<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>The purpose of this study was to evaluate the ethmoid roof on computerized tomography of nose and paranasal sinuses of Kashmiri people and distribute them on basis of KEROS classification.</p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>Cross sectional descriptive study, the randomly selected paranasal sinus computed tomography (PNS CT) scans coronal cuts .Total of One hundred PNS CT scans done at the SMHS Hospital from April 2015 to September 2015 were reviewed, and selected for study. The bilateral heights of the lateral lamellae of the cribriform plate were obtained, independently coded, and classified according to keros.</p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>The mean height of the lateral lamella among Kashmir’s was seen to be 5.08mm and 29% of patient’s CT PNS were classified as Keros I, 61% were classified as Keros II and 10% were classified as Keros III. There was significant difference in the distribution of Keros classification between the right and left lateral lamella. There was no significant difference in the height of the lateral lamella (t-test: p=0.98 on right side &amp; p =0.89 on left side) and the distribution of Keros classification (Fisher’s Exact test: p = 0.823) among younger (1-14 year) and older (&gt;14 year) Kashmiri age groups. There is significant difference in the height (t-test: p=0.03 on right side and p=0.03 on left side) and the distribution of Keros classification is statistically insignificant (Fishers Exact Test: p=0.11) between Kashmiri females and males.</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>Preoperative assessment of ethmoid roof anatomy and keros level is mandatory for alerting the surgeon of the potential iatrogenic injury during endoscopic sinus surgeries to minimize the grave complications during ESS.</p>

Thyroglossal cyst is the most common congenital neck mass and occurs in 7% of the population. They occur due to failure of thyroglossal duct to involute and atrophy thyroglossal duct cysts often occur in pediatric patients. Majority of them are found infrahyoid region. The purpose of the present study is to report our 5 year clinical experience of thyroglossal cysts in terms of clinical features and surgical findings with special emphasis on naked eye extend of patent thyroglossal duct when present. To the best of our knowledge this is first clinical study which has reported the extend of thyroglossal duct on naked eye. This prospective observational study was done in the Postgraduate Department of ENT, Head and Neck surgery of Government medical college, Srinagar for a period of five years from January 2011 to January 2016. Thirty patients of histopathologically confirmed thyroglossal cysts were enrolled in the study. Patients were initially diagnosed on the basis of clinical history, examination and USG findings suggestive of cyst. Clinical data and surgical data in terms of size and location of cyst, presence or absence of thyroglossal duct etc. was analyzed and formulated in tables for patients who had histopathologically confirmed cyst. Mean age was 10 years. Majority (73.3%) were less than 15 years of age. Males were 22 in number (73.3%) while females compromised 26.7% of population. Ninety percent of patients presented with neck swelling. Erythema/redness over swelling was seen in 13.3% of patients. Majority (83.3%) of cysts were subhyoid in location. Thyroglossal ducts were seen to be patent for different lengths and areas. Majority of patients (80%) had tract arising from cyst and disappearing at superior border of hyoid body while three patients (10%) had patent thyroglossal duct from cyst to vallecular mucosa. A complete patent thyroglossal duct was seen in one patient (3.3%) from cyst to base of tongue. Complete Absent tract was seen in two patients (6.7%). Majority (70%) of cysts were having size between 1.6 and 3 cm. Intraoperative 10% of cyst got ruptured. Thyroglossal cysts are most commonly seen in pediatric males. Most of them present with visible midline neck swelling. In few cases cyst can rupture after repeated infections leading to sinus formation. Most of them are subhyoid in location. These cysts are usually of size 1.5-3 cm. Complete patent thyroglossal duct from cyst to tongue musculature is rarely seen while most of the times, a patent duct just disappears at the superior border of body of hyoid. None of our cysts had malignant features.

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FBs get lodged in the right main bronchus. This is due to the fact that right main stem bronchus is in line with the trachea. [1] FBs are reported to be of different kinds and materials. These range from inorganic materials such as needles, nails, whistles, toy parts, and beads/rosary to organic substances such as groundnuts, maize seeds, water melon seeds, beans, variety of grains, and so on. This broad classification becomes important when considering obstruction to airflow, amount of mucosal reaction, inflammation/infection, and abscess formation akin to organic FBs in the tracheobronchial tree. On the other hand, inorganic FBs may cause total or partial obstruction, which may be tolerated for some time with mild signs and symptoms leading to the formation of granulation tissue after an interval of time. [2] The nature/type of FB and the site of arrest or impaction along the tracheobronchial tree decide the clinical course and outcome of inhaled FBs. TFBs can develop complications such as nonresolving pneumonia, hemoptysis, pulmonary atelectasis, bronchiectasis, and even deaths are reported. [3,4] Chest radiography and rigid bronchoscopy are commonly used in the diagnosis of foreign body aspiration (FBA). [5] Background: Foreign body aspiration (FBA) is a medical emergency in children. Delay in diagnosis and treatment can cause complications and even deaths are reported. Objective: The aim of this study was to find out clinical features and x-ray findings in patients with FBA. Materials and Methods: A retrospective analysis was done on all patients less than 15 years of age with the discharge diagnosis of FBA from 2011 to 2014 at SMHS Hospital in Kashmir province. Results: Out of 140 patients with FBA, 87 (62%) were male. The mean age was 48 months. The most common clinical findings were history of chocking (77%), decreased breath sounds (42%), wheezing (38%), cough (20%), respiratory distress (15.5%), and fever. CXR was normal in 46% of patients. Air trapping (emphysema) was the most common radiological finding (29.5%) followed by atelectasis (14%) and consolidations (9.2%) and opaque foreign bodies (5.7%). Gram seeds (pulses) were the commonest foreign body (40%). Bronchoscopic removal of foreign body was done successfully in 133 patients (95%). Conclusion: Although FBA in children diagnosed by history, physical examination and radiographic findings, but this finding may be misleading. Negative X-ray chest should not exclude the diagnosis of FBA in children especially with a strong history of FBA. Early bronchoscopic examination will be safe and lifesaving.

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