Karan Sharma

Hearing Impairment and Deafness

Among about 200 million hearing impaired in the world, 40% are in India. India, of course is the largest democracy of the world and every sixth person in the world is an Indian. According to the Census 2001, India’s population was 1027 million which is the second largest after China. As far as area is concerned, India occupies only 2.4% of the land area of the world and the density of population is 324 per sq.km. Rural versus urban distribution of its population is 72.22% against 27.78% and the present literacy rate is 65.26%. It has 29 states and 6 union territories.

Comparison of bacteriology in bilaterally discharging ears in chronic suppurative otitis media

Chronic suppurative otitis media is a disease with worldwide prevalence having potentially serious long term effects. It is a disease well known for its recurrence and persistence despite treatment. A study on culture and sensitivity of aural discharge collected from 40 cases of bilateral chronic suppurative otitis media was done to compare the bacteriological profile of either ear. Pseudomonas aeruginosa was the major organism isolated in both ears and was sensitive to Amikacin and newer drugs like Gatifloxacin. It was concluded that the infecting organisms in case of bilateral chronic suppurative otitis media are remarkably similar. If adequate treatment is instituted early, it can go a long way in reducing the prevalence of this socially embarrassing disease.

Middle ear cleft in chronic otitis media: a clinicohistopathological study.

Chronic mucosal diseases of middle ear cleft or chronic suppurative otitis media has been traditionally defined as a chronic inflammation of the middle ear and mastoid usually associated with perforation of the tympanic membrane and otorrhoea. Understanding the pathology and pathogenesis of chronic suppurative otitis media is important in predicting the management, prognosis and sequelae of the disease. The present prospective study was conducted to evaluate the clinical, intraoperative and histopathological changes in middle ear cleft. 100 patients diagnosed with CSOM who underwent surgery were taken. The mucosa and granulation tissue was removed along with ossicles wherever indicated and sent for histopathological examination. On clinical examination, 72 cases were found to be of tubotympanic type and 28 cases of atticoantral variety. However, intraoperatively, of the tubotympanic cases 8 were found to be of unsafe type which was also proven histologically. Stratified squamous epithelium was revealed in most of the cases accompanied by changes in the submucosa. Ossicular chain was involved in 40 cases with incus being the commonest bone to be eroded.

Ligation Versus Bipolar Diathermy for Hemostasis in Tonsillectomy: A Comparative Study

Tonsillectomy despite being less performed nowadays still is a very common surgery performed by ENT surgeons. The use of various modalities like bipolar diathermy, laser, cryosurgery, radiofrequency and ionic coblation for hemostasis in tonsillectomy remains controversial so far. A thorough scan of literature comparing the ligation with diathermy has been presented. In this prospective study, we analysed 50 patients undergoing tonsillectomy by dissection method. Right sided tonsillectomies act as study group (bipolar diathermy used) and left sided tonsillectomies as the control group (ligation for hemostasis used). The aim of our study is to compare the amount of blood loss, number of ligatures applied, average time taken and incidence of postoperative haemorrhage following the use of ligation and bipolar diathermy. The study found that diathermy hemostatic technique is associated with a quicker procedure, less intraoperative blood loss, comparable postoperative pain.

Prophylactic budesonide nasal spray after polypectomy

This double blind study compared the effect of budesonide nasal spray with placebo, in the prophylaxis of nasal polyp recurrence after avulsion. 38 cases were given budesonide nasal spray and 25 placebo for 3 months after polypectomy. Follow up of 9 months revealed budesonide treated patients to have significantly lower recurrence rate as compared to the placebo. Interestingly patients with recurrent nasal polyposis benefitted much more from topical budesonide treatment as compared to ones with no previous history of polypectomy.

Direct laryngoscopic observations in progressive hoarseness of voice.

Hoarseness is a common disorder of voice which indicates abnormality at the level of glottis. We present our study of forty cases of progressive hoarseness of voice who underwent direct laryngoscopy during a period of January 2003 to January 2004 in our hospital. The observations were recorded und the data was evaluated.

Neurilemmoma of larynx (A case report)

A Rare case of neurilemmoma arising from laryngeal surface of epiglottis and adjoining aryepiglottic fold is being reproted. Its clinical features, histopathological findings and management is being discussed.

An unusual impacted foreign body oesophagus in an infant.

Although foreign bodies in aerodigestive tract are quite common in children, but presence of an impacted, sharp foreign body which needed removal by trans-cervical oesophagotomy is quite rare and is thus being reported.

S M R of inferior turbinate in chronic hypertrophic rhinitis

A study was undertaken to evaluate the role of unilatcral/bilateral submucous resection of the inferior turbinates in fifty cases of chronic hypertrophic rhinitis. Patients associated with deflected nasal septum or sinus infectious were excluded from the study. Decongesiton of turbinates was done to exclude the cases with predominantly mucosal hypertrophy. Gertner (1984) plate method was used to asses the nasal patency preoperatively and then post-operatively at 1, 3 and 6 months follow up. The analysis of observations made revealed SMR of inferior turbinate to be a very effective modality tor relieving nasal obstruction due to bony turbinal hypertrophy. The procedure has least interference with nasal mucosal integrity and functions and complications associated with the procedure have been found to be minimal. Histopathological examination of mucosa and of ostenid tissue revealed infiltration by chronic inflammatory cells suggesting chronic nonspecific inflammation either due to non-specific infections and / or allergy).

Sino-nasal carcinoma with multiple cutaneous secondaries

An unusual case of an Anaplastic carcinoma of sino-nasal tract (maxillo-ethunoid angle) with multiple secondary deposits in the skin without lymph nodes and other known distant metastatic sites involvement is being reported.