AIM:To determine the hearing improvement in tympanoplasty by preoperative and postoperative audiometric evaluation after I month and 3 months and 6 months of tympanoplasty. MATERIALS & METHODS:50 Patients presenting having CSOM and presenting with complaints of deafness or ear discharge in ENT OPD at Basaveshwar Teaching and General Hospital, Gulbarga from 2012 to 2014. Pre-operative audiometry and appropriate investigation was done followed by tympanoplasty. Patient was followed up regularly with post-operative audiometry at 1 month, 3 month and 6 month. Assessment of hearing improvement was done by comparing preoperative and postoperative A-B gap at speech frequency. RESULTS: The number of patients who underwent Type l tympanoplasty was 26, Type II was 5, Type III was 6 and Type 4 was 1. They had a mean A-B gap closure of 10.3dB, 10.2dB, 9.33dB and 5dB respectively. When mastoidectomy was included as a part of the procedure the hearing improvement was comparatively lesser. The mean Air-Bone gap closure was 8.9dB.The mean A-B gap closure was 10.2 dB for temporalis fascia graft, 4dB for temporalis fascia with conchal cartilage and 9.2dB in case of autograft incus. The mean A-B gap closure of medium, large and subtotal perforation were 4.7, 11.7 and 6.6 respectively. The total success rate in terms of graft uptake rate was 88%. CONCLUSION: The study shows that A-B gap closure is greatest for Type I followed by Type II, Type III and Type IV in decreasing order. Tympanoplasty in which modified radical mastoidectomy was a part of the procedure did not give as much hearing improvement as otherwise. The grafting material also had significant bearing on the success of surgery. The Airborne gap closure is greatest for temporalis fascia graft than dura or autograft incus. Air-bone gap closure is also greater for temporalis fascia when used alone compared to when it is used along with conchal cartilage. Reperforation rates are higher when temporalis fascia is used alone compared to cases where reinforcement with cartilage is done showing greater graft stability in cartilage tympanoplasty.

Dysphonia plica ventricularis(DPV) is a type of functional dysphonia(FD) which can be caused by several reasons. DPV-emotional type is seen secondary to emotional crisis which is equivalent to psychogenic/dissociative dysphonia. Here we describe a case of DPV secondary to emotional dysregulation with an underlying emotionally unstable personality disorder. Crisis intervention and emphasis on regular compliance to treatment has been discussed.

Dissociative dysphonia is less commonly seen in general population. Previous literature has focussed on interplay of dysphonia mainly in schizophrenia or schizoaffective disorders. Here we discuss a unique case of delusional disorder with dissociative dysphonia. The challenges in the evaluation and management are discussed.

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Catatonia can have a mosaic of clinical presentations ranging from behavioural disturbances to neurological signs. Here we describe a case of depression presenting with catatonic signs and urinary retention. Challenges in the diagnosis and treatment have been discussed.