and 3 months. Information on average time of operation, intra-operative blood loss, post-operative pain, and time required regaining normal breathing pattern, presence of residual adenoid tissue 4 weeks after surgery and postoperative hemorrhage were gathered and compared. We found statistically significant differences in average operation time (p < 0.001), intra-operative blood loss (p < 0.001), post-operative pain (p < 0.0001) and time required regaining normal nasal breathing pattern (p < 0.001) presence of residual adenoid tissue 4 weeks after surgery (p < 0.0001) However, post operative hemorrhage (p > 0.5) was not significantly different between two groups. This study suggested a significantly less intra-operative or postoperative complications and morbidity in coblation adenoidectomy in comparison with conventional method. Coblation was associated with less pain and quick return to normal nasal breathing pattern. These findings indicate that coblation adenoidectomy is a safer, method and can be a better alternative of conventional method.

Hearing screening in a tertiary care hospital in India.

INTRODUCTION: To study the incidence of hearing loss among children and to determine and confirm the distribution of common risk factors in children with hearing loss presenting at a tertiary care hospital in India. MATERIALS AND METHODS: Babies underwent hearing screening using Transient Evoked Otoacoustic Emission (TEOAE) and Automated Auditory Brainstem Response (AABR) from November 2009 to September 2011. It was a cross-sectional study carried out at our institute involving 500 babies (≤2 y). To identify the high risk babies, Joint Committee on Infant Hearing (2007) High risk registry was used. RESULTS: In our study 110 (22%) babies belonged to high risk category and 11(2.2%) of total screened babies had significant hearing loss. Total number of babies who passed the initial screening with TEOAE was 284 (56.8%). On diagnostic AABR screening of TEOAE REFERRED babies, the babies with no risk factor showed normal AABR tracings whereas from among those with one or multiple risk factors (110 babies), 11(10%) showed different levels of hearing impairment. Hearing loss was highly associated with Neonatal Intensive Care Unit (NICU) admission i.e. 8/11(72.7%), followed by Low Birth Weight (LBW) and hypoxia (6/11 i.e. 54.5% each). CONCLUSION: Hearing loss is more common in those babies with risk factors (majority being NICU admission, LBW and hypoxia). OAE and ABR screening of infants at risk for significant hearing loss is a clinically efficient and cost effective approach for early detection of significant hearing loss.

Giant frontal osteoma: case report with review of literature.

Diagnosis of frontal osteoma is usually by chance, but rarely these can produce exceptional ophthalmologic and neurological complications apart from cosmetic disfigurement. Etiology of frontal osteoma may be multifactorial. Surgical management should be site and size specific. A combination of open surgery and endoscopic methods would help confirm complete removal of the tumor. Here we report a fronto-ethmoidal osteoma of size 7.1 × 5.3 × 5.1 cm which is one of the largest reported in literature. Also, we have done an extensive web search and text based review of the literature on frontal osteoma in terms of its incidence, etiology, pathology, clinical presentation, complications and important developments in management. The available literature and our own experience suggest that even large osteoma arising in the fronto-ethmoid region can be completely removed surgically with minimum complications. The surgical approach can be varied according to the extent of the tumor and patient considerations. A regular follow up is necessary in asymptomatic cases being treated conservatively, in view of the potential complications.

Incudostapedial joint arthroplasty using temporalis fascia/perichondrium ties.

Incudostapedial joint dislocation is the most frequently found ossicular chain defect. In these cases reconstitution of joint capsule is important in maintaining joint integrity. But reconstruction of dislocated incudostapedial joint is a challenging procedure as this joint is devoid of any muscular or soft tissue support. Here we describe a technique designed to reposition the incudostapedial joint in its anatomical position using temporalis fascia or perichondrium. Data have been collected and analyzed from 42 patients with incudostapedial joint discontinuity. The fascial ties used for reconstruction of joint capsule ensure a dynamic union of the repositioned incus with stapes, leading to a significant improvement in conductive hearing loss.

The effectiveness of handheld ventilated sanders in reducing inhalable dust concentrations.

Ventilated sanders are commonly used during aircraft surface abrasion but there is limited data on their effectiveness in reducing worker exposures. This study compared two handheld ventilated sander brands, DCM and Dynabrade, in a laboratory glovebox. Both sanders collect particulates by drawing air through holes in the sanding pads; the dust subsequently passes into a vacuum collection system. Aluminum panels coated with aircraft epoxy primer and polyurethane paint were abraded and inhalable dust concentrations were measured inside the glovebox with IOM samplers. The results indicate that both sanders effectively control inhalable dust, with the DCM sander reducing mass concentrations by 93 percent, and the Dynabrade by 98 percent, when the ventilation system is used. The Dynabrade unit, however, was more aggressive and produced over four times as much dust per unit time as the DCM unit. In spite of this, the Dynabrade sander adequately collected this additional dust. Varying abrasive grit size did not significantly affect dust generation, although the differences between the grit sizes used (180 and 240 grit) were not great and may have influenced the results.