Background: The orofacial cleft is the most common birth anomaly with a prevalence rate ranging from 1/1000 to 2.69/ 1000. The middle ear diseases are known to be associated with cleft palate, however, the prevalence and the magnitude of the condition is usually underestimated. Aims and Objectives: The purpose of this study was to find out the various exisiting ear abnormalities, to assess the middle ear function and hearing status  in patients with cleft palate and confirm the existence of these manifestations and their significance. Materials and Methods: All the patients with cleft palate with or without cleft lip over a one-year duration from January to December 2018 at the teaching hospital were include after informed consent. The patients with only cleft lip were excluded. General ENT examination and Otoscopy was performed.  Tympanometry and Pure tone Audiometry was done (in those above 5 years). The degree of hearing loss was categorized using the WHO guidelines. Results: Out of a total of 56 patients, there were 30(53.6%) male and 26(46.4%) female. The age range was from 2years to 31 years. The mean age was 12.8 years. Maximum number of patients were in the 10-20 years age group 29(51.8%) followed by 22 (39.3%) in the less than 10 years age group. 53 (47.3%) of 112 ears examined  had dull tympanic membrane, followed by retraction of tympanic membrane in 42 (37.5%) ears. Other findings were central perforation in 5 (4.5%), bulging tympanic membrane in 2 (1.8%) and atticoantral disease in 1 (0.9%) ear. 8 (7.1%) ears  had normal findings. There was one case with right ear atresia (0.9%). In Tympanometry findings, the maximum number of ears, 51 (48.1%) had  type B curve, followed by 33 (31.2%) ears with type As curve. 16 (15%) of ears had type C curve. 6 (5.7%) ears had type A curve. B type curve was found more common in less than 10 years age group. A chi Square test was performed and the findings had statistically significant association.  (P value: 0.03 for Right ear tympanometry ; P value: 0.043 for left ear tympanometry). In Pure tone audiometry findings of 105 ears, 72 (68.6%) ears had mild conductive hearing loss. 10 (9.5%) ears had moderate conductive hearing loss, while 1 (1%) ear had mixed hearing loss. 22 (20.9%) ears had normal hearing level. Conclusion: This study assessed the common ear problems prevalent in cleft patients, along with the hearing loss. Since, ear disease were quite common in these patients, these patients should be evaluated regularly by an otolaryngologist to detect, treat and prevent such problems in these patients so that long term morbidity could be avoided.

Background: Nasal Septal deviation is a frequently found entity in ENT OPD. The objective of the study was to describe the clinical presentations of deviated nasal septum, classify them according to the Mladina’s system and find out the relation of trauma with the type of septal deviation. Methods: One hundred fifty cases of septal deviation were classified ac­cording to Mladina’s classification, after thorough interview, nasal exami­nation and nasal endoscopy. Data were analyzed with SPSS version 21, after tabulation. Chi-square test was applied as the test of significance. Results: Out of 150 cases of septal deviation, Male 82 (54.6%) outnum­bered the female patients 68 (45.3%). Most of these patients were of sec­ond and third decade (20-40 years age group). The most common pre­senting complaint was that of nasal obstruction 121(80.6%), headache68 (45.3%) and nasal discharge52(34.6%). 78(52%) of patients revealed his­tory of trauma. Type II 32 (21.3%) and Type V 31 (20.6%) were the com­monest followed by Type III 24(16%). Conclusions: Nasal septal deviation is a common presentation in ENT OPD. Mladina’s classification found Type II and Type V to be quite common. Na­sal obstruction, headache and rhinorrhea are frequent associated com­plaints. Nasal endoscopy is very important for the diagnosis, especially of posterior deflections.

Background: Primary acquired nasolacrimal duct obstruction (PANDO) is a common entity with associated different types of intranasal abnormalities. The pathogenesis of PANDO is unknown. The objective of the study was to describe the intranasal findings in cases of PANDO and find out any association of these findings to the disease. Methods: A comparative cross-sectional study was designed consisting of 50 cases of unilateral PANDO with epiphora and 50 normal volunteers with no history of epiphora. Nasal Evaluation was done with anterior rhinoscopy and nasal endoscopy. Data was tabulated and analyzed using SPSS version 21. Results: The mean age in the unilateral PANDO group was 33.6 years and 34.5 years in the normal volunteer’s group (P-0.84). Left sided dominance of PANDO was observed in 64% (32/50) cases. The odds of having Nasolacrimal duct (NLD) obstruction was1.6 times more among individuals having septal deviation versus no deviation (95% CI, 0.907–2.78). The laterality of septal deviation was corresponding to the side of NLD obstruction in 91% (31/34) cases. High located DNS was more common in the PANDO group which was significant (P-value 0.012). Turbinate hypertrophy, the presence of septal spur or rhinitis had no significant association with NLD obstruction. Conclusions: Deviated nasal septum (DNS), turbinate hypertrophy, septal spur and rhinitis were the associated intranasal findings in cases of unilateral PANDO. A significant association exists between DNS and PANDO, although a cause and effect relation require further probing.

Introduction: Cleft lip and palate is one of the most common congenital anomaly, which contributes to eustachian tube dysfunction leading to impaired middle ear ventilation and middle ear pathology. It has been stated that the timely repair of cleft palate reduces the incidence of otitis media with effusion. Objective: To describe the ear findings in cleft palate patients who have undergone repair of cleft palate. Methodology: A total of 36 (20 male and 16 female) post cleft repair patients underwent Otoscopy and Tympanometry between January to December 2018. Cases with isolated cleft lip, ears with perforation of tympanic membrane and attico-antral disease were excluded. Results: The age range was from 4 years to 24 years, with a mean of 11.34 years. Maximum patients were of the age group of 10- 20 years (18, 50%) followed by that of 5-10 years range (15, 41.66%). Total number of ears examined were 72. Out of a total of 72 ears, 70 (97.2%) had abnormal otoscopic finding with dull tympanic membrane in 37 (51.39%) ears, retracted in 31 (43.05%) and bulging tympanic membrane in 2 (2.78%) cases. Type B curve was the commonest (36, 50%), followed by Type As (24, 33.3%). Type C curve was found in 11(15.3%) ears. Type A curve was found only in one ear. The duration of post-repair of cleft palate ranged from 6 months to up to 16 years with a mean of 8.52; 11 cases(30.56%) had history of repair of cleft palate of more than 10 years duration.16 cases (44.44%) had that of more than 5 years and 9 cases (25%) had less than 5 years history of duration of repair. When correlation was done statistically, the tympanometry findings and duration of repair had a very low correlation (Table 5). The time period of repair had no significant effect on tympanometric ear findings. Conclusion Abnormal otoscopic findings and tympanometric findings were common in post cleft palate repaired patients. The duration of cleft palate repair had low correlation to the tympanometric ear findings.

Background: Primary acquired nasolacrimal duct obstruction (PANDO) is a common entity with associated different types of intranasal abnormali­ties. The pathogenesis of PANDO is unknown. The objective of the study was to describe the intranasal findings in cases of PANDO and find out any association of these findings to the disease. Methods: A comparative cross-sectional study was designed consisting of 50 cases of unilateral PANDO with epiphora and 50 normal volunteers with no history of epiphora. Nasal Evaluation was done with anterior rhi­noscopy and nasal endoscopy. Data was tabulated and analyzed using SPSS version 21. Results: The mean age in the unilateral PANDO group was 33.6 years and 34.5 years in the normal volunteer’s group (P-0.84). Left sided dominance of PANDO was observed in 64% (32/50) cases. The odds of having Na­solacrimal duct (NLD) obstruction was1.6 times more among individuals having septal deviation versus no deviation (95% CI, 0.907–2.78). The lat­erality of septal deviation was corresponding to the side of NLD obstruc­tion in 91% (31/34) cases. High located DNS was more common in the PANDO group which was significant (P-value 0.012). Turbinate hypertro­phy, the presence of septal spur or rhinitis had no significant association with NLD obstruction. Conclusions: Deviated nasal septum (DNS), turbinate hypertrophy, septal spur and rhinitis were the associated intranasal findings in cases of uni­lateral PANDO. A significant association exists between DNS and PANDO, although a cause and effect relation require further probing.