Endoscopes are increasingly being used in cholesteatoma surgeries either as an adjunct to microscopes or sometimes exclusively. Their role at present is more as adjunct to microscope which still remains the work-horse for mastoidectomy. However, as endoscopy and endoscopic instruments are increasingly getting refined, role of endoscopy in management of cholesteatoma is continuously being appraised with progressively newer studies. This review aims to assess outcomes of several studies in which endoscopic techniques were used in cholesteatoma surgery and recognize common trends. An extensive review of literature on this theme was performed. Sixteen studies comprising of 1685 patients treated endoscopically either exclusively or in combination with microscope were included. Intra-operatively, in 267 (15.82%) cases, residual cholesteatoma was identified by endoscope in hidden areas after completion of surgery with microscope. On follow-up, recidivism was identified in 108 cases (6.4%) in second look procedures. Common sites of recurrence were hidden areas like sinus tympani. This review while acknowledging the value of microscope, highlights the merit of endoscope usage in cholesteatoma surgery and its role in reducing recurrence.

The WHO has designed a safe surgery checklist to enhance communication and awareness of patient safety during surgery and to minimise complications. WHO recommends that the check-list be evaluated and customised by end users as a tool to promote safe surgery. The aim of present study was to evaluate the impact of WHO safety checklist on patient safety awareness in otorhinolaryngology and to customise it for the speciality. A prospective structured questionnaire based study was done in ENT operating room for duration of 1 month each for cases, before and after implementation of safe surgery checklist. The feedback from respondents (surgeons, nurses and anaesthetists) was used to arrive at a customised checklist for otolaryngology as per WHO guidelines. The checklist significantly improved team member's awareness of patient's identity (from 17 to 86%) and each other's identity and roles (from 46 to 94%) and improved team communication (from 73 to 92%) in operation theatre. There was a significant improvement in preoperative check of equipment and critical events were discussed more frequently. The checklist could be effectively customised to suit otolaryngology needs as per WHO guidelines. The modified checklist needs to be validated by otolaryngology associations. We conclude from our study that the WHO Surgical safety check-list has a favourable impact on patient safety awareness, team-work and communication of operating team and can be customised for otolaryngology setting.

Nasofrontal masses belong to the group of congenital midface anomalies (CMFA) in paediatric age group. The usual list of differential diagnosis for such masses can be narrowed to Frontonasal dermoid, epidermoid, nasal encephalocele and nasal gliomas. Frontonasal dermoid with patent dermal sinus tract is a rare craniofacial anomaly resulting from the failure of normal embryonic development. Most of patients present in infancy or early childhood. CT, MRI and sinogram together are usually required for definitive diagnosis. Knowledge of embryonic development of nose & anterior skull base is important in understanding the pathologies of Frontonasal masses. Endoscopic 'key-hole' approach to these lesions via small incision allows better visualization & ensures complete removal.

Background: Ideal graft material in revision tympanoplasty is a topic of much research. Cartilage being sturdy and stable even in negative pressure situations, is a viable option. Aims and Objectives: The aim of the present study was to evaluate graft uptake and hearing improvement using the technique of island of tragal cartilage as a graft material in revision tympanoplasty. Materials and Methods: This was a prospective study of total of 60 Type 1 revision tympanoplasty surgeries which were done using tragal cartilage island graft from December 2017 to December 2019 in our institute with a follow-up of 3 months. Results: Graft uptake in our study was found to be 93.33%. Four patients showed a re-perforation during follow-up. The mean preoperative air-bone gap (ABG) was 28.13 dB, while the postoperative mean ABG was 16.83 dB and the mean gain was 12.83 dB. Conclusion: It is thus worthwhile to consider island of tragal cartilage as a graft material in revision tympanoplasty.

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