Renu Rajguru

Abstract

Introduction: Imaging of temporal bone helps the Otologists in preoperative surgical planning in ear surgery. Cone Beam Computed Tomography (CBCT) has much higher spatial resolution and clarity as compared to conventional X-Ray and much lower radiation exposure as compared to HRCT Temporal Bones. Aim: To evaluate the change in management plan of Chronic Otitis Media (Mucosal) after CBCT. Also to determine the sensitivity and specificity of the CBCT findings by comparing with intra operative findings in the study participants. Materials and Methods: We conducted an observational descriptive study in the ENT Department of an academic Tertiary care hospital from October 2017 to October 2019. We included 95 patients whose management plan before CBCT was compared with the plan after CBCT and the percentage of cases undergoing a change in the management after CBCT was determined. The correlation of CBCT findings and intra operative findings in terms of specificity and sensitivity was also statistically calculated. Results: Subsequent to imaging, the management plan was changed in only 4 patients which was statistically non-significant. CBCT showed a 100% sensitivity, specificity, positive predictive value and negative predictive value to detect pneumatisation of the Mastoid, high jugular bulb and low-lying dura. The sensitivity to detect ossicular erosion was 98.9%. Conclusion: Thorough clinical examination is the most important factor in decision making in patients with Chronic Otitis Media (Mucosal) and management plan remains unchanged after imaging. Though thorough clinical examination remains the gold standard in making a management plan of patients with Chronic Otitis Media (Mucosal), CBCT with its available details and minimal radiation helped to minimise intraoperative inadvertent injuries which might result due to normal anatomic variations like low lying dura, forward lying sinus, contracted mastoid cavity etc. Keywords: Cone Beam Computed Tomography, Chronic Otitis Media (Mucosal), management plan

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Abstract

Introduction: Facial aesthetic surgery requires a thorough preoperative analysis of face and identification of problems to frame a comprehensive surgical plan. The conceptions of an attractive face must be analyzed beforehand. Powell and Humphrey had defined facial angles and had formulated range which would be perceived as attractive. Objective: To compare the change in pre- and post-operative nasolabial, nasofrontal and nasofacial angles in patients undergoing Rhinoplasty. Materials and Methods: A prospective observational study was conducted from October 2014 to October 2019 in ENT department of a tertiary care hospital. Twenty-one patients undergoing Rhinoplasty and fulfilling the inclusion criteria were considered as study population. Their pre- and post-operative profile photographs were taken for morphometric analysis. The nasolabial, nasofrontal and nasofacial angles were measured and compared, before and one month after the surgery in profile pictures. Results: A significant change in the nasolabial and nasofacial angles were seen following Rhinoplasty. The mean nasofrontal angle showed an increase following Rhinoplasty but was not found significant. Conclusions: Rhinoplasty results in significant change in nasofacial and nasolabial angles and in expert hands, is expected to restore the various facial angles to their acceptable range. Keywords: Rhinoplasty, Nasolabial, Nasofrontal, Nasofacial angles, Morphometric measurements.

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