scholarly journals Effect of anterior nasal packing on middle ear pressure

1970 ◽  
Vol 17 (2) ◽  
pp. 125-131
Author(s):  
Mohammad Rokanuddin Bhuiyan ◽  
Mohammad Idrish Ali ◽  
Fatema Johora ◽  
Sk Nurul Fattah Rumi ◽  
Nazmul Haque ◽  
...  

Objectives: To assess the effect of anterior nasal packing on middle ear pressure. Methods: This cross-sectional study was carried out in the Department of Otolaryngology – Head & Neck surgery, Sir Salimullah Medical College & Mitford Hospital, Dhaka for the period of one year from July 2008 to June 2009. Thirty patients were selected purposively. Results: Thirty patients were studied. Minimum age 14 and maximum age 48 years, 50% patients were 3rd decade, 66.66% were male, male female ratio was 2:1 nasal obstruction was 100% of the patients 30% patients were nasal septum deviation, 30% patients DNS with nasal deformity, 30% patients were underwent septoplasty, 36.66% patients had septoplasty with submucosal diathering 26.66% were endoscopic sinus surgery and 6.66% were septorhinoplasty. The prepack middle ear presurre range from -50 daPa to 0 daPa were maximum followed by 0 daPa to +50 daPa, minimum -65 daPa 4 ears showed presume -100 daPa. Three ears were middle ear pressure between -150 daPa to -100 daPa. 2nd post operatively just before pack removal abnormal middle ear pressure was seen in 26 ears (43.33%) after 5 days abnormal pressure was found in 30 ears. Three ears (75%) out of 4 ears having antrochoanal polyp showed no improvement even five days after pack removed. Conclusion: Chronic nasal obstruction seems to have a detrimental effect on middle ear pressure, which may not return to normal even after removal of chronic obstruction. It appears from this study that there might be some permanent change in peritubal nasopharyngeal mucosa due to chronic nasal obstruction, which needs to be proved histopathologically. Lymphatic stasis at peritubal plexus of lymphatic channels and veins appears to be the causes of lymph oedema following nasal packing. Anterior nasal packing causes reversible negative middle ear pressure which return to normal 5 days after pack removal. Key Words: Anterior nasal pack; middle ear pressure DOI: http://dx.doi.org/10.3329/bjo.v17i2.8853 BJO 2011; 17(2): 125-131

Author(s):  
Abhinav Srivastava ◽  
Puneet Shukla

ABSTRACT Introduction Eustachian tube connects nasopharynx with the tympanic cavity. The normal middle ear has an inherent tendency to lose gas to maintain the middle ear pressure by diffusion into the surrounding tissues and circulation. Materials and methods This cross-sectional study was conducted in 2012 to 2014. A total of 100 ears of 50 consecutive cases undergoing nasal surgery followed by bilateral nasal packing were included in the study and the middle ear pressure and hearing threshold were determined in all the subjects in presurgery, and then after 48 hours of surgery with nasal packing in situ and then at 7 and 30 days of nasal pack removal. Conclusion There is an increase in middle ear pressure transiently for few days while the nasal pack is in situ, which returns to normal in a month after pack removal; but, in chronic nasal obstruction cases, such as nasal polyps, there is persistent negative middle ear pressure, probably due to irreversible changes in the Eustachian tube function. How to cite this article Mohan C, Srivastava A, Shukla P. Effect of Nasal Packing on Middle Ear Pressure. Int J Adv Integ Med Sci 2016;1(2):52-56.


2020 ◽  
Vol 24 (1) ◽  
pp. 50-55
Author(s):  
Mashuque Mahamud ◽  
Mani Lal Aich ◽  
Abdullah Al Mamun ◽  
Rafiul Alam

Objective: To evaluate hearing outcome after type I tympanoplasty in inactive mucous type of chronic otitis media. Methods: It was a cross-sectional study conducted in the department of Otolaryngology & Head Neck Surgery, Sir Salimullah Medical College and Mitford Hospital, Dhaka, from July 2014 to June 2016. 50 cases were selected by matching inclusion and exclusion criteria. Paired t-test and Z test was used to analyze the variables. P values <0.05 was considered as statistically significant. Results: The mean age was found 28.5 years with range from 15 to 41 years and male female ratio was 1.3:1. All patients had intermittent otorrhoea and varying degree of hearing loss. The mean air conduction threshold was 40.2 dB preoperatively and 27.1 dB post-operatively. Air-bone gap was found 26.9 dB in preoperative and 16.1 dB in post-operative group. The differences were statistically significant between preoperative and post-operative group. Thus mean improvement of air conduction threshold was 13.1 dB and air-bone gap was 10.8 dB. Two third (66.%) patients improved <15 db air conduction thresholds and 17(34%) improved ≥15 db air conduction thresholds. Using the proportion of patients with a postoperative hearing within 40 dB as the criterion, this study showed 46(92%) patients achieving this and 40(80%) patients achieving AB gap within 20 db postoperatively. Conclusion: Improvement of air conduction threshold and AB gap after type I tympanoplasty was statistically significant. Thus from this study it can be concluded that type I tympanoplasty is an effective technique for hearing improvement in inactive mucous type of chronic otitis media. Bangladesh J Otorhinolaryngol; April 2018; 24(1): 50-55


2018 ◽  
Vol 25 ◽  
pp. 26-29
Author(s):  
Subrata Ghosh ◽  
Milon Kumar Chowdhury ◽  
Ashik Iqbal ◽  
Monowar Hussain ◽  
Belayat Hussain Siddique

Objectives – To find out clinical presentation, management & Complication of surgery of Thyroglossal cyst.Methods – It was a cross sectional study done in the Department of Otolaryngology and Head-Neck Surgery, BSMMU, DMCH & RMCH, from January 2009 to June 2015. 200 Patients undergoing Sistrunk’s operation for cytologically proven Thyroglossal cyst were included in this study. Patients were reviewed after sugary and any complication that occurred were recorded. Results – Within 200 patients, most (34%) were in 1st decade, mean age19.17 years, male-female ratio 1.2 : 1, in 92.5% cases cyst in midline, Complication of surgical management in 8.5% cases and recurrence is 1.5% cases after Sistrunk’s operation.Conclusions – Thyroglossal cysts commonly present as midline neck swelling within 2nd decade of life and can be successfully treated with Sistrunk’s operation with minimal recurrence.TAJ 2012; 25: 26-29


2020 ◽  
Vol 23 (1) ◽  
pp. 27-31
Author(s):  
Md Manjur Rahim ◽  
Ahmmad Taous ◽  
Md Hasan Zafar ◽  
Mozharul Islam ◽  
Khalid Asad ◽  
...  

The present study includes evaluation 60 ears of 30 nasal patients admitted to department of Otolaryngology and Head-Neck Surgery at Banghabandhu Sheikh Mujib Medical University. Each patient underwent nasal surgery followed by anterior nasal packing for 48 hours. All patients were investigated by tympanometry prior to surgery, 2nd post operative day before pack removal and on 7th post operative day 5 days after pack removal. This study shows that nasal packing result in Eustachian tube dysfunction and negative middle ear pressure which is reversible in nature. Bangladesh J Otorhinolaryngol; April 2017; 23(1): 27-31


Author(s):  
Thirupathi K. ◽  
A. P. Preetham ◽  
Musarrat Feshan

<p class="abstract"><strong>Background:</strong> Epistaxis (nose-bleed) is one of the commonest emergencies presenting to an otolaryngological emergency that affects up to sixty per cent of the population in their lifetime; in this, six per cent needs medical care.</p><p class="abstract"><strong>Methods: </strong>Hospital-based cross-sectional study carried between October 2018 to January 2020 in the department of ENT at Southern Railway Headquarters Hospitals, Perambur, Chennai.</p><p class="abstract"><strong>Results: </strong>The mean age of the subjects was 47.76±23.01. Females were less affected compared to males with 1.68:1 male: female ratio. The results of ENT examination/anterior rhinoscopic examination revealed that all 153 (100%) subjects had anterior epistaxis and 5 (3.27%) had posterior epistaxis. 143 (93.46%) had deviated nasal septum. Diagnostic nasal endoscopy revealed that 90 (58.82%) had deviated nasal septum to the left, and 55 (35.94%) had to the right. The majority of subjects, i.e., 86 (56.21%), were managed conservatively, followed by 52 (33.99%), 5 (3.27%), and 1 (0.65%) patient were given treatment with anterior nasal packing, anterior and posterior nasal packing, and cauterization respectively. Whereas 9 (5.88%) subjects needed a surgical mode of treatment to manage their epistaxis.</p><p class="abstract"><strong>Conclusions:</strong> Findings revealed that the incidence was high in elderly individuals, with male preponderance over females. Anterior epistaxis more commonly occurred in comparison to posterior epistaxis. Our research supports the conservative management methods’ credibility in the epistaxis treatment. The practice of simple nasal packing is the commonest conservative approach that has a high rate of success. As a result, this method will be the best choice for epistaxis management.</p>


2014 ◽  
Vol 19 (2) ◽  
pp. 99-103
Author(s):  
Md Momenul Haque ◽  
Mohammad Idrish Ali ◽  
Md Harun-Ar-Rashid ◽  
Md Tariqul Islam ◽  
Mujibur Rahman ◽  
...  

Objective: To observe the pattern of clinical presentation according to site of origin of sinonasal carcinoma. Methods: This cross-sectional study was done in the Department of Otolaryngology-Head and Neck Surgery, BSMMU and Dhaka Medical College Hospital, Dhaka during the period from January 2008 to December 2009. Patients of sinonasal carcinoma were evaluated by detailed history, clinical examination and relevant investigations. Results: The present study included 40 patients of sinonasal malignancy bearing age limits of 4 years to 75 years with mean age 48.29. Male and female ratio was 2.6:1. Most patients (77.5%) came from rural area and illiterate (40%) and most of them were farmers (40%), having poor socio-economic condition (50%). About 35% of them were smokers and more than one other personal habit. Majority patients presented with multiple sinuses involvements (72.5%) and among single sinus involvement maxillary sinus was most common (63.63%), followed by nasal cavity (27.27%) and ethmoidal sinus (9.09%) as primary site. Conclusion: Though carcinoma of the nose and paranasal sinuses is relatively uncommon, it is not uncommon in our country. This disease generally presents in an advanced stage. Overall prognosis was directly related to diseases stages. DOI: http://dx.doi.org/10.3329/bjo.v19i2.17632 Bangladesh J Otorhinolaryngol 2013; 19(2): 99-103


2015 ◽  
Vol 20 (1) ◽  
pp. 15-19
Author(s):  
Md Aktar Kamal ◽  
Md Yousuf ◽  
Md Yusuf Haider ◽  
Kamrul Hasan Tarafder

Background: Oral carcinoma is the 6th most common carcinoma worldwide. The 5 year survival rate for oral carcinoma is only 50%. Patients of oral carcinoma are at high risk from secondary neoplasm. Over 90% of all primary malignant tumour of the oral cavity is squamous cell carcinoma. Aim: To find out the difference of clinical presentation and pathological aspects of oral cancer. Methods: In this cross sectional study 30 patients with carcinoma oral cavity from the department of otolaryngology and Head neck surgery, Bangabandhu Sheik Mujib medical University, Dhaka Medical College hospital and National Institute of cancer research & hospital, Mohakhali, Dhaka were included , period from march 2009 to September 2009. The patients were examined after admission into Hospital pre-operatively and in the post-operative period. The surgical specimen were sent for Histopathology. Results: Majority of the patients were at 6th decade where female outnumbered the male with male female ratio is 5:4. Out of 30 patients majority of the patients complains of soreness/ irritation and ulceration in the oral cavity followed by difficulty in mastication, foul breath, pain in the lesion, dysphagia, spitting of blood and excessive salivation. About the site of the lesion maximum patients having the lesion in buccal mucosa(30%) then anterior 2/3rd of tongue (23.33%), retromolar area (13.33%) in decreasing frequency. Conclusion: Oral carcinoma usually a disease of middle age and elderly people. Irritation or soreness is the commonest symptom. Most affected sites are buccal mucosa and anterior 2/ 3rd of tongue. DOI: http://dx.doi.org/10.3329/bjo.v20i1.22012 Bangladesh J Otorhinolaryngol; April 2014; 20(1): 15-19


2016 ◽  
Vol 21 (2) ◽  
pp. 85-89
Author(s):  
Md Nazmul Islam ◽  
Dipankar Lodh ◽  
Mohammad Mamun Siddiqui ◽  
AF Mohiuddin Khan ◽  
Kazi Meherunnesa

A Cross-Sectional Study was carried out from July 2006 to June 2007 at Department of Otolaryngology and Head-Neck Surgery of Dhaka Medical College Hospital, Dhaka. Data was collected from 150 patients with histologically diagnosed Hypopharyngeal carcinoma. Results of this study showed that hypopharyngeal carcinoma affects more in fifth (36.7%) and sixth (27.4%) decades of life. It was found that male were highly predominant to develop hypopharyngeal carcinoma and male female ratio was 9:1. People with lower educational level were found to be affected more by hypopharyngeal carcinoma. In this study 86 percent patients had history of smoking. Mean duration of smoking was 38.0±23.6 years. This study found that the key symptoms of hypopharyngeal carcinoma was dysphagia, pain and neck mass. In this study 83.5 percent patients presented with palpable lymph node and most (76.6%) of them were in level II. Pyriform fossa was found to be the commonest site (83.3%). In this study all malignancy in hypopharynx was histopathologically squamous cell carcinomaBangladesh J Otorhinolaryngol; October 2015; 21(2): 85-89


2014 ◽  
Vol 19 (2) ◽  
pp. 87-93
Author(s):  
Narayan Prosad Sanyal ◽  
Mohyammad Idrish Ali ◽  
Md Ahsanul Habib ◽  
Md Morshed Alam ◽  
Masroor Rahman ◽  
...  

Objectives: To determine the pattern of clinical presentation of hypopharyngeal carcinoma and pattern of metastases. Methods: This was a cross sectional study with 60 patients. Study was carried out in the Department of Otolaryngology and Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital and Mitford Hospital during the period of July 2005 to June 2007. This diagnosis was made by detailed history clinical examination and relevant investigation. Analyzed data and presented by various tables, graphs and figures. Result: In this study majority of the patients were within 51-60 years, male female ratio was 7.5:1, majority was smoker (91.66%), 58% patients had habit of tea, 88.32% of the patients chewed betel, Majority of the patients (81.16%) had presented with progressive dysphagia 76.66% and hoarseness of voice (60%), There was neck swelling in 53.3% and haemoptysis in 25% of patients. 63.33% patients had ulcerative lesion, 40% normal laryngeal movements, 63.33% were adequate airway, 65% patient had cervical lympadenopathy. Primary lesion was 75% in pyriform fossa, 20% in post cricoid region and 5% in posterior pharyngeal wall. 46.66% were T3 stage, 53.33% N1 and 48.71% were level IV nodal involvement. Conclusion: Hypophayngeal carcinoma usually presents in advanced state. DOI: http://dx.doi.org/10.3329/bjo.v19i2.17630 Bangladesh J Otorhinolaryngol 2013; 19(2): 87-93


2020 ◽  
Vol 1 (1) ◽  
pp. 012-017
Author(s):  
Najib Zouhair ◽  
Anass Chaouki ◽  
Amine M’khatri ◽  
Youssef Oukessou ◽  
Sami Rouadi ◽  
...  

Tympanoplasty is one of the most performed procedures in ENT. The aggressiveness of its microscopic approach has led otologists to adopt the endoscopic approach as a less invasive alternative. The purpose of this work is to appreciate the advantages and disadvantages of this surgical technique. We conducted a prospective descriptive cross-sectional study on 20 interventions within the ENT department of August the 20th 1953 Hospital of Casablanca from April 2019 to June 2019. The average age of operated patients was 36.3 years. Perforations were unilateral in (71%) of the cases with a predominance of the anterior (29%) and subtotal (36%) locations. The tympanoplasties were performed by 3 different senior otologic surgeons, and were left in (57%). The mean operating time was (59.5 min) and the mean anesthesia duration was 75.1 min. Intraoperative vision allowed us to fully visualize the margins of all perforations (100%) and anatomical structures of the middle ear in almost all interventions. The first procedures carried out were filled with difficulties whose management of intraoperative bleeding was the main one in (42.8%) of the cases. (57%) procedures were described as easy. No complication was detected intraoperatively or immediately postoperatively. Endoscopic tympanoplasty has several advantages, including: Minimally invasive approach to the middle ear; panoramic perioperative vision; Gain of operating time; decrease in the duration of anesthesia; Valuable educational tool; postoperative comfort; Decrease in hospital stay and early return to daily activities; Better aesthetic rendering; cost and transportability. However, we also note a number of disadvantages of endoscopic tympanoplasty, particularly: performing the procedure with one hand; difficulty passing through the EAC; 2D vision that alters the perception of depth; management of intraoperative bleeding; fogging; learning curve.


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