Department of ENT

Study of bacterial flora in external auditory canal and middle ear in chronic otitis media, tubotympanic type patients

Sat, 01 Jan 2022 00:00:00 GMT

Study of bacterial flora in external auditory canal and middle ear in chronic otitis media, tubotympanic type patients Sai Sushma Gadi BACKGROUND: Chronic suppurative otitis media (CSOM) is typified by persistent inflammation of the mastoid and middle ear mucosa, which results in ear drainage and TM perforation1. Geographical variation and patient demographic variables have been influencing the antibiotic resistance pattern of CSOM. Both bacterial isolate resistance and the excessive and illogical usage of broad spectrum antibiotics have grown widespread1. Staphylococcus aureus (both methicillin-resistant [MRSA] and methicillin-sensitive [MSSA]), Pseudomonas, Proteus, Coagulase-negative staphylococci, Enterococcus, and Anaerobes are among the frequently isolated bacteria1. AIMS AND OBJECTIVES: 1. To ascertain the aerobic bacterial isolates' microbial diversity in individuals with tubotympanic-type chronic otitis media. 2. To determine the antimicrobial susceptibility and resistance to antibiotics thereby helping in earlier management of the disease. METHODOLOGY: SOURCE OF DATA This prospective study is being undertaken in the Department of Otorhinolaryngology at SHRI B M PATIL MEDICAL COLLEGE AND RESEARCH CENTRE AND HOSPITAL [BLDE (DU) UNIVERSITY] ,Vijayapura from April 2023 to January 2025. METHOD OF COLLECTION OF DATA  Preoperative examination of the patient including complete clinical history.  Characteristics of patients including age, gender, residence.  The patient is thoroughly examined, with a focus on otoscopic findings to XI Docusign Envelope ID: 2920D593-692B-4D04-A21F-70EEE8B54013 assess the condition of the tympanic membrane and to examine the oropharynx, nose, and throat.  Patient will be subjected to investigations such as urine routine, blood routine examinations and aerobic culture of the discharge from both the external auditory canal and middle ear (under microscope).  Sample from the external auditory canal is taken out with the help of Cotton Swab.  Then, external auditory canal is cleaned using alcohol and normal saline and allowed to dry.  Mucus extractor used to collect sample from middle ear.  Both the samples are sent for aerobic culture and sensitivity. RESULT: Out of the 71 total swabs collected from external ear in our study, Staphylococcus aureus showed 100% sensitivity to Gentamycin and Linezolid, 95.5% to Clindamycin, 7.7% to Ciprofloxacin, and an overall sensitivity of 49.3% to the antibiotics used in this hospital. Pseudomonas aeruginosa showed 66.7% Amikacin and Colistin, 57.1% sensitivity to Meropenem, 50% to Cefepime, 38.5% to Ciprofloxacin and an overall sensitivity of 25.4% to the antibiotics used in this hospital. Out of the total swabs collected from middle ear in our study, Staphylococcus aureus showed 100% sensitivity to Linezolid and Clindamycin and an overall sensitivity of 19.7% to the antibiotics used in this hospital. Pseudomonas aeruginosa showed 100% Amikacin and Colistin, 86.2% to Ciprofloxacin, 52.6% to Meropenem, 50% to Cefepime and an overall sensitivity of 59.2% to the antibiotics used in this hospital. XII Docusign Envelope ID: 2920D593-692B-4D04-A21F-70EEE8B54013 CONCLUSION: Knowing the local susceptibility pattern of the causative agents is essential for treating the infection effectively and for developing antibiotic policy, as the susceptibility pattern of the pathogenic microorganisms is changing since antibiotics are widely used and readily available.

Microdebrider- assisted turbinoplasty versus coblation Method of turbinoplasty - a comparative study

Sat, 01 Jan 2022 00:00:00 GMT

Microdebrider- assisted turbinoplasty versus coblation Method of turbinoplasty - a comparative study Reshma Rajeev Introduction Inferior turbinate hypertrophy is a major cause of chronic nasal obstruction, significantly impairing nasal airflow and overall quality of life. Although medical management with antihistamines, decongestants, and corticosteroids is the first line of treatment, a subset of patients remains symptomatic and requires surgical intervention. Various surgical techniques, including partial turbinectomy, turbinoplasty, and submucosal tissue reduction, have been developed to improve nasal patency while preserving mucosal function. Microdebrider-assisted turbinoplasty (MAT) and coblation-assisted turbinoplasty (CAT) are two widely used mucosa-sparing techniques. However, limited comparative studies exist evaluating their efficacy, safety, and long-term outcomes. This study aims to compare the clinical outcomes of MAT and CAT in the surgical management of inferior turbinate hypertrophy. Methods This prospective comparative study included 60 patients diagnosed with symptomatic inferior turbinate hypertrophy unresponsive to medical therapy. Patients were randomly assigned to undergo either MAT (n = 30) or CAT (n = 30) under general anesthesia. In the MAT group, a microdebrider was used for submucosal tissue removal and turbinate lateralization, while in the CAT group, controlled radiofrequency ablation was performed using a coblator wand before out-fracturing the turbinate. Postoperative outcomes were assessed using the Nasal Obstruction Symptom Evaluation (NOSE) score and objective airflow measurements at 1 month, 3 months, and 6 months postoperatively. Intraoperative bleeding, postoperative healing, and complications were also evaluated. Docusign Envelope ID: 165D166E-2E7B-4A05-AD83-C5843C3043D8 12 Results Both MAT and CAT showed significant improvements in NOSE scores, with mean scores improving from 72.4 ± 8.6 preoperatively to 18.7 ± 4.2 at 6 months in the MAT group, and from 73.1 ± 7.9 to 19.3 ± 5.1 in the CAT group (p > 0.05). Peak nasal inspiratory flow (PNIF) improved by 62.3% in the MAT group and 58.7% in the CAT group at 6 months (p > 0.05). Intraoperative blood loss was slightly lower in the CAT group (21.5 ± 5.2 mL vs. 27.8 ± 6.4 mL in MAT, p < 0.05). Postoperative crusting and healing times were comparable between the two groups, with no significant difference in complication rates or recurrence of turbinate hypertrophy. Conclusion MAT and CAT are both effective and safe surgical options for managing inferior turbinate hypertrophy. While CAT offers a slight advantage in intraoperative hemostasis, both techniques provide comparable symptom relief, nasal airflow improvement, and mucosal preservation, making either a viable choice based on surgeon preference and patient-specific factors.

A study of sensorineural hearing loss in patients with diabetes mellitus by pure tone audiometry

Sat, 01 Jan 2022 00:00:00 GMT

A study of sensorineural hearing loss in patients with diabetes mellitus by pure tone audiometry Nivedha.N BACKGROUND: Diabetes mellitus is a significant public health problem with many secondary micro and macrovascular complications. [1] The most underestimated complication of diabetes mellitus is sensorineural hearing loss.[1] In 1857, Jordao was the first to document the correlation between diabetes mellitus and hearing impairment. Incidence of hearing loss in diabetes patients ranges up to 80%. The hearing loss observed in diabetic patients will be of progressive bilateral sensorineural type affecting high frequencies. [2] Goal of the present study is to establish a relationship between glycemic control and sensorineural hearing loss. OBJECTIVES OF THE STUDY:  To assess the association of sensorineural hearing loss in patients with diabetes mellitus.  To measure levels of HbA1c in diabetes mellitus patients to know the glycemic control and its influence on sensorineural hearing loss . DESIGN OF STUDY: Hospital based cross-sectional study. MATERIALS AND METHOD: Study included 70 patients among which 35 were clinically diagnosed diabetes mellitus patients experiencing hearing loss and 35 were non-diabetic patients with similar complaints who were selected from the ENT and Medicine outpatient departments at BLDE (Deemed to be University) Shri B.M.Patil Medical College and Research Centre , Vijayapura. All participants were < 60 years of age and were chosen based on specific inclusion and exclusion criteria. Comprehensive history XV Docusign Envelope ID: 7881F31D-DA44-40F2-B6DF-BB9E17B7154E taking, clinical examinations, and tuning fork tests were performed. Blood tests, including fasting blood sugars (FBS), postprandial blood sugars (PPBS), and HbA1c (glycosylated hemoglobin), performed on these patients. All the subjects underwent pure tone audiometry, and the results were analyzed and documented. RESULTS : In our study SNHL is more prevalent in cases i.e reduced hearing with known diabetic, whereas in non diabetic with reduced hearing controls only 20 % had SNHL according to PTA values (right ear) . According to PTA values (left ear) , SNHL is more prevalent in cases i.e reduced hearing with known diabetic, whereas in non diabetic with reduced hearing controls only 22.9 % had SNHL .This signifies that SNHL is more prevalent in diabetic patients compared to non -diabetic controls . Cases were further divided into two groups , HbA1C less than 7 were considered as good control and HbA1C more than 7 were considered as poor control . In our study out of 35 cases only 11(31.43%) were good control patients and the remaining 24(68.57%) were poor control patients. It was observed that all 11 good controlled dm patients experienced mild SNHL whereas in poorly controlled dm patients 3(40%) had severe SNHL and 16(66.7%) had moderate SNHL and 5 (14.3%) had mild SNHL in right ear . In the left ear out of 11 good controlled dm patients 7 (63.6%) experienced mild SNHL and 4 (36.4%) had moderate SNHL ,whereas in poorly controlled dm patients 3(8.6%) had very severe SNHL and 10 (28.6%) had severe SNHL and 14(40.0%) had moderate SNHL and 8 (22.9%) had mild SNHL in the left ear. pvalue is less than 0.001 showing strong significance which proves poorly controlled XVI Docusign Envelope ID: 7881F31D-DA44-40F2-B6DF-BB9E17B7154E diabetes mellitus patients exhibited more severe hearing loss compared to those with well-controlled diabetes. CONCLUSION: The prevalence of sensorineural hearing loss (SNHL) is higher in patients with type 2 diabetes based on PTA values, while patients with poorly controlled diabetes mellitus, as indicated by HbA1c values, exhibited more severe hearing loss. In our current study, we emphasize the importance of impact of diabetes on hearing health. Therefore complete audiological evaluation and maintaining strict glycemic control is crucial for reducing the impact of diabetes on hearing sensitivity.

Assessment of middle ear risk index factor on outcome of surgery for chronic otitis media

Sat, 01 Jan 2022 00:00:00 GMT

Assessment of middle ear risk index factor on outcome of surgery for chronic otitis media Adishree. Shivaji. Mali. Background: Chronic otitis media (COM) is described as a highly prevalent disease of the middle ear which constitutes a serious health problem worldwide, especially in developing countries. This study was done to evaluate the role of the middle ear risk index (MERI) on the outcome of surgeries for COM in the form of successful graft uptake and improvement in hearing. Methods: A total of 52 patients of COM were included in this study. Detailed ENT examination and preoperative pure tone audiometry were done in all patients. MERI score was calculated and patients were stratified based on the MERI score. All patients were evaluated at the end of 3 months postoperatively, for the status of graft uptake and improvement in hearing. Results: The MERI was found to be a remarkable predictor of the outcome of surgeries for COM. The patients with mild MERI scores had a significantly better prognosis than patients with severe MERI scores. Conclusions: MERI is a very useful and honest predictor of the graft uptake and hearing benefit in patients undergoing surgeries for COM. It has an inverse relation with graft uptake and hearing benefit. Based on the MERI score, the likelihood of surgical success and hearing benefit could be explained to the patient of COM to give them realistic expectations.