The study showed that circumferential grafting technique is superior in graft success rate and postoperative hearing improvement when compared to conventional underlay technique.

BACKGROUNDSwelling in the head and neck region is always a diagnostic dilemma. Approximately, 7% of the swellings in head and neck regions turn out to be cases of epidermoid or dermoid cysts. Epidermoid cysts are known as benign, squamous epithelium-lined cystic spaces, they may occasionally contain skin adnexa (true dermoid cyst) or derivatives from all 3 germ layers (teratoma). We here present a case of a suprasternal cystic swelling in a 5-year-old girl, present since 3 years. The mass was soft, mobile and nontender. FNAC and USG were suggestive of a dermoid cyst. The cyst was excised under general anaesthesia. Histopathological examination confirmed it to be an epidermoid cyst. There was no recurrence over 6 months followup. This is an interesting case of epidermoid cyst in the suprasternal notch which is a very rare presentation and only few cases have been reported in literature.

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) is a chronic inflammation of the middle ear cleft that is characterised by discharge from the middle ear through a perforated tympanic membrane for at least 6 weeks. The pattern and degree of hearing loss greatly vary in individuals with COM. Conductive hearing loss is the most common pattern. This could be managed conservatively or surgically. Mastoidectomy and/or tympanoplasty are frequently used management procedures for COM. The study aimed to investigate the efficacy of the type I tympanoplasty through a canal widening procedure on hearing sensitivity.</p><p class="abstract"><strong>Methods:</strong> Two groups participated in the study. Group I included 25 participants who underwent type I tympanoplasty with canal widening procedure and group II included 25 participants who underwent type I tympanoplasty without canal widening procedure. The audiometric results of pre-operative condition and post-operative condition at 1 month and 3 months were documented for further analysis.  </p><p class="abstract"><strong>Results:</strong> The mean difference of pre-post (1 month) air conduction threshold was 12.68 dB in group I and 5.5 dB in group II participants. The mean difference of pre-post (3 month) air conduction threshold was 18.86 dB in group I and 8.24 dB in group II participants. There was a significant difference in thresholds that was obtained between the two groups and across conditions.</p><p class="abstract"><strong>Conclusions:</strong> The study provides clear evidence that Type I tympanoplasty with canal widening procedure provides a better improvement in hearing sensitivity for individuals with COM, where surgical procedure is an indication.</p>