OBJECTIVES To determine the sensitivity of pre-op ultrasonography in localizing parathyroid adenoma for minimally invasive parathyroidectomy (MIP) technique. METHODOLOGY The study was conducted at the department of ENT and Head & Neck Surgery, MTI Hayatabad Medical Complex Peshawar. It included a retrospective analysis of records of patients who underwent MIP from Jan 1, 2019, to July 31, 2022.  All patients had pre-operative meta-iodobenzylguanidine (MIBG) scans, and serum PTH, Serum calcium levels were determined. A pre-op ultrasound scan was acquired to mark the site of the parathyroid adenoma. MIP was carried out using a 3.5 to 4 cm transverse skin incision over the marked site to expose the thyroid gland. If the marked parathyroid gland was identified without using any other aids, the result was labelled as "True positive". The sensitivity of pre-op ultrasonography was calculated using SPSS v 26.0. RESULTS A total of 53 cases were included in the study. The male: female ratio was 1:1.8. The ages of patients ranged from 23-70 years with a mean age of 48.49 years with a standard deviation of +_ 10.818. Pre-op ultrasonography accurately localizes the site of parathyroid adenoma in 49 patients. Statistical analysis showed this to be a significant finding. CONCLUSION Pre-op ultrasonography is significantly helpful in localizing the parathyroid adenoma. Therefore its routine use is recommended to help localize the adenoma in minimally invasive parathyroidectomy.

Otitis media with effusion (OME) is a common cause of treatable hearing impairment in children. As OME is a recurrent problem, a ‘wait and see’ policy is therefore worthwhile before embarking on treating it surgically. Objective: To determine the frequency of cases having spontaneous resolution of otitis media with effusion in the first 3 months after acquiring the disease. Methods: This study was conducted in ENT Department of Hayatabad Medical complex, Peshawar during the period from July 1, 2021 to Sep 3, 2022. Children aging 3-13 years diagnosed with recent onset OME were followed upto 3 months. Children were categorized into two categories; “Resolved” and “Persistent OME” on the basis of pure tone audiometry and tympanometry at the end of 3 months. Using this data, the frequency of spontaneous resolution of otitis media with effusion (glue ear) was calculated. Results: A total of 185 patients were included in the study. The male: female ratio was of 1.28: 1 with mean age of 7.71 ± 2.75years. The 6-9 years comprised 88(47.57%) & was the commonest age group involved by OME and it was in the same group where maximum percentage of spontaneous resolutions of disease occurred. Overall 148(80%) of children with glue ear achieved spontaneous resolution. Statistically this number has been highly significant (p=0.001). Conclusion: OME resolves spontaneously in a significant proportion of children in first 3 months of illness. A close follow up is recommended before embarking on surgery which is best reserved for persisting cases.