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Avinash B, Bharathi MB, Channanayak C, Vasthare R, Arron Lim YR, Nayak PP. Interprofessional collaboration in Paediatric Obstructive Sleep Apnoea (POSA) treatment: Assessment of professional orientation levels amongst otolaryngologists in South India. J Oral Biol Craniofac Res 2024; 14:180-184. [PMID: 38389715 PMCID: PMC10882163 DOI: 10.1016/j.jobcr.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/29/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
Objective The primary goal was to assess the knowledge, attitude and practice among otorhinolaryngologists regarding orthodontic intervention for Paediatric Obstructive Sleep Apnoea (POSA). Methods An online survey was conducted by sending an email invitation to members of The Association of Otorhinolaryngologists of Karnataka, India. A total of 141 otorhinolaryngologists participated in the survey. Results Most of the participants (70.2%) agreed that orthodontic interventions help in opening up the airway, but very few knew about its application in nasal obstruction management. Conclusion Otorhinolaryngologists are aware of dental effects of POSA and they believe that an interprofessional team is essential for its management. This learning can also be used to initiate interprofessional collaborations and academic and curricular improvisations for enhanced health outcomes.
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Affiliation(s)
| | - M B Bharathi
- Dept of Otorhinolaryngology, JSS Medical College, Mysuru, Karnataka, India
| | | | - Ramprasad Vasthare
- Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, India
| | - Y R Arron Lim
- Discipline of Orthodontics, Department of Family Oral Health, Faculty of Dentistry, National University of Malaysia, Malaysia
| | - Prajna P Nayak
- Dept of Public Health Dentistry, Manipal College of Dental, Sciences, Manipal, Manipal Academy of Higher Education, India
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Kameswaran M, Bharathi MB, Periera C, Chandra S, Reddy HK, Gupta M, Sholapuri D, Peethamabaran K. Effectiveness and Safety of Prochlorperazine in Indian Patients with Acute Vertigo: Results from a Large, Prospective, Post-marketing Observational Study. Indian J Otolaryngol Head Neck Surg 2023; 75:3152-3160. [PMID: 38027535 PMCID: PMC10646058 DOI: 10.1007/s12070-023-03831-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 04/24/2023] [Indexed: 12/01/2023] Open
Abstract
Aim To assess the efficacy and safety of prochlorperazine in Indian patients with acute vertigo. Methods In this prospective, multicenter, open-label, post-marketing observational study, patients with acute peripheral vertigo of different etiologies received 5 mg prochlorperazine thrice a day for 5 days. The primary endpoints were percentage of patients with improvement in (1) vertigo symptoms and (2) clinical response as per scale for vestibular vertigo severity level and clinical response evaluation (SVVSLCRE) from baseline to end of treatment (Day 6). The key secondary endpoints were (1) improvement in nystagmus grading, and (2) safety and tolerability Efficacy of prochlorperazine by route of administration of first prochlorperazine dose (oral or intramuscular) was also assessed. Results Of 1716 enrolled patients (mean [standard deviation, SD]) age (42.0 [12.95] years; 53.6% men), 57.4% were diagnosed with Meniere's disease, followed by vestibular neuritis (17.4%), labyrinthitis (16.7%), or ear surgery (8.5%). In the overall population, 91.1% of patients showed improvement in clinical response per SVVSLCRE grading at Day 6 (p < 0.0001 vs. non-responders). Nystagmus grading was improved in 99.7% (of patients. No adverse drug reactions events were reported. Tolerability of prochlorperazine was rated as good, very good, and excellent by 43.6%, 32.9% and 20.7% of patients, respectively. Among patients with postoperative vertigo, 80.1% showed improvement in clinical response. In the intramuscular and oral subsets, 85.5% and 92.1% of patients showed improved clinical response, respectively. Conclusion Prochlorperazine showed improvement in severity of symptoms and clinical response in all subsets of vertigo patients, with a good safety and tolerability profile. Trial Registration Number CTRI/2022/01/039287. Date of Registration 10 January 2022.
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Affiliation(s)
- Mohan Kameswaran
- Madras ENT Research Foundation, Chennai, Tamil Nadu India
- Madras ENT Research Foundation, No-1, 1st Cross Street Off, 2nd Main Road, Raja Annamalaipuram, 600028 Chennai, Tamil Nadu India
| | | | - Carlton Periera
- Bosco ENT Nursing and Research Centre, Mumbai, Maharashtra India
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Menon NN, Bharathi MB. Rare Presentation of Venous Malformation in Parapharyngeal Space. Indian J Otolaryngol Head Neck Surg 2023; 75:2453-2455. [PMID: 37636612 PMCID: PMC10447762 DOI: 10.1007/s12070-023-03683-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/05/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Venous malformations are commonly seen in muscles like masseter, temporalis, tongue musculature, oral and airway mucosa in the head and neck region but is rarely seen in parapharyngeal space. Case Summary We report a case of a 60 year female patient who presented with foreign body sensation of throat, sticky sensation and dysphagia to solids for 2 years. She was subjected to relevant investigations including MRI and USG guided FNAC. Following which she underwent endoscopic parapharyngeal space tumour excision and specimen was sent for HPE. Post operatively patient is doing well and symptomatically better. She is being followed up on regular basis. Conclusion Parapharyngeal space tumours accounts for only 0.5% of head and neck tumours, of which 70 to 80% are benign and the rest are malignant. Out of the benign tumours of parapharyngeal space we should also keep in mind rare tumours like venous malformations.
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Affiliation(s)
- Nandini N Menon
- Department of Surgical oncology, BLK- MAX Super speciality hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - M B Bharathi
- ENT and Head and Neck surgery, JSS Medical college and hospital, Mysore, Karanataka India
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Gowrav MP, Siree KG, Amulya TM, Bharathi MB, Ghazwani M, Alamri A, Alalkami AY, Kumar TMP, Ahmed MM, Rahamathulla M. Novel Rhinological Application of Polylactic Acid-An In Vitro Study. Polymers (Basel) 2023; 15:polym15112521. [PMID: 37299320 DOI: 10.3390/polym15112521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
A novel approach to the treatment of sinusitis is the use of nasal stents. The stent is loaded with a corticosteroid, which prevents complications in the wound-healing process. The design is such that it will prevent the sinus from closing again. The stent is 3D printed using a fused deposition modeling printer, which enhances the customization. The polymer utilized for the purpose of 3D printing is polylactic acid (PLA). The compatibility between the drugs and polymers is confirmed by FT-IR and DSC. The drug is loaded onto the polymer by soaking the stent in the drug's solvent, known as the solvent casting method. Using this method, approximately 68% of drug loading is found to be achieved onto the PLA filaments, and a total of 72.8% of drug loading is obtained in terms of the 3D-printed stent. Drug loading is confirmed by the morphological characteristics of the stent by SEM, where the loaded drug is clearly visible as white specks on the surface of the stent. Drug release characterization is conducted by dissolution studies, which also confirm drug loading. The dissolution studies show that the release of drugs from the stent is constant and not erratic. Biodegradation studies were conducted after increasing the rate of degradation of PLA by soaking it in PBS for a predetermined duration of time. The mechanical properties of the stent, such as stress factor and maximum displacement, are discussed. The stent has a hairpin-like mechanism for opening inside the nasal cavity.
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Affiliation(s)
- M P Gowrav
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru 570015, Karnataka, India
| | - K G Siree
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru 570015, Karnataka, India
| | - T M Amulya
- Department of ENT, JSS Medical College and Hospital, JSS Academy of Higher Education & Research, Mysuru 570004, Karnataka, India
| | - M B Bharathi
- Department of ENT, JSS Medical College and Hospital, JSS Academy of Higher Education & Research, Mysuru 570004, Karnataka, India
| | - Mohammed Ghazwani
- Department of Pharmaceutics, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia
| | - Ali Alamri
- Department of Pharmaceutics, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia
| | - Abdulatef Y Alalkami
- Department of Pharmacy, Mental Health Hospital, Ministry of Health, Abha 61421, Saudi Arabia
| | - T M Pramod Kumar
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru 570015, Karnataka, India
| | - Mohammed Muqtader Ahmed
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdul Aziz University, Al Kharj 11942, Saudi Arabia
| | - Mohamed Rahamathulla
- Department of Pharmaceutics, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia
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Bharathi MB, Madhu A, Murthy S, Sandhya D, Kavya S. Assessment of Otoacoustic Emissions (OAE) in Birth Asphyxiated Neonates. Indian J Otolaryngol Head Neck Surg 2023; 75:38-42. [PMID: 37206857 PMCID: PMC10188707 DOI: 10.1007/s12070-022-03222-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/23/2022] [Indexed: 05/21/2023] Open
Abstract
One of the congenital abnormalities encountered in newborns is hearing loss. Birth hypoxia, asphyxia, and ischemia have all been implicated as primary causes of early hearing loss or deafness. Prospective study was done on neonates in NICU having APGAR scoring of < 7 in 5th minute or neonates diagnosed with birth asphyxia. OAEs were measured from both ears from 3rd to 5th day in sound-proof chamber. MRI reports of these neonates were collected and analyzed. The neonates who did not clear the 1st OAE testing further underwent a second OAE testing between 10 and 14th days. Results were further plotted. 21.9% of neonates had hearing loss. 28.1% of mothers had infections amongst which 6.3% were of hypothyroidism. 56% of neonates with normal OAE result had normal MRI findings. 71.4% of neonates showing a 'REFER' in OAE had normal MRI reports. 44% of neonates with normal OAE result had abnormal MRI report. 7 neonates who failed 1st OAE underwent secondary OAE testing after 10-14 days. 28.6% of the neonates with abnormal OAE report had abnormal MRI findings. There is no statistical correlation between OAE findings with MRI findings of the birth asphyxiated neonates. (p value = 0.671). Hence, there exists no correlation between hearing loss and birth asphyxia.
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Affiliation(s)
- M. B. Bharathi
- Department of ENT, Head and Neck Surgery, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - Ashima Madhu
- Department of ENT, Head and Neck Surgery, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - Srinivasa Murthy
- Department of Paediatrics, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - D. Sandhya
- Department of Paediatrics, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - S. Kavya
- Department of Paediatrics, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
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Bharathi MB, Kasaragod SK, Basavaraj S, Prakash BG. Ingrained Insight into Nasal Polyposis; Role of Human Papillomavirus: An Indian Study. Indian J Otolaryngol Head Neck Surg 2022; 74:858-862. [PMID: 36452816 PMCID: PMC9702506 DOI: 10.1007/s12070-020-01915-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/13/2020] [Indexed: 10/24/2022] Open
Abstract
Nasal polyposis (NP) are benign lesion of nasal cavity, affecting up to 1-4% of population. It is known to have up to 70% recurrence rate. The underlying pathophysiology is still undetermined. Recent literatures have thrown light on the viral aetiology for NP. To our knowledge this is the first Indian study done, that aims to evaluate the prevalence of Human papillomavirus (HPV) in NP. It was a prospective case control study done among 40 individuals with NP and 40 healthy controls in a tertiary care centre. All the patients were subjected to routine clinical evaluation, investigations prior to proposed surgeries. The mucosal samples after the surgery were subjected to HPV DNA analysis by RT-PCR. Among the cases, the male to female ratio was 1.3:1. The mean age of patients with NP was 39 ± 14.6. The mean serum IgE levels among the case were 154 IU/ml and was significantly higher as compared to controls. Other inflammatory markers such as absolute eosinophil count, erythrocyte sedimentation rate, and neutrophil to leukocyte ration were found to be not significant. There was no HPV DNA detected among both case as well as controls. There seems to be strong association of IgE and NP, suggesting an IgE mediated pathway for its Causation. There is no association of HPV in NP.
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Affiliation(s)
- M. B. Bharathi
- Department of Otorhinolaryngology, JSS Academy of Higher Education and Research, Mysuru, India
| | | | - S. Basavaraj
- Department of Otorhinolaryngology, JSS Academy of Higher Education and Research, Mysuru, India
| | - B. G. Prakash
- Department of Otorhinolaryngology, JSS Academy of Higher Education and Research, Mysuru, India
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Saju S, Bharathi MB, Prakash BG, Rakesh BS. Assessment of Quality of Life and Symptoms in Non Syndromic Paediatric Obstructive Sleep Apnoea Patients: Before and After Adenotonsillectomy. Indian J Otolaryngol Head Neck Surg 2022; 74:1453-1458. [PMID: 36452848 PMCID: PMC9702229 DOI: 10.1007/s12070-021-02588-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 04/26/2021] [Indexed: 10/21/2022] Open
Abstract
This study aims to assess the improvement in quality of life and symptoms in paediatric obstructive sleep apnoea patients before and after adenotonsillectomy. From all paediatric patients who presented to our OPD with complaints of mouth breathing and snoring, a subset of patients fulfilling our inclusion criteria were selected and evaluated with PSQSRBD scale, quality of life (QoL) inventory and PSG level-III. Later37 patients who had moderate to severe OSA were selected for study and underwent adenotonsillectomy. They were further followed up postoperatively at 3 months and 7 months with PSQSRBD Scale and QoL inventory. The study cohort had 37 patients with moderate to severe OSA, with a mean age of 8yrs.The postoperative (mean of 3rd and 7th month) values of PSQSRBD Scale and QoL inventory values was significantly (p < 0.001) reduced compared to preoperative Values after adenotonsillectomy. There is statistically significant correlation between adenoid and tonsil size to the relief of symptoms (PSQSRBD SCALE values) and improvement of quality of life. In our study, surgical (adenotonsillectomy) intervention has significant effect in management of moderate to severe non syndromic paediatric OSA patients.
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Affiliation(s)
- Sunena Saju
- Department of Otorhinolaryngology, JSS Medical College, JSSAHER, Sri Shivarathreeshwara Nagara, Mysore, 570015 Karnataka India
| | - M. B. Bharathi
- Department of Otorhinolaryngology, JSS Medical College, JSSAHER, Sri Shivarathreeshwara Nagara, Mysore, 570015 Karnataka India
| | - B. G. Prakash
- Department of Otorhinolaryngology, JSS Medical College, JSSAHER, Sri Shivarathreeshwara Nagara, Mysore, 570015 Karnataka India
| | - B. S. Rakesh
- Department of Otorhinolaryngology, JSS Medical College, JSSAHER, Sri Shivarathreeshwara Nagara, Mysore, 570015 Karnataka India
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Amulya TM, Siree KG, Kumar TMP, Bharathi MB, Divith K, Nihar G, Gowrav MP. Biomaterials – Novel Advances in Nasal Medical Implants, 3D Printing Applications. JPRI 2021. [DOI: 10.9734/jpri/2021/v33i56a33885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The scope and applications of biomaterials have spread out throughout a broad spectrum. Particularly in pharmacy, biomaterials are an attractive choice because they can be modified to decrease toxicity, increase the targeting ability among many other aspects of drug delivery. Extensive studies have led to the development of many metal-based, ceramic, biocompatible and biodegradable biomaterials for medical purposes among many others. The utilization of 3D printing in this discipline is a very novel research subject with infinite potential. Personalized and customized nasal implants are a great option to increase patient compliance and 3D printed accurate anatomical structures are rendered to be effective tools of learning. One of the disadvantages of biomaterial-based implants is the formation of a thick fibrous capsule formation around the implant, others being breakage, soft tissue loss and so on. Regulatory aspects are less explored for nasal implants. 3D printing is a unique technique that allows for a high degree of customisation in pharmacy, dentistry and in designing of medical devices. Current research in 3D printing indicates towards reproducing an organ in the form of a chip; paving the way for more studies and opportunities to perfecting the existing technique.
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Dharmarajan S, Bharathi MB, Sivapuram K, Prakash BG, Madhan S, Madhu A, Devi GN, Aliya SA, Ramya SB. Hearing Loss-a Camouflaged Manifestation of COVID 19 Infection. Indian J Otolaryngol Head Neck Surg 2021; 73:494-498. [PMID: 33996529 PMCID: PMC8109216 DOI: 10.1007/s12070-021-02581-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 04/17/2021] [Indexed: 11/28/2022] Open
Abstract
The symptomatology of novel Severe Acute Respiratory Syndrome Corona virus type 2 infection runs the entire gamut of mild to moderate and serious illness among the affected individuals. As listed in recent literature, respiratory, cardiovascular, gastrointestinal, olfactory and gustatory systems are commonly involved. With the growing knowledge about the disease, varied manifestations have been identified and lately, otorhinolaryngology dysfunctions in COVID 19 have been described. Hearing loss in COVID era is one of the emerging areas of concern and calls for further research in the field for the better understanding and treatment of this entity. This study was designed to assess the audiological profile among 100 mild to moderately affected COVID-19 individuals, so as to make a contribution to the emerging literature on otologic manifestations in COVID 19. In our case series, high frequency hearing loss and referred OAE was noted among significant number of COVID 19 positive patients. This was even observed in patients without any otologic symptoms. Hence, early identification and intervention if required helps to give a better quality of life to the patient.
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Affiliation(s)
- Sandhya Dharmarajan
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - M. B. Bharathi
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - Kavya Sivapuram
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - B. G. Prakash
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - Sriram Madhan
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - Ashima Madhu
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - G. Nivetha Devi
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - Shaik Ayesha Aliya
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - S. B. Ramya
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
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Bharathi MB, Kumar MRA, Prakash BG, Shetty S, Sivapuram K, Madhan S. New Visionary in Upper Airway Surgeries-THRIVE, a Tubeless Ventilation. Indian J Otolaryngol Head Neck Surg 2021; 73:246-251. [PMID: 34150599 DOI: 10.1007/s12070-021-02491-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/22/2021] [Indexed: 11/29/2022] Open
Abstract
THRIVE stands for Transnasal Humidified Rapid Insufflation Ventilatory Exchange. Usage of THRIVE technique is common in emergency settings and of late its usage in upper airway surgeries is gaining popularity. (1) To determine the operative time, total anaesthesia time, safety and efficacy of THRIVE in patients undergoing upper airway surgeries for varied pathologies. (2) To assess the surgeon's satisfaction and patients post-operative comfort. An observational study was from May 2019 to Oct 2020. Study was conducted through a detailed proforma which consists of patient demographic details, physical status, co-morbidities and various domains to assess the safety and efficacy of THRIVE. A total of 32 patients were divided into four groups depending on the type of surgery. We had 18 patients in microlaryngeal excision, six in direct laryngoscopy and biopsy, four in tracheostomy and four in balloon dilatation for subglottic stenosis groups. The mean operation time was 16 ± 2 min in the first three groups and 29 ± 0.8 in the fourth group. All the patients underwent successful surgeries without any episodes of desaturation, without complications and with good surgical satisfaction. THRIVE with appropriate safety precautions can be tried in patients undergoing various upper airway surgeries of short duration. All the patients in our study maintained stable vital parameters throughout the surgery. Initial results with the use of THRIVE as per our study and other studies are definitely encouraging to use THRIVE in upper airway surgeries with varied pathologies.
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Affiliation(s)
- M B Bharathi
- Department of ENT, Head and Neck Surgery, JSS Academy of Higher Education and Research (JSSAHER), Mysore, Karnataka 570004 India
| | - M R Anil Kumar
- Department of Anaesthesiology, JSS Academy of Higher Education and Research (JSSAHER), Mysore, Karnataka 570004 India
| | - B G Prakash
- Department of ENT, Head and Neck Surgery, JSS Academy of Higher Education and Research (JSSAHER), Mysore, Karnataka 570004 India
| | - Sandeep Shetty
- Department of ENT, Head and Neck Surgery, JSS Academy of Higher Education and Research (JSSAHER), Mysore, Karnataka 570004 India
| | - Kavya Sivapuram
- Department of ENT, Head and Neck Surgery, JSS Academy of Higher Education and Research (JSSAHER), Mysore, Karnataka 570004 India
| | - Sriram Madhan
- Department of ENT, Head and Neck Surgery, JSS Academy of Higher Education and Research (JSSAHER), Mysore, Karnataka 570004 India
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Bharathi MB, Rakesh BS, Rudrappa B, Aggarwal N, de K. Neurogenic tumors of parapharyngeal space – Clinical evaluation and management: Our experience. J Head Neck Physicians Surg 2021. [DOI: 10.4103/jhnps.jhnps_1_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Bharathi MB, Babu AR, Malik E. Evaluation of Dynamic CT Scans and Analyzing Its Efficacy Accuracy in Staging of Laryngeal CA: A Prospective Analysis of 30 Patients and Review of Literature. Indian J Otolaryngol Head Neck Surg 2019; 71:265-275. [DOI: 10.1007/s12070-018-1262-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 01/30/2018] [Indexed: 11/29/2022] Open
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Singh V, Rakesh BS, Bharathi MB, Harish Nag K. Evaluation of outer hair cells function of non-operated ear after mastoid drilling using distortion-product otoacoustic emissions. J Med Res 2019. [DOI: 10.31254/jmr.2019.5307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Aim: To analyze the effect of acoustic and mechanical trauma of drilling on the outer hair cell function of the non operated ear using distortion-product otoacoustic emissions (DPOAE’s) after mastoidectomy and its relation with the duration of drilling, age, and gender of the patient along with duration and permanency of the effects. Study Design: Observational study. Materials and Methods: Screening DPOAE’s were recorded preoperatively, immediate postoperative period, one hour postoperatively, 1st and 7th postoperative days in the normal ear in 94 patients who underwent tympanomastoidectomy for unilateral chronic suppurative otitis media (CSOM). DPOAE’s were measured using Neuro-audio-screener (Neurosoft Inc.) at 1.5 KHz, 2.1 KHz, 3.3 KHz, and 4.2 KHz. If DPOAE’s were absent preoperatively, the patients were not evaluated further and patients who had absent DPOAE’s post-operatively were successively followed till DPOAE’s were regained. Results: Of the 94 patients included, in 62 patients DPOAE’s were present preoperatively. Out of these 62, in 30 patients DPOAE’s were absent immediate postoperatively. On repeat testing, DPOAE’s were absent in 20 patients after 1 hour and in 8 patients after 1 day. On re-evaluation of these 8 patients after 1 week all of them had regained the DPOAE’s. In terms of duration of drilling, 66.6% patients in immediate post operative period, 90% patients in 1-hour post operative and 100 % patients on post operative day 1, having absent DPOAE’s had drilling time more than 60 minutes. Patients more than 30 years of age are affected more, but there is no preponderance for any gender. Conclusion: Nonoperated ear does have the effect of acoustic and mechanical trauma by vibration transmitted from another side during drilling of the operative ear mastoid bone. This effect is temporary and depends on the duration of drilling also.
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Bharathi MB, Rajendra Prasad J, Satish K. Drug-Induced Sleep Endoscopy as a Selection Tool for Surgical Management of Obstructive Sleep Apnoea Syndrome: Our Personal Experience. Indian J Otolaryngol Head Neck Surg 2017; 69:313-318. [PMID: 28929061 DOI: 10.1007/s12070-017-1113-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 04/04/2017] [Indexed: 11/25/2022] Open
Abstract
The role of Drug-induced sleep endoscopy as a selection tool for surgical management of obstructive sleep apnoea syndrome. SOURCE OF DATA Polysomnography proved OSA patients, who are planned for surgery in dept. of ENT AND HEAD& NECK, JSS Hospital, Mysore. STUDY DESIGN A prospective clinical study. METHOD 30 Polysomnography proved OSA patients, age between 20 and 60 years have been selected for Drug Induced Sleep Endoscopy (DISE) after taking informed consent for proposed surgery. Inj propofol infusion given throughout the DISE procedure and upper airway nasal endoscopy performed for assessment of site of collapse (Retropalatal, Retrolingual, Hypopharyngral), type of collapse (circumferential, lateral) and severity of obstruction, Lowest SpO2, apnoeic episodes and DISE findings were recorded. Out of these thirty patients 90% were male and 10% were female, observed that 66.7% of males and 40.7% of females belonged to 31-40 age group, and BMI of 63.3% of patient population were overweight, 20% were obese and 5% were normal. Mean fall in SpO2 was 90.20 ± 2.77 in normal subjects, 83.05 ± 5.14 in overweight subjects and 68.83 ± 9.11 in obese subjects. Normal subjects had 0.4 ± 0.9 apnoeic episodes, overweight subjects had 0.9 ± 1.6 episodes and obese subjects had 4.0 ± 2 apnoeic episodes. We observed that 40% had retropalatal airway collapse, 23.3% had airway obstruction at the base of the tongue, 20% had airway obstruction with floppy epiglottis, 12% multiple level collapse, 6.7% of patient population had grade 4 enlarged tonsils, 3.3% had lateral pharyngeal wall collapse, and 0% hypopharyngeal collapse. Out of 30, 29 Patients underwent surgery (Expansion sphincter pharyngo plasty-14, Hyoid advancement-4, Uuvulopalatoplasty-10, Epiglottic surgery-6, Zeta pharyngoplasty-2, midline glossectomy-3, Endoscopic septoplasty-5, Inferio turbinoplasty-2, LASSER Assisted lingual tonsillectomy-1), All these 29 patient were followed for 3 months, at the end of 3rd month again Each subject was evaluated with a baseline Epworth Sleepiness Scale and LEVEL-3 PSG, the results were impressive with statistically significant. DISE is a dynamic, safe, and easy-to-perform technique that visualizes, the anatomical sites of snoring or apneas for assessment site of collapse (Retropalatal, Retrolingual, Hypopharyngral), type of collapse (Circumferential, Lateral) and severity of obstruction and guides the design of a tailor-made treatment plan for a OSA SURGEON in individual cases, which will improves perioperative outcome.
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Affiliation(s)
- M B Bharathi
- Department of ENT, JSS Medical College and JSS University, Mysore, India
| | - J Rajendra Prasad
- Department of ENT and Head and Neck Surgery, JSS Medical College and JSS University, Mysore, Karnataka 570004 India
| | - K Satish
- Department of ANAESTHESIA, JSS Medical College and JSS University, Mysore, India
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Prabhakar SK, Bharathi MB, Singhal AK. Recurrent inverted papilloma of paranasal sinus presenting as acute proptosis. Rom J Ophthalmol 2016; 60:255-259. [PMID: 29450358 PMCID: PMC5711290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2016] [Indexed: 06/08/2023] Open
Abstract
Objective. To describe the course of events that followed from the time of the diagnosis to the management of a rare case of recurrent inverted papilloma presenting as an acute proptosis. Methods. A seventy-year-old diabetic female patient presented with a painful left eye proptosis for 15 days. She had a history of resection of inverted papilloma of paranasal sinus followed by radiotherapy for eight years before. The examination revealed a 23 mm proptosis, with restricted ocular movements, corneal oedema, funnel shaped anterior chamber, and total retinal detachment with a complete visual loss. The lobulated fixed hard mass was palpable circumferentially but more in the inferior orbital compartment. The transconjunctival incisional biopsy showed features of highly undifferentiated cytology. The lid sparing exenteration was done under general anesthesia with cosmetic reconstruction. Results. Immunohistochemistry of exenterated mass was doubtfully suggestive of a small cell tumor. However, histopathology confirmed features of rhabdomyosarcoma. Conclusion. The present case study revealed rhabdomyosarcoma cytology presenting as an association-inverted papilloma. Abbreviations : IP = Inverted papilloma, PNS = Paranasal sinus, SCC = Squamous cell carcinoma, IOP = Intraocular pressure, CT = Computed tomography.
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Affiliation(s)
- S K Prabhakar
- Department of Ophthalmology, JSS Hospital, Mysore, India
| | - M B Bharathi
- Department of ENT and Head & Neck Surgery, JSS Hospital, Mysore, India
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