Lupine Publishers | Acute Infectious Cervical Lymphadenitis of Children in A Tropical Country

 

Abstract

Introduction: The volume increase of a cervical lymph node is frequent in infancy .It is most often secondary to a benign infection of the upper aerodigestive tracts [1,2]. It is a medical and surgical emergency frequently encountered in developing countries, despite the generalization of antibiotics. Its gravity depends on the virulence of the germ and the fragility of the patient.

Patients and Methods: It’s about a retrospectively study of all the medical files records of patients under 16 years old hospitalized at the ENT department of Fann Teaching Hospital for the management of infectious cervical lymphadenitis . The studied period is January 1st, 2008 to November 30th, 2017.

Results: We had collected 83 medical files of patients with acute infectious cervical lymphadenitis including 66 cases of suppurative acute lymphadenitis and 17 cases of simple acute adenitis (uncollected). The average age of our patients was 2.4 years with extremes ranging from 1 month to 16 month. The location of swelling was the submandibular region in 57 patients, upper jugular area in 8 patients and submental region in 6 patients. Stapphyloccocus aureus is the most frequent bacteria found in 29 cases. Initial antibiotic therapy consisted of the association of amoxicillin/clavulanic. A favorable evolution marked by an apyrexia after 48h of treatment with regression of the swelling and a resumption of the feeding was noted in 92% of the cases. We deplored two cases of death.

Conclusion: Acute adenitis is frequent in pediatric otorhinolaryngology. It is often secondary to oropharyngeal infections, dental and skin diseases. The treatment is essentially based on antibiotics.

Keywords:Acute lymphadenitis; pediatric infection; cervical lymph’s nodes

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Olfactory Outcome After Endoscopic Sinus Surgery in Chronic Rhinosinusitis

 

Abstract

Background: Olfactory dysfunction is one of the major symptoms of CRS. Olfactory dysfunction affects the quality of life. Endoscopic sinus surgery is the surgical modality of treatment in cases of failed medial therapy. Assessment of olfaction in patients undergoing endoscopic sinus surgery is essential to know the impact on olfaction.

Objective: To assess the olfaction before and after Endoscopic sinus surgery.

Methods: This is a prospective study. Total 45 Patients were included in this study based on the inclusion and exclusion criteria. Diagnostic nasal endoscopy and CT scan were done preoperatively. Olfaction was assessed in all patients preoperatively, postoperatively at 1month and 3 months using olfactory testing tool.

Results: There were 45 patients of both gender 57.78% were females and 42.22% were males. The mean age of patients in our study was found to be 39.82±6.264 years. Most of these patients were in fourth decade of life. Of 45 patients 75% had symptoms of hyposmia/anosmia before surgery. Average Lund Mackey score for CT scan findings was found to be 13.42 ± 3.1. The patients were assessed postoperatively at 1st month and 3rd month using olfactory testing tool. The mean composite olfactory score was 5.83±2.89 preoperatively increased to 8.28± 2.33 at 1 month and 10.12 ±1.11 at 3 months, this difference was found to be statistically significant (p < 0.001). All patients mean olfactory scores improved postoperatively. The mean composite olfactory scores improved following endoscopic sinus surgery by 3.5 in Anosmic patients, 2.22 in Hyposmic patients and 1.04 in Normosmic at 1 month. Whereas at 3 months, 6.65, 3.22 and 1.95 in Anosmic, Hyposmic and Normosmic patients, respectively. The study was an attempt to assess the olfaction preoperatively and postoperatively in patients undergoing ESS.

Conclusion: The evaluation of olfaction in patients undergoing endoscopic sinus surgery showed improvement in olfactory outcome following the surgery in patients with CRS. 61% to 69% of CRS patients have a reduced sense of smell. Approximately two thirds of cases are due to the sinonasal disease. Olfactory dysfunction as result of sinonasal disease is unlikely to improve spontaneously without treatment.

Keywords: Olfaction; endoscopic sinus surgery; chronic rhino sinusitis

Abbreviations: CRS: Chronic Rhinosinusitis; ESS: Endoscopic Sinus Surgery; CCCRC: Connecticut Chemosensory Clinical Research Centre 

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Ossiculoplasty Using Preserved Septal Cartilage

 

Abstract

Ossicular chain reconstruction is the primary method of restoring conductive hearing deficit seen in chronic middle ear disease. Many factors affect outcomes in this procedure including the middle ear environment, status of the Eustachian tube, surgical technique, type of prosthesis and status of residual ossicular remnants. Many materials have been used for Ossiculoplasty including both biologic and alloplastic materials, with varying degrees of success. This study was done to evaluate the efficacy of preserved septal cartilage as ossicular reconstruction prosthesis in patients with mucosal type of COM (chronic otitis media) with ossicular discontinuity.

Objective: To evaluate the efficacy of preserved septal cartilage as ossicular reconstruction prosthesis in patients with mucosal type of COM with ossicular discontinuity.

Materials and Methods: A prospective study of 20 patients with mucosal type of COM, undergoing Ossiculoplasty was conducted at a teaching tertiary care hospital from January 2019 to July 2020.

Results: A total 20 patients (13 males and 7 females) between the age group of 18-60 years with mucosal type of COM with ossicular discontinuity were included in the study. Out of 20 patients 18 patients (90%) had improvement in A-B gap (air bone gap) after surgery and 2 patients had no improvement in A-B gap after 3 months of follow up. The mean hearing gain was 12.25±7.23 dB which was statistically significant (p value 0.001).

Conclusion: Preserved septal cartilage is a good material for ossicular reconstruction in terms of postoperative hearing improvement and closure of A-B gap. By giving careful attention to the principles of ossicular construction and understanding basic principles and applying them in clinical practice, it is possible to give more desirable hearing results for the patients.

Keywords:Ossiculoplasty, septal cartilage

Abbreviations: COM: Chronic Otitis Media

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