Brain abscess is the ultimate otogenic complication, both in severity and difficulty of management. In developing countries with high incidence of cholesteatoma, brain abscess is not a rare complication. In India, brain abscesses constitute about 8 % of all intracranial lesions. The surgical treatment of brain abscess is very controversial. This prospective study was done in ENT department of a tertiary care hospital in Kolkata, during the period from May 2009 to April 2014. 22 such cases of otogenic brain abscess managed by single-stage trans-mastoid drainage along with meticulous mastoid clearance. On the basis of clinical, radiological and operative findings, data of all patients with otogenic brain abscess were analyzed. There was male predominance and 9 (40.91 %) of them were younger than 20 years. 15 (68.18 %) cases were of cerebellar abscess and in 7 (31.82 %) cases were of the temporal abscess. Lateral sinus thrombosis was the most common associated complication found (22.73 %) in our study. All the patients peri-operatively revealed cholesteatoma. All the patients recovered well and there was no recurrence of symptoms on a minimum 15 months followup. This approach suits the otologists in clearing the cause and effect of pathology, at the same sitting. This singlestage approach decreases the peri-operative morbidity and mortality of the two-stage procedure. It also decreases the hospital stay and financial burden.

Introduction Traumatic retropharyngeal hematoma is rare, but can be lethal, if not identified and managed promptly. It isclinically important because of the close proximity of the retropharyngeal space to the upper airway. Case report A case of upper airway obstruction in a 75 year old man due to a large retropharyngeal hematoma following minor injury to neckis presented.Progressive dysphagia, hoarseness and dyspnoea developed over time. Emergency tracheostomy and subsequent surgical drainage was performed. Conclusion Retropharyngeal hematoma is a rare but potentially lethal problem that can be faced in an emergency department. Clinicians should be alert to the potential occurrence of this cause of acute or delayed airway collapse. Thus, an awareness of the possibility of airway obstruction secondary to massive hematoma formation after an asymptomatic interval is needed.

Reconstruction of nose is a very challenging task. It has been practiced since ancient ages. Since, then various techniques have evolved. We have used forehead and nasolabial advancement flap for reconstruction of skin defect over iliac crest bone or conchal cartilage grafts. In small gap we used composite graft from pinna. In this article we share our experience with various grafts and flaps, their success and failures and methods to avoid or treat them.

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