Chronic Suppurative Otitis Media (CSOM) is a chronic inflammation of middle ear cleft. It presents with discharging ear and decreased hearing. The diagnosis is mostly on clinical examination with otoscope or oto endoscope. Computerised Tomography (CT) of mastoids is done to evaluate the extent of the disease and its complication. High resolution CT is now the investigation of choice for temporal bone disease. This study emphasizes on the importance of CT scan in diagnosis of inflammatory ear diseases and most importantly identifying pitfalls or complications which a surgeon can come across during surgery. The aims and objectives of this study is (1) to establish the efficacy of CT in the diagnosis of the complications and surgical management of chronic inflammatory pathologies of middle ear. (2) To find subgroups of CSOM where CT is particularly useful. In this series, a total of 25 cases presenting to our OPD at Govt. ENT Hospital between 2013 and 2014 have been diagnosed and findings of surgery correlated with HRCT scan of temporal bones done preoperatively. In this study, 64 % of the patients were male and incidence of CSOM with patients undergoing surgery belonged to the age group 21-30 years (32 %). The most common presenting symptom was ear discharge (92 %) and decreased hearing (96 %). The most common type of pathology in this study was attic perforation (36 %) and granulations (40 %) followed by cholesteatoma (36 %) and mucosal edema (16 %). Not all cases presented with complications, facial palsy (12 %) and mastoid abscess (8 %) were among few complications seen. 14 patients (56 %) of 25 cases underwent simple cortical mastoidectomy followed by 9 cases (36 %) for modified radical mastoidectomy and atticotomy for 2 cases (8 %). CT scan findings correlated well with surgical findings for cholesteatoma, middle ear mass and bone erosions. Where as for ossicular integrity and facial canal dehiscence, there was a discrepancy.

Laryngoceles are rare, cystic dilatation of saccule of ventricle of larynx. Three types are recognized -internal, external and mixed types. Many of the laryngoceles are asymptomatic; few require surgical excision via internal/endoscopic or external approach. Contrast CT is the investigation of choice. A 40year old male presented to our OPD with a neck Scar, later diagnosed as laryngocele. Here is the case report about presentation, diagnosis and management of a large mixed layngocele.

BACKGROUND The approach to patients with chronic rhinosinusitis has been changed with arrival of endoscopic functional surgery of paranasal sinuses and nasal cavity. Computed tomography has become indispensable to surgical planning since it allows a detailed study of the whole structure of this region. Paranasal sinuses and nasal cavity anatomical variants are usual findings with estimated prevalence of 65% on CT scans. Concha bullosa is a result of pneumatisation of the osseous plate of the middle turbinate due to ethmoidal extension is one of the commonest variant. It may occur at several degrees from that affecting only the bulbous portion (distal) or lamellar portion (proximal) or true variation where there is pneumatisation of both portions. It has been postulated that the enlarged middle turbinate has a negative influence on sinus ventilation and mucociliary clearance in ostiomeatal unit. Objective of the study is: 1. To estimate incidence of concha bullosa, its types, laterality and pathology within. 2. To evaluate contribution of concha bullosa in pathogenesis of inflammatory sinus disease. 3. To estimate incidence of associated anatomical variations. MATERIALS AND METHODS Study included 100 patients from Department of ENT, Gandhi hospital, Secunderabad. 50 patients with sinusitis who underwent endoscopic sinus surgery were included into study group. 50 patients who had nonsinogenic pain were included into control group. CT scan and endoscopic preoperative findings were noted and evaluated using Fisher test. RESULTS AND CONCLUSIONS This study showed incidence of concha bullosa as 43% with male preponderance and higher incidence among middle aged (20-40 years). Intralamellar type of concha bullosa was commonest in the study. Right laterality was commonly seen among concha bullosa patients. Absence of inferior turbinate hypertrophy was strongly associated with presence of concha bullosa. Maxillary and ethmoid sinusitis were the associated sinus inflammation noticed in the study. Study also showed low recurrence rate in patients who underwent conchoplasty.

Thyroglossal cyst is a commonly encountered clinical entity resulting due to persistence of Thyroglossal duct and transformation of few embryonic cells into a cyst. It is more common in the supra-hyoid portion of the midline of the neck. The incidence of malignant change in the Thyroglossal cyst is reported as between 1 to 1.8 percent. Papillary carcinoma is common and seen in nearly 80 percent of the cases of the Thyroglossal cysts. Surgical excision with Sistrunk operation is the standard treatment of choice followed by subtotal or total thyroidectomy whenever indicated. CASE PRESENTATION: A female patient aged 31 years presented with swelling in supra-Hyoid region of the neck. FNAC confirmed Thyroglossal cyst; Histopathology showed de novo papillary carcinoma of thyroid. DISCUSSION: windstorm criteria were used to confirm the diagnosis. Post-operative care was taken to exclude primary in the Thyroid gland. CONCLUSIOINS: Primary Malignancy in the Thyroglossal cyst is a rare entity. It is presented here for its presentation as there was no other malignant focus in the Thyroid gland. Thorough work up is necessary to rule out occult primary.

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