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Exactly what is a 'serious' innate issue? The views of people living with innate circumstances.
A good graft material is the one which is easily available and harvestable, tough and is easy to be handling and survival is good. Both temporalis fascia and fascia lata graft satisfy all these criteria. Keeping all these factors in mind, the comparative study of temporalis fascia and fascia lata graft in tympanoplasty is undertaken. All the patient reporting to ENT OPD with tympanic membrane perforation who are fit for surgery were advised tympanoplasty or tympanoplasty with mastoidectomy were included in the study. Our observation and data analysis have shown that fascia lata is definitely better than temporalis fascia in terms of intactness of graft (95.1% in fascia lata and 90.24% in temporalis fascia) and PTA average improvement is higher in fascia lata graft (11.56 ± 5.005) as compared to temporalis fascia graft (10.32 ± 4.634) and ABG improvement is higher in fascia lata graft (2.7317 ± 1.118) as compared to temporalis fascia graft (2.634 ± 1.089). Fascia lata has better dimensional stability, easy handling and thickness of the graft and it provides more resistant to negative middle ear pressure. Hence, fascia lata is one of the good choices in otologist's armentorium for tympanoplasty graft material.Ramsay Hunt Syndrome is a rare condition in children. There are currently no internationally accepted protocols in the management of these patients. Selleck MYCi975 We present a case of a 9 month old child that presented to our Department with Ramsay Hunt syndrome. Included is the management of the clinical condition and a brief literature review. Early identification, a high index of suspicion and prompt treatment is required to achieve a good clinical outcome.Hearing is a special sense needed for appropriate mental, speech and language development and academic performance. Even among normal babies, 50% of cases of hearing loss are missed out if screening protocol is not followed. In this study, we assess the hearing of all neonates born and brought to the tertiary care hospital, and also find out how many well babies with hearing loss would have been missed if this screening had not been done. Hence, the study aims to estimate the prevalence of neonatal hearing loss and study the associated risk factors. Neonates (N = 1559) attended the outpatient department of paediatrics were included. A detailed history of the neonates with special emphasis on prenatal, natal, postnatal, family history, and maternal risk factors were elicited. Three-stage hearing testing protocol was followed with transient evoked otoacoustic emission testing, a gold standard test for stage 1 and 2 and brainstem evoked response audiometry for stage 3. Of 1559 neonates, 138 had hearing loss. History of drug intake, order of the child, place of delivery and maternal history were the significant factors associated with hearing loss in neonates. Bivariate analysis revealed order of child, maternal history, and history of drug taken were the significant factors affecting the hearing loss in the neonates (P  less then  0.001). The prevalence of hearing loss was 8.85%. Early detection of hearing loss is essential for timely intervention and development of optimal communication skills. Further studies are required to decide the essentiality of Universal New-born hearing screening.External auditory canal cholesteatomas (EACC), are rare, more so when they affect the facial nerve in its vertical mastoid segment. EACC are known to possess bone eroding properties, causing a variety of complications, similar to the better-known attic cholesteatomas. We describe here the novel surgical management of a case of EACC, affecting only the vertical segment of the facial nerve, causing seventh nerve palsy at the time of presentation. A 46 year old male, complaining of right-sided otalgia and otorrhea, presented with grade IV facial palsy and associated mild conductive hearing loss. Clinical examination and radiological investigations suggested the diagnosis of an external auditory canal cholesteatoma. The patient underwent a trans-canal facial nerve decompression along with the cholesteatoma removal. Post-operatively, the patient showed marked clinical improvement with the facial palsy reverting to grade II. EACC involving only the vertical segment of the facial nerve can be approached via the trans-canal route, in contrast to the conventional postauricular approach, with a good clinical outcome. To the best of our knowledge, our case pertains to the only case of EACC with complications, managed by trans-canal facial nerve decompression.The aim of our study is to compare the outcomes in unilateral and bilateral cochlear implants in pediatric age and also between simultaneous and sequential cochlear implant surgery. This retrospective study was carried out with 83 children aged between 12 months to 2.5 years which included 41 children with bilateral Cochlear implants and 42 with unilateral implants. Out of these 41 children, 21 were simultaneous and 20 were sequential cochlear implant. All the children were operated at civil hospital Gandhinagar, Gujarat, India. CAP, SIR, localization, traffic noise and speech in noise scores were assessed at regular intervals over the period of 4 years. Also the drug administration time, surgical time, operating room time were assessed for simultaneous and sequential cochlear implant surgery. Children with bilateral simultaneous implants fared significantly better with CAP, SIR, localization, speech noise and traffic noise scores than sequential bilateral implants and unilateral implants with a significant difference of means t tests between the two groups. Simultaneous cochlear implant surgery is associated with reduced surgical time, operating room time, it shortens the total in patient stay. There is less of drug administration and bilateral ones are stimulated simultaneously. Bilateral cochlear implants perform better with respect to auditory perception skills and spontaneous speech when compared with unilateral implants, but simultaneous surgery is better and safe option for pediatric cochlear implantation.The aim of study was to evaluate various otological manifestations of temporal bone fractures and to suggest their management. This prospective observational study was conducted in a tertiary care hospital of Armed Forces over 2.5 years in 57 cases of temporal bone fracture in patients of age group of 12-59 yrs comprising 49 males and 8 females. Radioimaging was done for diagnosing the fracture, mapping its extent and for clinical correlation. Hearing was assessed by tuning forks, free field hearing and pure tone audiogram as per the fitness of patient. Majority of patients were in the age group 20-40 years who had met with road accidents. Important otological features included Battle sign (24.6%), ear canal laceration (53%), tympanic membrane perforation (7%), haemotymanum (40%), ear discharge (66.7%), hearing loss (63%), vertigo (16%), tinnitus (21%), facial paralysis (68%) and cerebrospinal fluid otorrhea (3.5%). Otic capsule sparing fracture was three times more common than violating ones. Facial palsies were treated with oral steroid with complete recovery in 56.41% cases but three required decompression surgery. 4 patients underwent tympanoplasty. Both the cerebrospinal fluid leaks stopped in 2 weeks time. Facial palsy is as common as hearing loss. TM perforation is as rare as CSF leak. Otic capsule violating fracture line is less common. Hearing loss shows recovery in most of the cases. Delayed onset positional vertigo is more common than acute vertigo. Large numbers of immediate onset complete facial palsy do recover from injury without surgery.Classification systems provides a tool for segregating cases based on their similarities. It can be used by healthcare professionals for representation, comparison, communication, discussion and for standardizing treatment protocols across the geographical boundaries. Cholesteatoma is prevalent in developed as well as developing nations posing a great burden on economic and health sector. Even though systems for classification of cholesteatoma are already being used in some places, however none of them is yet universally accepted due to their complex nature. After a thorough review of the most popular systems, we attempt to propose an Indian classification system for cholesteatoma "TAMPFIC". The system is based on clinical representations and will allow us to standardize the reporting of the disease and its extension along with all possible complications in a simple and unique way and will also help in reporting surgical outcomes for the same. Reporting of surgical outcomes will not only help in comparison but will also help in standardizing treatment protocols for similar kind of cases in future. It will require multi centric approach for validating our system to reach a common consensus for defining treatment protocols. We hope this system acquires universal acceptance and presents itself as a single new tool for classification of cholesteatoma with international consensus in near future.Absorbable gelatin sponge (Gelfoam) has been used for many years in middle ear surgeries. It not only provides support to the graft and ossicular reconstruction materials but also helps in haemostasis and aeration of the middle ear. Although gelfoam is generally well tolerated but fibrosis and granulations in the mesotympanum have been attributed to its usage in some studies. This study was conducted to compare the results of middle ear surgeries with and without gel foam in terms of both objective and subjective improvements of symptoms. To study the outcome of tympanoplasty with and without gel foam in the middle war by measuring following attributes (for measuring outcomes) at an intervals of 6 weeks, 12 weeks and 6 months after surgery. (a) Graft take up rate as evaluated by otoscopy. (b) Pre and post-operative hearing levels as measured on Pure Tone Audiogram. (c) Subjective improvement in symptoms of ear discharge, heaviness in ears, hearing loss and tinnitus. Study design-prospective clinical study. pa or granulations in the middle ear.Prior to antibiotic era, complications rate of CSOM was 2.3 to 4% cases. With advent of newer antibiotics, radiological surgical techniques the complication greatly reduced to 0.15-0.04% and mortality decreases from 25 to 8% 5, still early diagnoses and management is still the cornerstone of prevention of CSOM complications. To study the prevalence of extracranial and intracranial complications in CSOM. It is a prospective cross sectional study done in one year from January 2018 to January 2019, at Department of ENT, G R Medical College, Gwalior, M P, India. In our study 50 patients presented with complications of CSOM during January 2018 to January 2019, ECC was found more common than ICC ECC-52%, ICC-46%, mastoid abscess was found most commonly in ECC 50%, brain abscess was the most common found intracranial complication of CSOM. Continuous negligence of CSOM leads to various extracranial complications lethal intracranial complications like brain abscess, meningitis, etc. hence it is recommended that health education program should be provided as prevalence is still higher in younger age group and low socioeconomic class especially in rural and tribal regions. In spite of newer antibiotics, radiological modalities and surgical advancement.
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