Papers by Siddharth Nirwan
Indian Journal of Otology, 2023
Introduction The use of endoscope is rapidly increasing in otological and neurootological surgery... more Introduction The use of endoscope is rapidly increasing in otological and neurootological surgery in the last 2 decades. Middle ear surgeries, including tympanoplasty, have increasingly utilized endoscopes as an adjunct to or as a replacement for the operative microscope. Superior visualization and transcanal access to diseases normally managed with a transmastoid approach are touted as advantages with the endoscope. Objectives The present study aimed to compare the outcomes of endoscopic and microscopic cartilage tympanoplasty (Type I) Methods This was a retrospective comparative study of 70 patients (25 males and 45 females) who underwent type I tympanoplasty between March 2015 and April 2016. The subjects were classified into 2 groups: endoscopic tympanoplasty (ET, n ¼ 35), and microscopic tympanoplasty (MT, n ¼ 35). Tragal cartilage was used as a graft and technique used was cartilage shield tympanoplasty in both groups. Demographic data, perforation size of the tympanic membrane at the preoperative state, operation time, hearing outcome, and graft success rate were evaluated. Results The epidemiological profiles, the preoperative hearing status, and the perforation size were similar in both groups. The mean operation time of the MT group (52.63 AE 8.68 minutes) was longer than that of the ET group (48.20 AE 10.37 minutes), but the difference was not statistically significant. The graft success rates 12 weeks postoperatively were 91.42% both in the ET and MT groups, that is, 32/35; and these values were not statistically significantly different. There was a statistically significant improvement in hearing within the groups, both pre-and postoperatively, but there was no difference between the groups. Conclusion Endoscopic tympanoplasty is a minimally invasive surgery with similar graft success rate, comparable hearing outcomes and shorter operative time period as compared to microscopic use.
International journal of scientific research, 2015
Cavernous sinus thrombosis is a dreaded complication of sinusitis and may prove to be fatal,once ... more Cavernous sinus thrombosis is a dreaded complication of sinusitis and may prove to be fatal,once it develops. After antibiotic therapy fewer than 50 % of the patients recover completely,and mortality rate is approximately 30 %.We present a case of pansinusitis with cavernous sinus thrombosis in a 65 years old female.With timely detection of this complication followed by prompt endoscopic endonasal sinus surgery,we were not only able to prevent further catastrophy but also reverse the morbidity already sustained. CASE REPORT A 65 yrs. old female patient presented to ENT OPD with severe headache and giddiness since 3 days which was associated with generalized weakness and fatiguibility.
Background: Hematoma of auricle is a collection of blood beneath the perichondrial layer of pinna... more Background: Hematoma of auricle is a collection of blood beneath the perichondrial layer of pinna usually posing a challenge to an ENT surgeon due to its high rate of recurrence after treatment and lack of appropriate material for use as stitch dressing. This is a pilot study in which shirt buttons were used as a stitch dressing after routine incision and aspiration. Aim: To determine the effectiveness of buttons in the treatment of auricular seroma/hematoma. Materials and Methods: 20 patients of recurrent auricular seroma/hematoma presenting at OPD, SMS hospital, Jaipur, underwent aspiration and button suturing and were taken up for the study. Results: All patients underwent aspiration and button suturing, had uneventful recovery and were followed up for 1-3 months. Conclusion: Buttons which are readily available have been found very helpful as stitch dressing g in the management of auricular seroma/hematoma.
International Journal of Otorhinolaryngology and Head and Neck Surgery, Feb 7, 2023
Background: India was furiously hit by the second wave of COVID-19 that peaked during the months ... more Background: India was furiously hit by the second wave of COVID-19 that peaked during the months of April and May 2021. It led to an unprecedented number of rhino-orbital-cerebral mucormycosis cases that came as a bitter surprise. Several parameters were found to be consistently elevated in the patients like serum ferritin, D-dimer, and HbA1C. Methods: A cross-sectional observational study was conducted at the SMS medical college that included 120 patients presenting with post-COVID mucormycosis from 1 st May to 31 st May 2021. HbA1c, D-dimer, serum ferritin levels were measured at the time of admission. Results: Our study showed a mean range of serum ferritin of 539.6±484.9, mean D-dimer range was 636.3±303.5, both of which were higher than normal. In the present study 94.1% of the patients had diabetes mellitus. Among them 60.80% of the patients had newly detected diabetes and 33.30% were known cases of diabetes with mean HbA1c 9.7±2.3. The p value was less than 0.001 which was statistically significant. Conclusions: Timely detection and categorization of the patients based on severity of the above parameters can not only help in executing the existing institutional resources but can also help in saving valuable lives, and preventing radical surgical procedures like orbital exenteration and maxillectomy.
Journal of Evidence Based Medicine and Healthcare, Jan 8, 2015
Bengal Journal of Otolaryngology and Head Neck Surgery
Introduction: A nasoalveolar cyst is a benign nonodontogenic mass situated in the anterior region... more Introduction: A nasoalveolar cyst is a benign nonodontogenic mass situated in the anterior region of the maxilla. They are often located submucosally in the anterior nasal floor giving rise to swelling in the nasolabial area at the base of nasal alae. Traditionally, the approach of choice was intraoral sublabial marsupialization, however the trend is shifting to lesser invasive and scarless transnasal endoscopic marsupialization. Materials and Methods: This is a retrospective observational study comprising of 16 patients who underwent microdebrider assisted endoscopic transnasal marsupialization of nasoalveolar cyst. Results: 16 patients underwent endoscopic transnasal marsupialization under general anaesthesia. They were followed up for 6-16 months (mean 9.43) and none of them had any recurrence. Conclusion: The traditional treatment for the same has been by external approach. However, a scar in this area of face is not acceptable for many. Also, it is not easy to excise the whole ...
International Journal of Otorhinolaryngology and Head and Neck Surgery
Background: The tremendous growth of cosmetic surgery among Asians is largely due to strength of ... more Background: The tremendous growth of cosmetic surgery among Asians is largely due to strength of indigenous economies accompanying globalization. This increase in number can also be attributed to usage of social media as well as increased desire to look perfect. The current study is an attempt to measures aesthetic outcome and identify possible interactions between other possible outcome determinants. Methods: The present study was a 1.5 years prospective interventional study conducted at SMS Medical College, India from January 2021 to July 2022. A total of 51 samples were included in our study. The rhinoplasty outcome evaluation (ROE) questionnaire was used to assess patient satisfaction which was presented and completed by all patients before and after 6 months of surgery and data was analysed. Results: In the present study mean age of study participants was 25.7 years and most subjects (64.7%) were male and (35.3%) were female. Mean total ROE at pre-op and post-op 6 months was ...
International Journal of Otorhinolaryngology and Head and Neck Surgery
Background: India was furiously hit by the second wave of COVID-19 that peaked during the months ... more Background: India was furiously hit by the second wave of COVID-19 that peaked during the months of April and May 2021. It led to an unprecedented number of rhino-orbital-cerebral mucormycosis cases that came as a bitter surprise. Several parameters were found to be consistently elevated in the patients like serum ferritin, D-dimer, and HbA1C. Methods: A cross-sectional observational study was conducted at the SMS medical college that included 120 patients presenting with post-COVID mucormycosis from 1st May to 31st May 2021. HbA1c, D-dimer, serum ferritin levels were measured at the time of admission. Results: Our study showed a mean range of serum ferritin of 539.6±484.9, mean D-dimer range was 636.3±303.5, both of which were higher than normal. In the present study 94.1% of the patients had diabetes mellitus. Among them 60.80% of the patients had newly detected diabetes and 33.30% were known cases of diabetes with mean HbA1c 9.7±2.3. The p value was less than 0.001 which was stat...
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, 2023
Background: Hematoma of auricle is a collection of blood beneath the perichondrial layer of pinna... more Background: Hematoma of auricle is a collection of blood beneath the perichondrial layer of pinna usually posing a challenge to an ENT surgeon due to its high rate of recurrence after treatment and lack of appropriate material for use as stitch dressing. This is a pilot study in which shirt buttons were used as a stitch dressing after routine incision and aspiration. Aim: To determine the effectiveness of buttons in the treatment of auricular seroma/hematoma. Materials and Methods: 20 patients of recurrent auricular seroma/hematoma presenting at OPD, SMS hospital, Jaipur, underwent aspiration and button suturing and were taken up for the study. Results: All patients underwent aspiration and button suturing, had uneventful recovery and were followed up for 1-3 months. Conclusion: Buttons which are readily available have been found very helpful as stitch dressing g in the management of auricular seroma/hematoma.
International journal of scientific research, 2015
Fibrous dysplasia is a non-neoplastic, expansile lesion of unknown origin. In about one-fourth of... more Fibrous dysplasia is a non-neoplastic, expansile lesion of unknown origin. In about one-fourth of cases this disorder affects the head and neck area, where the mandible and maxilla are the most frequently involved sites. Its localization to the skull base is a rare event. Since the disease slowly progresses, its management is delayed until significant clinical symptoms or non-well-tolerated aesthetic deformities are present.We present a case of fibrous dysplasia of skull base in a 59 years old female. This tumorlike growth was not restricted to the skullbase, but also compressed the orbit and the globe. Endoscopic endonasal removal of the mass with a drill was performed under general anesthesia. No residual tumor was observed 4 months later.
International Journal of Scientific Research, Apr 1, 2015
Cavernous sinus thrombosis is a dreaded complication of sinusitis and may prove to be fatal,once ... more Cavernous sinus thrombosis is a dreaded complication of sinusitis and may prove to be fatal,once it develops. After antibiotic therapy fewer than 50 % of the patients recover completely,and mortality rate is approximately 30 %.We present a case of pansinusitis with cavernous sinus thrombosis in a 65 years old female.With timely detection of this complication followed by prompt endoscopic endonasal sinus surgery,we were not only able to prevent further catastrophy but also reverse the morbidity already sustained. CASE REPORT A 65 yrs. old female patient presented to ENT OPD with severe headache and giddiness since 3 days which was associated with generalized weakness and fatiguibility.
Journal of Evidence Based Medicine and Healthcare, 2015
Global journal for research analysis, 2016
Rhinophyma,also known as ‘potato tumor’ is a late development of Rosacea,occurring solely in men.... more Rhinophyma,also known as ‘potato tumor’ is a late development of Rosacea,occurring solely in men. Overgrowth of nasal tip , alar rim and columella results from progressive increase in connective tissue , sebaceous gland hyperplasia and chronic deep inflammation.Sometimes it can result in nasal obstruction due alar collapse due to mass effect.We report the case of a 42 years old male who presents with progressively increasing swelling for the past 29 years.He underwent excision using diathermy knife. He achieved complete healing of the wound and near normal cosmetic appearance of the nose during a two month follow up period.
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Papers by Siddharth Nirwan