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Background: The aim of the study was to study the role of hypertension in patients hospitalized for serious epistaxis. Methodology: This is a retrospective study conducted over duration of 2 years from August 2014 to July 2016 over 140 patients hospitalized for serious epistaxis. Epistaxis was classified into serious and severe type. The following parameters were recorded: age, gender, blood pressure recordings, patients in whom blood pressure is difficult to control, duration of hospital stay, history of hypertension, severity of epistaxis, including medical and/or surgical management, medications affecting clotting.Results: Mean age of our patients was 52 years, 55% of the patients had a history of hypertension. There was no statistically significant difference between patients with a history of epistaxis in the two groups (with or without a history of hypertension). There was no statistical significance between blood pressure recordings on admission between the two groups. The severity of hypertension was also not associated with severe epistaxis versus serious epistaxis.Conclusion: Hypertension does not appear to be causal factor of serious epistaxis.

Background: Coronavirus disease of 2019 (COVID-19) has made an imperishable haunting mark worldwide, and has changed in many aspects the way medicine had been practiced till now. This study is intended to highlight the approach that was followed in the department of ear, nose, and throat (ENT) learning from the existing available guidelines to provide safe routine and emergency ENT care to all the patients irrespective of the COVID status. Objectives of the study were to highlight the changes, challenges, triage and safety recommendations associated with patient management during the ongoing pandemic.Methods: This study conducted between 25th March 2020 to 15th September 2020 constitutes of following points covering various aspects of patient management such as education about personal protective equipment, the 3-station triage system starting from the patient’s entry in the hospital, general working and precautions at the ENT outpatient department (OPD) registration counter, medical consultation with otorhinolaryngologist in OPD or in ER, general precautions in endoscopy room/voice lab, and operation theatre, patient transport, and postoperative care. Results: A total of 8930 patients were seen from 25th March 2020 to 15th September 2020. 7885 patients were seen in ENT outpatient department, 561 in emergency room, and 484 patients were seen as referrals sent from other departments. 297 patients were advised admission for various surgical procedures whereas 22 patients were admitted for conservative management.Conclusions: Through this study, we suggest a paradigm consisting of safety and triage recommendations to be followed while dealing with patients in a way to minimise the cross transmission of virus.

Background: Chronic suppurative otitis media (CSOM) is a common chronic ear disease causing serious local damage and complications. Irrational use of antibiotics for its management has led to the emergence of multidrug-resistant strains. This study was conducted to find out the microbial profile and their antimicrobial sensitivity patterns in CSOM patients in Garhwal belt.Methods: A total number of 100 patients of clinically diagnosed CSOM were enrolled over the duration of 1 year. Ear discharge was collected using sterile swabs and processed for the identification of aerobes, anaerobes and fungal isolates. Antimicrobial susceptibility testing of the isolates was performed. Results: Maximum incidence of CSOM was observed in patients of 10–20 years age group with female preponderance. Decreased hearing was the main associated symptom. Out of 100 swabs, microbial growth was obtained in 88 samples amongst which 61 had monomicrobial growth while 39 had polymicrobial growth. Pseudomonas aeruginosa was the most common isolate. Amikacin showed maximum activity to most of the isolates.Conclusions: Evaluation of microbes and their antibiotic sensitivity pattern in local area becomes helpful in prescribing empirical treatment for successful cure of CSOM.

Background: To highlight the changes, challenges, and safety recommendations associated with surgical management of a patient which were practiced effectively at our institute during the pandemic and share our experience.Methods: This retrospective observational descriptive study conducted between 25th March 2020 and 31st October 2020 constitutes of following points covering various aspects of surgical management of patient such as- general precautions followed by otrorhinolaryngologist while doing OPD surgical procedures, while doing endoscopy, in every major operative elective or emergency surgical procedure. This study also mentions focussed considerations for specialised surgical procedures like otology surgeries, endoscopic sinus and skull base surgeries, airway surgeries, tracheostomy, head and neck carcinoma etc. Results: Of the 342 cases operated between 25th March 2020 and 31st October 2020 during this pandemic, 69 nasal surgeries, 83 ear surgeries, 37 throat surgeries, 37 head and neck surgeries, 26 oesophagoscopies, 17 bronchoscopies, 63 tracheostomies, and 10 cases of maxillofacial trauma were performed. 983 patients were taken up for endoscopic examination of the mucosa of the head and neck in OPD as an office-based procedure.Conclusions: Through this study, we suggest a safety and recommendations procedural framework to be followed while managing surgical patients in a way to minimise the cross transmission of virus.

Background: The main objective of the study was to assess the anatomical and functional results of cartilage tympanoplasty using full thickness cartilage graft (with or without perichondrium) reinforced with fascia in high risk situations.Methods: This prospective non-controlled, non-randomized study included 124 cases of chronic otitis media who underwent cartilage (reinforcement) tympanoplasty (underlay) and ossicular reconstruction with or without mastoidectomy in following seven groups: revision cases, atelectatic cases, subtotal perforation (dry), larger anterior perforations (dry), tympanosclerosis, cholesteatomatous ear, and wet (discharging) ears . Graft success was accepted labelled as an intact graft at the end of six month postoperatively. At the same time, hearing results were also assessed by comparing pre- and post-operative pure tone average air-bone gap (PTA-ABG) of each group using Student “t” test and pResults: Anatomical success rate in this series was 94.36%. The overall mean pre- and post- operative pure tone average air-bone gap (PTA-ABG) were 31.33±10.41 dB and 19.55±12.04 dB, respectively and the difference was statistically significant (pConclusions: This study discusses the results of cartilage tympanoplasty in specifically indicated seven situation and reveals good anatomic results in each group (minimum success rate was 86.66% in wet ears) and statistically significant differences in mean pre- and post op PTA-ABG in groups except cholesteatoma and wet ear group.

Background: Tuberculous otitis media (TOM), a rare cause of chronic otitis media, is easily confused with nonspecific chronic otitis media owing to its unexpectedly changing and variable presentation, low suspicion and low prevalence which causes difficulty in its early diagnosis. The purpose of this study was to analyze its changing clinical pattern and to formulate an acceptable management protocol.Methods: This retrospective observational, descriptive study included 457 cases of Chronic otitis media who were operated between January 2017 to July 2020 in a tertiary care center. Histo-pathological examination of tissue from the middle ear and mastoid were sent and positive results were corroborated retrospectively to the clinical findings.Results: Diagnosis of TOM was established post-operatively in five cases (1.09%) with a positive histopathology report in four out of five cases and by polymerase chain reaction (PCR) in one case. Three cases (60%) presented with facial palsy and one with profound hearing loss (20%). All cases received 6 months course of anti-tubercular therapy postoperatively and were in regular follow up.Conclusions: Tuberculosis of the middle ear can present unexpectedly either as a complication or completely as a non-specific chronic otitis media. The extent of pathological findings might not be in commensuration with the clinical features. In operated chronic otitis media cases, specimen for histopathological examination must be sent in all cases and further specific microbiological investigations may as well be advised accordingly.