Post Operative Sensorineural Hearing Loss Following Middle Ear Surgery—A Study of 100 Cases

Background: Drill and surgical tools can cause noise induced hearing loss when used on or adjacent to the ossicular chain and stapes footplate or while working on the mastoid bone. Therefore the drill generated noise has been incriminated as a cause of sensorineural hearing loss in the operated ear. Objective: This study has been undertaken to estimate the proportion of sensorineural hearing loss following middle ear surgery and to assess the bone conduction thresholds of operated ear following middle ear surgery at different follow up periods. Methods: 100 cases of chronic suppurative otitis media posted for middle ear exploration surgery were included in the study. Results: Sensorineural hearing loss was present in 3 cases out of 100 cases (3%) after undergoing mastoid surgery. There was a mean increase in bone conduction thresholds of 0.75 dB at 500 Hz, 1.4 dB at 1 kHz, 1.7 dB at 2 kHz and 2.7 dB at 4 kHz at 6th month of follow up period after surgery with statistical significance at 2 kHz (p = 0.011) and 4 kHz (p Conclusion: Post mastoidectomy hearing loss is of high frequency in nature.

Etiology Profile of the Patients Implanted in the Cochlear Implant Program

Hearing loss in children constitutes a considerable handicap because it is an invisible disability and compromises optimal development and personal achievement of a child. The period from birth to 5 years of life is critical for the development of speech and language;therefore, there is need for early identification and assessment of hearing loss and early rehabilitation in infants and children. Cochlear implants are the treatment of choice for patients with severe to profound sensorineural hearing loss. The goal of the present study was to investigate the different hearing impairment etiologies of patients implanted in cochlear implant program. The hospital based interventional study was conducted in the Department of Otorhinolaryngology, SMS Medical College, Jaipur from July 2011 to Dec. 2013. Present study included 60 prelingually deafened patients who attended ENT OPD and underwent cochlear implant. The most common cause of deafness in our study was acquired (56.66%), which predominantly included perinatal risk factors (64.70%), followed by prenatal risk factors (41.17%). The second common cause was hereditary (26.66%), followed by unknown (16.66%). Infection and ototoxic drug history were the most common risk factors in prenatal and postnatal group. The most common perinatal cause was low birth weight and prematurity.

Primary Histoplasmosis of Larynx: A Case Series and Review of Literature

Objective: Aim of the study was to analyze 10 managed cases of Primary Histoplasmosis of Larynx, over a period of 10 years. Design: Retrospective, non-randomized, interventional case series. Patients and Method: This study was conducted in the Department of Otorhinolaryngology S.M.S Medical College from 2002 to 2011. The study consisted of evaluation of self-reported and referred patients who presented to ENT OPD and emergency. In all the cases a detailed history and clinical examination was done. All the patients underwent fiber optic laryngoscopy and subsequent direct laryngoscopy and biopsy. CT Scans were obtained for few cases. The study was a retrospective analysis of 10 treated cases. Main Outcome and Measures: Success of the treatment was defined as resolution of symptoms, differ-entiation from malignancy, no recurrence and regular follow up. Result: A total of 10 cases were managed between 2002 and 2011 and were reviewed. The main presentation was hoarseness of voice, with lesion simulating malignancy. Most common site of involvement was false cord and aryepiglottic fold (6 cases). Primary laryngeal Histoplasmosis was essentially a disease of adult males in all 10 cases. Treatment was exclusively medical with use of Itraconazole as drug of choice in 7 cases. Conclusion: Isolated laryngeal Histoplasmosis is a rare entity. Because of its simulation with malignancy it needs to be included in the differential diagnosis of neoplasm both benign and malignant. Our study clearly limits this kind of disease to adult males most commonly involving false cord and aryepiglottic fold in an endophytic pattern. Though it looks like cancer;biopsy confirms the diagnosis. The treatment is mainly medical with Itraconazole being the drug of choice.