In monitoring patients for drug-induced hearing loss, most audiometric evaluations are limited to the range of frequencies from 0.25 to 8 kHz. However, such testing would fail to detect ototoxicity in patients who have already experienced hearing loss in the ultrahigh frequencies from 10 to 20 kHz. Awareness of ultrahigh-frequency ototoxicity could lead to changes in a drug regimen to prevent further damage. We conducted a prospective study of 105 patients who were receiving a potentially ototoxic drug-either gentamicin, amikacin, or cisplatin-to assess the value of ultrahigh-frequency audiometry in detecting systemic drug-induced hearing loss. We found that expanding audiometry into the ultrahigh-frequency range led to the detection of a substantial number of cases of hearing loss that would have otherwise been missed.

Objectives: To assess the reliability of paper-patch test in predicting the intra-operative ossicular status of patients with tympanic th membrane perforation from small to medium size. Methods: This is a hospital based prospective study conducted from 30 April, st 2016 to 1 May, 2017 in the Department of Otorhinolaryngology of Nepalgunj Medical College Teaching Hospital. The patients of chronic otitis media with small to medium sized central perforation were subjected to complete history taking and thorough examination. Audiological evaluation was done before patching, then after patching the perforation with cigarette paper. The result was recorded to predict the ossicular status. Result: The most common age group affected by the disease was 20-30 years with 21(42%) patients. Most of them were females 28(56%). Left ear was affected more 19(38%) than right ear 16(32%) and bilateral 15(30%). All the patients had conductive type of hearing loss out of which moderate degree of hearing loss was present in 36(72%) and mild degree of hearing was present in 14(28%). Following patch test, the hearing improved and in 7(14%) of patients the hearing came to normalcy. Majority of patients had mild degree of hearing loss, i.e., 36(72%) and moderate degree of hearing loss was seen in 7(14%). It was found that in those patients in whom there was less improvement in hearing that i.e. less than 10 dB, the mobility of the ossicles was restricted intra-operatively. Conclusion: The type of hearing loss was conductive hearing loss out of which most common was moderate degree of hearing loss in 36(72%) followed by mild degree of hearing present in 14(28%). Following patch test, it was found that in those patients in whom there was less improvement in hearing i.e., less than 10 dB,ossicular discontinuity was noted intra-operatively and thus ossicular reconstruction by tympanoplasty procedures had to be undertaken.

Objective To identify the side of vestibular dominance in right handed & left handed people. Method A total of 50 normal subjects, aged between 15 - 45 years were included as Left handers (n = 25) and Right handers (n = 25). Handedness was confirmed by the Annett Hand Preference Questionnaire. Bithermal caloric testing was done which was recorded by Electronystagmography (ENG). Maximum Slow Phase Velocity (MSPV) was taken as the parameter of choice. Directional Preponderance (DP) and Canal Paresis (CP) were calculated in each group. Results Out of the 25 Left handed subjects, 8 had DP towards Left whereas 7 had DP towards the Right and the remaining 10 showed no DP to any side (normal) (p<0.001). Out of the 25 Right handed subjects, 4 had DP towards Right and none had DP towards the Left, remaining 21 showed no DP to any side (normal) (p<0.001). For CP, out of 25 Left handed subjects, 2 showed CP towards the Left and 1 towards the Right, the remaining 22 showed no CP (normal) at all. Similarly out of the 25 Right handed subjects, 2 showed CP towards the Left and 1 towards the Right, the remaining 22 showed no CP (normal) at all. Out of 25 Right handers, it was found that Right handers showed Right vestibular preference whereas vestibular preference was almost equally distributed to Left and Right side in Left handers. Conclusion On considering DP, it was found that Right handers showed Right vestibular preference whereas vestibular preference was almost equally distributed toLeft and Right side in Left handers (p<0.001).

Introduction: Hearing impairment is the most common congenital abnormality that occurs in 1 to 4/1000 newborns. It has a profound effect on their optimal development of language, speech and cognitive skill. Early detection in order to achieve effective treatment is essential. An association between low birth weight and hearing loss is commonly associated with multiple risk factors that can alter hearing in a synergistic fashion. Universal neonatal hearing screening programs have become widely implemented aiming for the screening, confirmation of the diagnosis and intervention by 1, 3 and 6 months respectively. Transient Evoked Otoacoustic emissions is one of the test found to be a quick, objective, non-invasive, accurate and easy test for early detection of this problem.   Aims: Early detection of hearing loss in neonates focusing on low birth weight for early optimum rehabilitation. Methods: A comparative case control study conducted in 100 neonates under 2 groups. 50 neonates with low birth weight and 50 with normal birth weight who were born at NGMCTH, Kohalpur. Their hearing evaluation was done with Transient Evoked Oto Acoustic Emission (TEOAE). Results: The total referral rate was 12 % and pass rate was 88 %. The referral rate in LBW group was 20 % and 4 % in normal weight neonates. The pass rate in low birth weight was 80 % and 96 % in normal weight babies. Conclusion: Hearing impairment is a severe consequence in neonates with low birth weight. To decrease the economic and social burden of effects of hearing loss, it is assumed that newborn screening can immeasurably improve the future of newborn with early rehabilitation.