Ossicular necrosis and erosion is commonly seen in CSOM with cholesteatoma but can also occur in tubotympanic CSOM. This usually comes as a surprise during surgery. Preoperative knowledge of ossicular necrosis helps the surgeon to be better prepared for the surgery and ossicular construction if required. Hence, this study is intended to identify the pre-operative indicators of ossicular necrosis. This cross sectional study was conducted in Father Muller Medical College in Mangalore. Sixty nine consecutive patients with tubotympanic CSOM underwent a detailed clinical examination with pure tone audiometry and subsequently tympanoplasty with or without cortical mastoidectomy. All clinical findings, pure-tone audiometry, and intraoperative otomicroscopic observations were recorded. Incidence of ossicular necrosis was 23 %. The incus was most frequently eroded followed by malleus and then stapes. On bivariate analysis patients age above 30 years (p = 0.05), duration of CSOM more than 10 years (p = 0.02), presence of granulation (p \ 0.05), absence of tympanosclerosis (p = 0.01), moderately severe (45-60 dB) hearing loss (p = 0.01) and an air bone gap of more than 55.7 dB in the right ear and 63.95 dB in the left ear was found to be statistically significant (p \ 0.05). On multivariate analysis only presence of middle ear granulation tissue was found to be the significant predicator [(p = 0.005), OR 14.37, 95 % CI 2.26-90.0]. The presence of granulation tissue and a wide air bone gap on pure tone audiometry were the best indicators of ossicular necrosis. Preoperative identification of these indicators can help the surgeon to be better prepared for the surgery.

Prevalence of migraine is high among females. Younger age and female sex are other contributory factors as prevalence of migraine is higher in these groups. Degree of allergic sensitisation determines the severity and frequency of headaches in those whom allergic rhinitis is a risk factor as evidenced by higher levels of IgE.

IntroductIonBy tradition, the postaural incision is closed in two or three layers. The layers consisting of periosteum, soft-tissue, and skin, each layer being closed separately. It not only consumes more of suture material, but also plenty of surgeon's time, sometimes the time for suturing equals or exceeds the time taken for mastoidectomy or tympanoplasty. The postaural incision closure can also be done in a single layer. Here, only the soft tissues and skin are sutured in a single layer. It saves both time and suture material, thereby reducing the cost of surgery as well. We did a random search on the internet to find out the efficacy of either of the procedures and to our surprise did not find any. Hence this study was undertaken to study and compare the efficacy of closing the postaural incision in a single layer versus closing in multiple layers.Data was sourced from patients who attended the outpatient department of Otorhinolaryngology, Fr. Muller Medical College Hospital, and who were diagnosed to have chronic suppurative otitis media, either tubo-tympanic or attico-antral type.Background: By tradition, the postaural incision is closed in single or multiple layers. In this study single layer closure is compared with multiple layer closure. Materials and Methods: Two hundred patients with Chronic suppurative otitis media undergoing ear surgery by post aural approach at our department were included in the study. Results: It was observed that time taken for single layer closure was far less compared with time taken for multiple layer closure, which was of statistical significance. Conclusion: single layer closure is as effective as multiple layer closure of postaural incision, with the distinct advantages of reduced closure time and lesser cost of suture material.

OBJECTIVE OF THE STUDY:To study the efficacy of underlay tympanoplasty by elevating the annulus by 360 degrees. SUBJECTS AND METHODS: Two hundred patients with chronic otitis media, tubotympanic disease, inactive stage who underwent tympanoplasty by the above technique between the years 2009 to 2013 were selected for the study as and when they were admitted. All the patients were followed up for 6 months following surgery. Any complications like secondary infection, wound dehiscence, granulations, were looked for and treated appropriately. Status of the neotympanum was evaluated at the end of 3 months. Any anterior blunting, medialisation or lateralisation of the graft was noted. Any residual perforation was considered as failure. Hearing was evaluated in all patients with an intact neotympanum. RESULTS: Our study showed an overall success rate of 96% as far as graft uptake was concerned. Hearing improvement was seen in 93% of our patients. 6 patients had complete air bone gap closure, 49 had AB gap of 10db or less, 131 had AB gap of 11-20db. 14 patients had no improvement in hearing. Overall hearing improvement was seen in 93% of our patients. CONCLUSION: In conclusion 360 degree sub-annular tympanoplasty is a efficient technique of tympanoplasty with very good results.

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