Journal of Otorhinolaryngology and Facial Plastic Surgery

Background: Septal mucocele is very uncommon. Those reported mostly have a prior history of trauma however; idiopathic septal mucocele is even rarer.

Case presentation: We report a case of idiopathic septal mucocele who presented with bilateral, progressive nasal obstruction. Clinical examination revealed bilateral, smooth bulge on the anterior cartilaginous septum, which on radiology indicated an expansile cystic mass. As it extended to the nasal spine superiorly, an open rhinoplasty approach was taken for its complete removal. The septal cartilage was absent inside the cyst.

Discussion: Histology showed tissue lined by respiratory epithelium with mucinous glands in the stroma is confirmative of mucocele. Two months post-surgery, the septal perforation had healed well with no evidence of recurrence.

Conclusion: Although rare, septal mucocele should also be considered as differential diagnosis of long-standing septal swelling.

Background: Intraoperative bleeding is a common problem encountered during endoscopic sinus surgery.

Aim: This study aimed to assess the role of pterygopalatine fossa block in reducing the intraoperative bleeding and operative time during bilateral functional endoscopic sinus surgery.

Methods: It was a prospective, comparative study. 38 patients requiring bilateral functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis with nasal polyps (CRSwNP) were enrolled. Pterygopalatine fossa (PPF) block was given using 2% xylocaine and 1:2,00,000 adrenaline through greater palatine canal trans-orally on one side only based on lottery. The intraoperative bleeding was graded as per Boezaart and Van Der Merwe scale for endoscopic grading of bleeding on each side. The operative time on each side was also noted.

Results: The mean endoscopic grading of intraoperative bleeding on the side of PPF block was 2.06±0.50 and 2.50±0.47 on the contralateral side, with the difference being statistically significant (p value = 0.00). The mean operative time on the side of PPF block was 44.97±12.85 minutes and 51.47±15.35 on the side without the PPF block and the difference was statistically significance (p value – 0.04).

Conclusion: The PFF block with 2% xylocaine and 1:2,00,000 adrenaline significantly reduced both intraoperative bleeding and operative time during FESS.  It provided a comparatively better visualization of the surgical field consequently reducing the need for frequent cleaning of endoscope and nasal packing to secure hemostasis hence reducing the operative time.

Background: Holes in the tympanic membranes, known as perforations, are a common ear condition often resulting from trauma, infection, or medical procedures. These perforations can lead to various degrees of hearing loss and require timely detection and treatment to prevent further damage to the middle ear.

Aim: This study aimed to investigate the correlation between the size of perforations in the tympanic membrane and the degree of hearing loss. Specifically, the study categorized the perforations into small, medium, and large sizes to assess their impact on hearing function.

Methods: The study conducted an observational analysis of 1000 patients (1230 ears) with chronic otitis media, focusing on those aged between 16 to 45 years. Patients with central perforations in the pars tensa were included, while those with squamosal chronic suppurative otitis media or wet ear were excluded. Data collection included detailed medical history, general examination, ENT examination, and assessment of perforation size using otoendoscopy. Pure-tone audiometry was utilized to measure hearing loss, categorized according to WHO standards. Statistical analysis was performed to determine the correlation between perforation size and hearing loss.

Results: Of the 1000 patients included, 23% had bilateral perforations, with varying sizes observed. The majority of patients had mild conductive hearing loss (69.9%), followed by moderate (27.6%) and severe (1.6%) loss. The analysis revealed a significant correlation between perforation size and hearing loss (p < 0.05). Smaller perforations were associated with mild hearing loss (averaging 28 dB), while larger perforations led to more severe loss (averaging 47 dB).

Conclusion: The study confirmed that the size of perforations in the tympanic membrane correlates with the degree of hearing loss, with larger perforations resulting in more significant impairment. These findings underscore the importance of early detection and appropriate management of tympanic membrane perforations to prevent further hearing deterioration. However, future research should consider additional factors such as patient age and the condition of the middle ear bones to provide a comprehensive understanding of hearing outcomes in these cases.

Hearing loss, an increasing problem across the globe, results in an important solution in the form of cochlear implants, highlighting the critical need for effective interventions. This review involves analyzing 46 relevant publications via databases such as PubMed and Google Scholar, providing current insights into pre-operative issues. Studies through databases such as PubMed and Google Scholar, ensuring contemporary insights into the pre-operative considerations. The pre-operative evaluation encompasses medical history, covering prenatal events and immediate post-natal health, along with physical examinations and complete audiometric assessments. High-Resolution Computed Tomography (HRCT) and Magnetic Resonance Imaging (MRI) emerge as crucial imaging techniques, guiding surgical planning and electrode placement. Brainstem Evoked Response Audiometry (BERA) supplements inconclusive MRI data, while vestibular screening aids in candidate selection. Cochlear duct length determination, often assessed through imaging techniques, contributes to optimal electrode array selection. Models in cochlear implant research, spanning computational, animal, tissue engineering, and physical models, further enhance our understanding and refinement of cochlear implant designs. In conclusion, this comprehensive pre-operative workup plays a significant role in assessing patient health, identifying causes of deafness, and contributing to the overall success of cochlear implantation, a transformative solution for profound hearing impairment.