INTRODUCTIONThere is high incidence of conductive hearing loss caused by perforations of tympanic membrane in chronic otitis media. The results of studies regarding the effect of the size and the site of perforations on the degree of hearing loss conflicting.Some studies show a correlation between degree of hearing loss and the size of tympanic membrane perforation that larger perforation causes larger hearing loss.1-4 The weak point of these studies is the crude estimation of the size of tympanic membrane perforation. In our study, we use a program enable us to calculate the surface area of perforation precisely and designing a logarithmic equation between degree of hearing loss and surface area of perforation.The results of articles were conflicting about the effect of perforation site on the degree of hearing loss. The present studies depend on comparing the mean of the degree of hearing loss of different site of perforation ABSTRACT Background: Study performed to evaluate relationship between surface area of tympanic membrane perforation and degree of hearing loss and the effect of perforation site on that relationship in patients with chronic otitis media. Methods: Seventy-five perforated tympanic membranes from 63 patients aged between 14-45 years with inactive mucosal chronic otitis media included in this study. Rigid endoscope (0 degree) used to take an image for each perforation that analyzed by Autodesk Design Review 2013 program. Degree of hearing loss assessed by pure tone audiometry. Surface area of perforation classified into four groups according to its percentage. Perforation site categorized into three groups regarding its relation to handle of malleus. Data analysis carried out with SPSS program version 17. Results: We studied 34 females and 29 males with different surface area and site of perforations. It observed that with increment of surface area of tympanic membrane perforation, the degree of conductive hearing loss increases (P value=0.000). This relationship expressed in a logarithmic equation. The mean hearing loss of posterior perforation was 1.7±0.5 dB for each 1% of perforation but in anterior perforation was 1.5±0.6 dB for each 1% of perforation (p value 0.185). Conclusions: In chronic otitis media, there is a quantitative logarithmic relationship between surface area of tympanic membrane perforation and degree of conductive hearing loss. The site of perforation does not play a significant role in determining degree of conductive hearing loss.

The dental surgeon can play an important role in the early referral of malignancy of the maxillary sinus, and should be familiar with the signs and symptoms of disease of the paranasal sinuses. Here we report a case of a 71-year-old male patient diagnosed with high-grade B-cell lymphoma of the maxillary sinus that was initially thought to be an odontogenic infection. We discuss the signs and symptoms of lymphomas and malignancy of the maxillary sinus.

Dentigerous cyst is a type of odontogenic cysts occurs in the ages of twenties or thirties and rarely occurs in the first decade of life with male predominance.  In this report, a case of a large dentigerous cyst in 34 years old female patient   complaining from progressive painful swelling of the right cheek for a month duration. CT scan of the paranasal sinuses showed a well-defined solitary expansile right maxillary cystic mass eroding the antero-lateral maxilla, with a crown of a tooth projecting inside the cystic cavity.  The dentigerous cyst totally enucleated through sublabial incision in combination with nasal endoscopic approach. The unerupted tooth removed from inside the right maxillary antrum. Follow-up at 2 weeks showed no abnormality at the surgical site and no any paresthesia.