Objective: To compare the conventional surgical turbinoplasty versus microdebrider assisted turbinoplasty in cases of inferior turbinate hypertrophy. Design of the Study: It was a cross-sectional survey. Place and Duration of Study: This study was carried at the Department of ENT Nishtar Medical University and Hospital, Multan from January 2022 to June 2022. Patients and Methods: Patients with hypertrophy of the inferior turbinates, the most common cause of nasal obstruction, were split into two groups of 30. The size of the inferior turbinates was classified as Grade I if they took up less than a third of the nasal cavity, Grade II if they took up more than a third but less than half, and Grade III if they took up more than half. Each group had either a standard partial inferior turbinectomy or a turbinoplasty with the help of a microdebrider. Visual evaluation was used to categorise blood loss during and after surgery. Patients were checked on at 1, 2, 4, and 6 months after surgery. Relief from symptoms and the occurrence of problems such crusting and synechiae formation were evaluated. Results of the Study: Both groups showed comparable significant improvements in nasal blockage. Most patients in the CPIT group experienced intraoperative blood loss of grade II (66.66%) or grade III (10%). When the packs were taken off, 60% of patients experienced grade I blood loss, 36.66% experienced grade II blood loss, and 3% experienced grade III blood loss after surgery. Most patients (46%) and surgeons (40%) in the MAT group experienced grade II or higher intraoperative blood loss. The majority of patients' postoperative blood loss was classified as grade I. Six months later, 6.66 percent of the CPIT group had acquired crusting, and 6.66 percent had developed synechiae. Those that received MAT did not have these problems. Practical implication: The choice of surgical procedure is up to the surgeon's attitude and experience due to the lack of agreement regarding their efficacy. That’s why we compared the effectiveness of these treatment methods for turbinate reduction in order to provide evidence to evaluate the results of the several surgical techniques in local population. Conclusion: According to the findings, both surgical approaches are effective in addressing nasal blockage. Complications are less likely to occur with microdebrider-assisted inferior turbinoplasty since the mucosa and nasal physiology are preserved. Keywords: Microdebrider assisted inferior turbinoplasty, Hypertrophied inferior turbinate, Conventional partial inferior turbinectomy,

Objective: The objective of this study was to compare transseptal suture and anterior nasal packing after septoplasty in terms of frequency of postoperative crusting. Design: It’s a randomized controlled trial. Study Settings: Research was conducted at Department of ENT and Head & Neck Surgery Abbas Institute of Medical Sciences (AIMS) Muzaffarabad, Azad Kashmir for a period of six months from 26/5/2020 to 25/11/2020. Patients and Methods: This study involved 132 patients of both the genders undergoing septoplasty for deviated nasal septum. These patients were randomly divided into two groups. Patients in Group-A were treated with transseptal suturing of mucoperichondrial flaps while patients in Group-B were treated with anterior nasal packing. A written informed consent was obtained from every patient. Results: The mean age of patients was 28.44±6.16 years in the range of 18 years to 40 years. The study group had 53 (40.2%) female and 79 (59.8%) male with a female to male ratio of 1:1.5. In terms of gender distribution and mean age both the groups were comparable (p-value=0.859 and 0.978 respectively). In patients treated with transseptal suturing, the frequency of post-operative nasal crusting was significantly lower (4.5% vs. 27.3%; p=0.000) as compared to anterior nasal packing. This difference was observed across all age and gender groups. Conclusion: This study has reported transseptal suturing to be better than anterior nasal packing in terms of significantly lower frequency of post-operative nasal crusting regardless of patient’s age and gender in patients undergoing septoplasty for deviated nasal septum. The results of this study thus advocate the use of transseptal suturing in future practice. Keywords: Deviated Nasal Septum, Septoplasty, Transseptal Suturing, Anterior Nasal Packing, Post-Operative Nasal Crusting

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Objective: The objective of this study was to compare the effectiveness of graft uptake by underlay and overlay technique in patients undergoing myringoplasty Design of the Study: It was a randomized controlled trial Study Settings: Research was conducted at Department of Otorhinolaryngology and Head and Neck surgery Holy Family Hospital, Rawalpindi from January 2021 to June 2021. Material and Methods: In this study, 80 patients underwent myringoplasty for tympanic perforation who were randomly divided into two groups. Patients ranged in age from 20 to 40 years old. Those in Group A had an underlay myringoplasty, while those in Group B had an overlay procedure. One of the study's outcome variables was the procedure's effectiveness, which was observed and compared among groups. Results of the Study: There were 1.2:1 men to women patients, with 44 (55.0%) men and 36 (45.0%) women. Patients who underwent underlay versus overlay myringoplasty had a considerably greater rate of hearing improvement (97.5 percent vs. 77.5 percent ; p=0.007) and a significantly lower rate of complications (5.0 percent vs. 32.5 percent ; p=0.002). Conclusion: Underlay myringoplasty was found to be much more successful than overlay myringoplasty in 95.0 percent of patients compared to 57.5 percent of patients who received overlay myringoplasty. Keywords: Underlay Myringoplasty, Overlay Myringoplasty, Tympanic Perforation, Graft,

Background: Benign positional paroxysmal vertigo (BPPV) is one of the most prevalent causes of dizziness, affecting between 11 and 64 people per 100,000 each year and 2.4% of the population overall. Vestibular suppressants have been shown in recent studies to be effective in reducing residual symptoms after a successful Epley’s maneuvers, however to the best of our knowledge, very few research have analyzed the features of residual symptoms in BPPV patients following Epley’s maneuvers. There has been no definitive research on what causes symptoms duration, canal involvement, cumulative successful ratee, residual symptoms and dysregulation are among possibilities put up to explain the phenomenon. Objective: This research focused on role of vestibular suppressants including B.histine, cinnarizine, and meclizine after successful Epley’s maneuvers in benign paroxysmal positional vertigo Study Design: Cross-sectional study Study Setting: The study was conducted at department of ENT CMH, Multan from 01 January 2022 to 30th October 2022. Methodology: Total 135 patients were divided into two groups. In group A 60 patients were taking vestibular suppressants and in group B 75 patients were not taking any drugs, both groups had successful Epley’s maneuvers in benign paroxysmal positional vertigo Patients were considered for inclusion if they had idiopathic BPPV. A single doctor made the BPPV diagnosis after examining a patient's history and doing a hall pike test. The patients' symptoms duration, canal, cumulative success rate and residual symptoms were measured immediately after treatment, and two weeks. The statistical analysis was done by using SPSS version 20. Results: In group A out of which 24 were taking B.histine, 26 were taking cinnarizine, and 25 were taking meclizine as vestibular suppressants. In group B, 75 participants after successful Epley’s maneuver were not taking any vestibular suppressants. In this study there is 29 males and 31 females in group A and 37 males and 38 females in group B. Interestingly, the success rate with one treatment cycle was higher in the group A (p = 0.001). Further analysis of outcomes showed the residual symptoms in patients with a short (≤4 days) symptom duration revealed a correlation with the successful Epley’s maneuver in group A. Practical Implication: Vestibular suppressants have been standard practice in most hospitals for the treatment of severe vertigo for decades. Vertigo caused by vestibular imbalance can be treated with vestibular suppressants. When Epley's Maneuvers have been performed successfully in patients with BPPV, the efficacy of Vestibular Suppressants (B.Histine, Cinnarizine, Meclizine) has not been conclusively established. So, their role must be studied. Conclusion: Finally, we found that patients who used anti-vestibular suppression medication following an Epley's technique for treating and controlling BPPV symptoms fared better than those who did not. We advise the Epley method for BPPV therapy with the maintenance of suppressants for the better management. Keywords: B.histine, cinnarizine, meclizine, Epley’s maneuvers, paroxysmal positional virtigo