P.K. Rathore

Sutureless tympanoplasty using acellular dermis

OBJECTIVE A prospective randomized unblinded controlled trial was conducted by comparing acellular dermis with temporalis fascia as graft materials in tympanoplasty (type 1) in terms of operative time, postoperative pain, graft success rate, and audiologic outcome. STUDY DESIGN Forty-two patients with (inactive) chronic suppurative otitis media of tubotympanic type were randomized, matched, and divided equally into 2 groups of 21 each. One group underwent tympanoplasty (type 1) via transcanal route using temporalis fascia graft and the other using acellular dermis. Both groups were compared for operative time, postoperative pain, graft success rate, and audiologic improvement in hearing. RESULTS There was a statistically significant reduction in operative time (P < .05) and postoperative pain (P < .05) in the acellular dermis group. However, there was no statistical difference in graft success rate (P > .05) and hearing improvement (P > .05) between both the groups. CONCLUSION Results of tympanoplasty using acellular dermis as graft material are comparable to that using temporalis fascia in terms of graft uptake and hearing improvement. However, tympanoplasty using acellular dermis has the advantage of shorter operative time and lesser postoperative pain.

Speaking and Nonspeaking Voice Professionals: Who Has the Better Voice?

INTRODUCTION Voice professionals can be classified into two major subgroups: the primarily speaking and the primarily nonspeaking voice professionals. Nonspeaking voice professionals mainly include singers, whereas speaking voice professionals include the rest of the voice professionals. Although both of these groups have high vocal demands, it is currently unknown whether both groups show similar voice changes after their daily voice use. Comparison of these two subgroups of voice professionals has never been done before. AIM This study aimed to compare the speaking voice of speaking and nonspeaking voice professionals with no obvious vocal fold pathology or voice-related complaints on the day of assessment. METHODOLOGY After obtaining relevant voice-related history, voice analysis and videostroboscopy were performed in 50 speaking and 50 nonspeaking voice professionals. RESULTS Speaking voice professionals showed significantly higher incidence of voice-related complaints as compared with nonspeaking voice professionals. Voice analysis revealed that most acoustic parameters including fundamental frequency, jitter percent, and harmonic-to-noise ratio were significantly higher in speaking voice professionals, whereas videostroboscopy did not show any significant difference between the two groups. CONCLUSION This is the first study of its kind to analyze the effect of daily voice use in the two subgroups of voice professionals with no obvious vocal fold pathology. We conclude that voice professionals should not be considered as a homogeneous group. The detrimental effects of excessive voice use were observed to occur more significantly in speaking voice professionals than in nonspeaking voice professionals.

Role of Bupivacaine in reducing post tonsillectomy pain.

Pain following tonsilleclomy is of major concern to both the surgeons and the Anesthesiologists. Pre-incisional Bupivacaine infiltration into the tonsillar fossa has been used as a method of relieving post-operative pain in children. In this study pre-incisional Bupivacaine infiltration into the tonsillar fossa resulted in immediate post-operative pain lasting four to six hours.

Bilateral spontaneous salivary otorrhoea: Case report and a review of the literature

Spontaneous salivary otorrhoea is an extremely rare clinical entity. Most of the times, salivary otorrhoea results from various forms of trauma. It has also been attributed to the patent foramen of Huschke, and fissures of Santorini. Here, we present a rare case of an 8 year old child presenting with salivary discharge from both the ears. The diagnosis was established on the basis of biochemical and radiological investigations. The patient was managed by surgical exploration and ligation of the fistulous tract.

Ear abuse in school children

Ear abuse in school children is common in low socio-economic strata and is often associated a long-term morbidity in our country. This paper presents a study of 250 such children with discussion. Incidence of ear abuse with long term learning deficit was found to be 18.4%.

Is the Voice of Professional Voice Users With no Vocal Cord Lesions Similar to That of Non Professional Voice Users

OBJECTIVE The objective of this study was to analyze if the voice of professional voice users (PVU) is comparable with that of a nonprofessional voice users (NPVUs), both of whom have no obvious vocal cord lesions. MATERIALS AND METHODS Fifty professional and 50 NPVUs with no obvious vocal fold pathologies underwent voice analysis and videostroboscopic study, and various parameters were analyzed. RESULTS Majority of the participants were found to be less than 40 years. Teachers formed the largest group (40%) of PVUs. PVUs had a significantly higher incidence of voice-related complaints compared with NPVUs. The former group also showed a higher deviation from the normative data. A significant influence of gender and the duration of work experience was also observed among PVUs. CONCLUSIONS The voice of an apparently normal PVU is not similar to that of an apparently normal NPVU. Female PVUs and PVUs with a longer duration of work experience show the highest deviation from normative data.

Gunshot Injury with Facial Palsy: An Unusual Case

As the use of firearms has become increasingly common in the civilian society, the incidences of homicidal as well as suicidal firearm injury have increased several folds. We here present an interesting case of celebratory firing which accidently caused injury in the head & neck region and an unusual trajectory adopted by the bullet which prevented a fatal outcome.