Search

Introduction: "As the septum goes, so goes the nose". A wellknown phrase by Maurice Cottle forms the pillar of septoplasty. Since the inception of septal surgeries, numerous methods of septoplasty have been described. But, if not performed meticulously, may lead to deformity. For a successful surgery, understanding the anatomy and addressing the anterior nasal spine and maintaining the tip integrity is vital. Aim: Study the outcomes of "ROUND ABOUT technique" to correct deviated nasal septum which focuses on the importance of anterior spine and hence maintain the tip integrity. Materials and Methods: This was a prospective, singlecentre outcome study of 35 patients with symptomatic nasal obstruction. Here, we describe a method of elevating the mucoperichondrial and mucoperiosteal flaps bilaterally, without transecting the quadrilateral cartilage of the septum. The Sino Nasal Outcome Test-22 (SNOT-22) Questionnaire was administered pre-operatively and after 3 months following surgery. The post-operative follow-up period ranged from 3 to 6 months (mean= 4.5 months) to evaluate the functional and aesthetic outcomes of the performed procedure. Results: A total of 35 patients underwent surgery by this technique who presented with deviated nasal septum and variable degrees of nasal obstruction. To assess the statistical outcome Paired t-test was applied. Mean SNOT-22 scores decreased significantly from 40.02 pre-operatively to 18.65 three months after surgery. The results sustained after 6 months (p-value <0.0001), 85% of these patients had improved breathing post-operatively and none of the patients complained any aesthetic criticisms. The patients were content and the requirement of medications post-operatively were minimal. Conclusion: The ROUND ABOUT technique is a very effective and safe method in correcting the septal deviations especially the ones with caudal or dorsal deflections. It also helps in maintaining the tip integrity and addressing the anterior nasal spine. It avoids the complications of conventional septoplasty. [ABSTRACT FROM AUTHOR]

Aims: To compare the efficacy and tolerability of Oxymetazoline 0.05 % plus Dexpanthanol 5% versus Xylometazoline 0.1% nasal drops in patients with nasal congestion due to allergic rhinitis and following nasal surgery. Methods: An investigator-blind, randomized, controlled, phase IV clinical trial conducted in 100 patients with acute allergic rhinitis or patients post-nasal surgery. Patients received either Oxymetazoline 0.05% with Dexpanthanol 5% (OD) or Xylometazoline 0.1% (XO) nasal drops. Results: Relief from nasal congestion was significantly better in the OD group then in the XO group (mean nasal scores 1.24 vs 1.86). Significantly more improvement in sneezing and decrease in nasal discharge was seen in the OD group than the XO group. Nasal irritation in the OD group was significantly less as compared to XO group (0.38 v/s 1.12 on second day and 0.10 vs 0.36 on the fourth day). The recovery time for OD group was 1,08 hours, which was significantly (46 min) lesser than that of the XO group. Rebound congestion was significantly less in OD as compared to XO group (6.25% vs 82.98%). 93.75% of the physicians in the OD group and 51.28% in XO group reported response to therapy as good to excellent. 95.83% patients in the OD group and only 52.91% patients in the XO group rated tolerability to therapy as good to excellent. Conclusion: Oxymetazoline and dexpanthenol combination has a better efficacy, shorter recovery time, causes lesser rebound congestion and has better tolerability than xylometazoline. [ABSTRACT FROM AUTHOR]

Langerhans cell histiocytosis (LCH) is a rare disorder of mononuclear phagocytic system whose clinical presentation varies from the localised involvement of a single bone to a widely disseminated disease. Langerhans cell histiocytosis rarely involves the thyroid gland and isolated involvement of thyroid is even rarer. We report a case of an eight-year-old male child diagnosed with Langerhans cell histiocytosis limited to thyroid gland with review of literature. Should thyroidectomy be done or proceed with chemotherapy? Our case report raises this question with a note on the role of 18 fluorodeoxy glucose positron emission tomography-computed tomography in the management of the same. [ABSTRACT FROM AUTHOR]

Maxillary defect reconstruction has been a grave challenge which unfortunately has stopped many ENT surgeons from attempting maxillectomy due to the fear of reconstruction. With our technique of reconstructing the maxillary defect with titanium mesh and fascia lata, the need for microvascular assistance is obviated. Here we describe a revision case of ameloblastoma of maxilla in a 33-year-old female for which total maxillectomy with reconstruction was done without the aid of microvascular tissue transfer. The aim of this article is to encourage and alleviate the fear among the ENT surgeons, in attempting maxillectomy and its reconstruction for delivering an equally good aesthetic and functional outcome especially at the centres where the facility of plastic assistance is not readily available.

Voice rehabilitation after a total laryngectomy is an important requisite for patients' rehabilitation. Oesophageal speech using tracheo-oesophageal-valved prostheses is now considered the state-of-art in postlaryngectomy voice rehabilitation. One of the major drawbacks of voice prostheses is their limited device lifetime. This is due to the deterioration of the silicone rubber material by different bacterial and yeast species, which are organised in the form of a biofilm resulting in internal leakage, increased airflow resistance, impeding speech, respiration and swallowing. The use of antimicrobials though easily applicable is associated with development of resistance if used on long-term basis. Other techniques in the form of modification of physicochemical properties of the silicon surface or covalent binding of antimicrobial agents to the silicon surface have been employed. This article reviews the different strategies investigated until now and the future trends in preventing biofilm formation for prolonging the lifetime of the silicon voice prostheses. Data was collected by conducting a computer aided search of the MED-LINE and PUBMED databases, supplemented by hand searches of key journals. Over 35 articles in the last two decades on the topic have been reviewed out of which 27 were found to be of relevant value for this article.

A vibrant health research industry is an indispensible asset for societal development. Health research focus and output in India is sadly not at par with the magnitude and distribution of the prevalent disease burden. In the current scenario of the ever evolving Indian public health sector, the balancing of research efforts between different competing fields, especially when resources are meagre, is a delicate one and quite typical of the problems anticipated in developing countries. To progress, the nation's clinical health research needs good quality, authentic and relevant research in the varied aspect of public health. Rhetoric or theoretical concepts alone cannot move the health status and research forward in this country. Evidence and evidence based medicine have revitalised the academic aspects of the public health sector. But, its up to the Indian policy makers, administrators and medical professionals to assure that the vast research opportunity this country offers is exploited to its maximum potential.

Myoepithelioma is a rare benign neoplasm. Pure accounting for less than 1% of all salivary gland tumors. Only three cases of sinonasal myoepithelioma have been reported in the literature. Diagnosis of myoepithelioma through light microscopy is possible and immunohistochemistry is done to facilitate the diagnosis. The lesion is so rare that there are no specific indications/guidelines for its treatment. We report to you a rare case of sinonasal myoepithelioma in a 57 year old Asian female.Myoepitheliomas are rare tumours that account for only about 1% of all salivary gland tumors. Most are benign, but some can be malignant. Only three cases of sinonasal myoepithelioma have been reported in the literature so far.