Objective: To evaluate the clinical outcome of scutumplasty in the treatment of limited attic cholesteatoma. Materials and Method: A prospective interventional study was performed in 30 patients with limited attic cholesteatoma who underwent scutumplasty. The status of the reconstructed scutum was assessed at postoperative 1 st , 3 rd , 6 th month. Pre operative and post operative hearing results were recorded by pure tone audiometry and compared at 3 rd and 6 th month. Results: Out of thirty patients who underwent scutumplasty, two developed retraction pocket and one developed recurrence of cholesteatoma. There was a statistically significant reduction in the Air Bone Gap in the post operative period with p<0.05. Conclusion: Attic reconstruction with cartilage prevents future retraction and recurrence of cholesteatoma. It could also improve the hearing postoperatively but it depends on the ossicular status and the type of tympanoplasty that was done. Scutumplasty can be used successfully in the treatment of limited attic cholesteatoma cases.

Objective: The effect on patient anxiety of lidocaine infiltration into nasal packing following septoplasty was investigated by this prospective, case- control study. Methods: 60 patients, who underwent septoplasty operation with bilateral merocele nasal packing were included in this study. Nasal packs were infiltrated with 0.9% saline (5 mL in each nostril) for 30 patients and remaining 30 were infiltrated with 2% xylocaine (5 mL in each nostril), 15 minutes before nasal pack removal. Patient anxiety levels were measured at various time points i.e. 24 hours pre-operatively, 48 hours post operatively, 30 minutes after pack removal. Patients marked their level of pain on a visual analogue scale during pack removal. Results: Hamilton Anxiety Scale scores for saline infiltration patients were found to be (Mean ± SD) 12.3 ± 5.35, 16.23 ± 5.12 and 14.23 ± 4.55 for 24 hours pre-operatively, 48 hours post operatively, 30 minutes after pack removal respectively. The respective scores for lidocaine infiltration patients were: 13.83 ± 4.46, 17.07 ± 3.98 and 11.7 ± 3.52. at 24 hours before surgery, 48 hours after surgery and 30 minutes after pack removal. The visual analogue scale pain score was 5.6 ± 0.89 for Saline study group and 7.13 ± 0.73 in the lidocaine study group. Conclusion: Patient pain was significantly reduced following infiltration of lidocaine into nasal packing. Patients developed mild to moderate anxiety before nasal packing removal. Use of techniques without nasal packing like soluble packs or quilting methods after septoplasty for patient comfort can be recommended after septoplasty to ease patient post-operative discomfort.

Objectives To evaluate the anatomical and audiological outcomes of synchronous ossiculoplasty with ossicular replacement prosthesis during canal wall down mastoidectomy for advanced cholesteatoma. Methods The prospective study was done at a tertiary referral institute included 30 patients of cholesteatoma who underwent canal wall down mastoidectomy. Ossicular reconstruction was performed using polytetrafluoroethylene (PTFE) (teflon) partial or total ossicular replacement prosthesis. Patients were assessed at 1st, 3rd and 6th postoperative months for graft uptake and hearing evaluation using pure tone audiometry (PTA) in which air bone gap (ABG) closure and mean ABG was calculated and compared with the mean preoperative ABG. Results The mean ABG [both total occicular replacement prosthesis (TORP) and partial occicular replacement prosthesis (PORP) groups combined] considerably reduced from 34.33 ± 4.10 dB preoperatively to 15.47 ± 7.65 dB postoperatively at 6 months. There was a 46.29% of closure of ABG in 1st month, which closed more (53.89%) in 3rd month and even more (55.34%) in 6th postoperative month. p < 0.001 showed the ABG closure ratio and reduction in the mean ABG was statistically significant in the postoperative period. Conclusion Ossicular reconstruction with ossicular replacement prosthesis offers good functional results when performed during canal wall down surgery for advanced cholesteatoma, as a single-stage procedure. How to cite this article Shareef M, Motwani G, Verma D, Malik NUD, Choudhary SR. Synchronous Ossiculoplasty with Ossicular Replacement Prosthesis during Canal Wall Down Mastoidectomy for Advanced Cholesteatoma: Anatomical and Audiological Outcomes. Int J Otorhinolaryngol Clin 2015;7(3):109-113.

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