The present study was conducted prospectively to evaluate how accurately high resolution computed tomography scanning could define the extent and severity of the underlying disease in patients with chronic suppurative ear disease, thus, helping convert a surgical exploration into a planned procedure. Sixty adult consecutive cases of chronic suppurative otitis media underwent a detailed high resolution computed tomography by a single radiologist. The recorded radiological findings in various heads were then compared to the surgical findings during mastoid exploration of these patients by a single otologist and the two statistically compared. The presence and distribution of soft tissue in the middle ear cleft and mastoid could confidently be predicted using this modality. The malleus, body and short process of incus were well visualized, but not the long process of incus and the stapes suprastructure. Lateral semicircular canal fistulae could be demonstrated with an acceptable degree of accuracy. It was possible to detect facial nerve dehiscence and defects in tegmen tympani in significant number of cases although, statistical values were low for these structures. High resolution scanning is a modality which can accurately image the pathological anatomy in unsafe chronic suppurative otitis media. Otologists should use it more often, especially in complicated cases as an adjunct to better preoperative assessment, and thus, the surgical outcome. Its accuracy is likely to improve with larger studies and better experience, wherein its routine use may become justifiable.

This randomized double blind study was conducted prospectively to determine whether coblation tonsillectomy fared better than the conventional dissection method in terms of postoperative pain, bleeding, and rapidity of healing in adult Indian patients undergoing tonsillectomy. Sixty adult patients undergoing tonsillectomy for benign indications were randomized to have one tonsil removed by subcapsular radiofrequency ablation method and the other by conventional dissection method. The operative time and blood loss was noted for each side.Patients were evaluated at 6, 12, 24, 48, 72 h and then on 7th and 20th postoperative day for postoperative pain (by visual analog scale), bleeding, and tonsillar fossa healing. Statistical comparison was done using appropriate tests. The two groups were demographically matched. It took longer to perform the coblation procedure (15 vs 11 min) (P [ 0.05). The operative blood loss on the radiofrequency side was 11 ml, vs 34 ml on the conventional side (P = 0.009). 77% patients said that the coblation side was less painful for the overall 20-day recovery period. There were significant differences seen at 6, 12, 24, 48, and 72 h in terms of postoperative pain scores. Beyond that, the pain was consistently less on the coblation side, but the difference was not significant. There was no case of reactionary or secondary hemorrhage in either arm. The healing took longer on the radiofrequency side. Coblation tonsillectomy is an easy to learn technique with significantly reduced operative blood loss and postoperative pain. Longer operative times maybe further reduced with experience.

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Background: Multilevel surgical techniques are important in the treatment of obstructive sleep apnoea especially when the patient is non-compliant to Continuous Positive Airway Pressure therapy (CPAP). A modified pharyngoplasty technique is described in OSA patients where the major cause of upper airway obstruction was due to concentric collapse of velopharynx. Methods: Twenty four patients with evidence of OSA on polysomnography were included. In all patients the major cause of obstruction was due to concentric collapse of velopharynx as evidenced on Muller Maneuver (MM) and Drug Induced Sleep Endoscopy (DISE). All had non-adherence to (CPAP) therapy and underwent Barbed Palato Pharyngoplasty (BPP) for correction of concentric collapse of velum. Apnoea-Hypopnoea Index (AHI), Lowest Oxygen Saturation (L-sat), Epworth Sleepiness Score (ESS), Visual Analog Score (VAS) for snoring were assessed both pre-operatively and six months post-operatively. All patients underwent awake flexible nasopharyngoscopy with MM to assess the site and score the severity of obstruction before and six months after surgery. Results: Post-operative flexible nasopharyngoscopy with Muller Maneuver revealed absence of collapse of velum in eleven patients, 25% collapse in 10 and 50% collapse in 3 patients. Post-operatively, significant reduction of mean values were observed in AHI, ESS, VAS for snoring from 32.04 to 15.27, 12.75 to 4.54 and from 7.17 to 2.54 respectively. The mean L-sat improved from 74.44 to 86.04. There were no major surgical complications. Conclusion: BPP is a minimally invasive knotless technique and is best suited in OSA, where the major obstruction is due to concentric collapse of the velum.

Introduction: Pterygium is ocular surface lesion thought to originate from damage to limbal stem cells by chronic ultra violet light exposure. It has high recurrence rates following resection. Both amniotic membrane and conjunctival autograft are source of stem cells. We compare recurrence after pterygium excision with conjunctival autografting and amniotic membrane grafting. Methods: Prospective case study of seventy patients after pterygium excision with Amniotic membrane transplantation or Conjunctival autografting. Thirty five patients divided in each group and fibrin glue used for both Amniotic membrane transplantation and Conjunctival autografting. Results: Six follow up from first postoperative day to one year were done in each group. Group A (Amniotic membrane transplantation) had less Post operative complaints. In group A, all patients have well placed graft while in group B (conjunctival autografting) nine patients have graft displacement on first post operative day. It was statistically significant (p value 0.001). The recurrence occurring four patients in group A (11.42%) while in 7 patients in group B (20%). The recurrence was more in group B although it was statistically insignificant (p value <0.511). Amniotic membrane transplantation with fibrin glue having less postoperative complaints, better graft stability and less recurrence as compare to conjunctival autografting. Conclusion: Our study shows good outcome with Amniotic membrane transplantation. Probably this is because of antiinflammatory property of amniotic membrane, minimum surgical trauma and uniform thickness of graft.