Objectives Many routine sinonasal procedures utilising powered instruments are regarded as aerosol‐generating. This study aimed to assess how different instrument settings affect detectable droplet spread and patterns of aerosolised droplet spread during simulated sinonasal surgery in order to identify mitigation strategies. Design Simulation series using three‐dimensional (3‐D) printed sinonasal model. Fluorescein droplet spread was assessed following microdebriding and drilling of fluorescein‐soaked grapes and bones, respectively. Setting University dry lab. Participants 3‐D printed sinonasal model. Main outcome measures Patterns of aerosolised droplet spread. Results and Conclusion There were no observed fluorescein droplets or splatter in the measured surgical field after microdebridement of nasal polyps at aspecific irrigation rate and suction pressure. Activation of the microdebrider in the presence of excess fluid in the nasal cavity (reduced or blocked suction pressure, excessive irrigation fluid or bleeding) resulted in detectable droplet spread. Drilling with either coarse diamond or cutting burs resulted in detectable droplets and greater spread was observed when drilling within the anterior nasal cavity. High‐speed drilling is a high‐risk AGP but the addition of suction using a third hand technique reduces detectable droplet spread outside the nasal cavity. Using the instrument outside the nasal cavity inadvertently, or when unblocking, produces greater droplet spread and requires more caution.

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Pustular eruptions in a neonate are mostly benign, but several are serious and have infectious aetiology. A detailed history, complete physical examination and careful assessment of the lesions are essential for diagnosis. The need to investigate every neonate with pustules for an infectious aetiology is emphasised. This case of generalised pustulosis in a neonate is reported as it is an uncommon presentation of Staphylococcus aureus infection, diagnostic difficulty caused by atypical skin lesions and similarity of clinical features with other causes of neonatal pustular diseases.

Dysventilation in the middle ear is thought to be important in the pathogenesis of chronic otitis media and its sequelae, but there is limited understanding of cause of the ventilator disorders.The mechanics responsible for regulation of the normal middle ear pressure are similar to pulmonary physiology both being mucosa lined air filled cavities. Stalwarts like JocobSadé and Charles Bluestone were amongst the first to use the analogy. This study discusses the Pulmonary Model to explain physiology and pathology of the middle ear cleft. It is concluded that the middle ear is a very similar to the pulmonary system, and that this can be a effective teaching tool. The implications of findings in the physiology and pathophysiology of the ear are discussed.

Objective: To study the surgical outcomes between power assisted and conventional curettage adenoidectomy.And to perform retrospective analysis by comparing the two surgical methods on the basis of duration of surgery, intra-operative blood loss, postoperative complications like bleeding and associated trauma. Design: A retrospective and prospective study of 100 cases was performed in a tertiary care teaching hospital in Mumbai. Over 1 year and 8 months. The mean operative time was faster in conventional method (p<0.0001). Subjects: 100 cases. Methods: After selection of cases retrospective assessment of peri-operative conditions were obtained from case records duration of surgery, Intraoperative blood loss, Postoperative complications. The same cases were called for prospective analysis data on long-term postoperative outcome was obtained by using 'Paediatric Throat Disorders Outcome Test' Result: Our 100 patients ranged from 4 to 27 years with mean age of 10.43 years with SD of 4.24 F : M ratio was 1.17. The operative blood loss between two groups was not statistically significant (p=0.4901). The symptomatic relief after conventional surgery and power assisted method was statistically significant (p < 0.0001). There was no statistical significance between outcomes of both methods. Conclusions: Our study shows that the power assisted adenoidectomy was a safe, well tolerated procedure and an useful tool for adenoidectomy with disadvantages of high cost. Conventional adenoidectomy with a curette is safe, fast and economical. It fails to obtain complete tissue removal and thus is less effective than the power assisted techniques.