Introduction: Functional endoscopic sinus surgery (FESS)has become most preferred  procedure in treatment of diseases of the nose and paranasal sinuses.The purpose of this study is todiscuss the incidence of skull base injury during surgery and radiologically analyse the depth of the olfactory fossa and the length of the lateral lamella in a CT PNS scan using the Keros classification, to determine the age and gender distribution, and to discuss its significance in surgical practice. Methodology: The is a retrospective study which was conducted among 200 patients above 10 years of age who visited ENT department in the past one year and had undergone CT PNS scan in radiology in VMKVMCH, Salem for sinusitis, headache, sinonasal polyposis and deviated nasal septum and those undergoing surgery. Scans of patients with previous history of surgery or trauma to nose and PNS and congenital anomalies of face were excluded. The results correlated with surgical relevance in FESS. Results: There were about 17% in Keros classification I, 78% Keros classification II and 6% Keros classification III.

Aims and objectives:  Tympanic membrane retraction occurs due to inadequate ventilation of middle ear cavity. The aim is to evaluate the surgical management of TM retractionits effectiveness and analyse the hearing improvement after surgery. Materials and methods: A retrospective study with 100 patients came to ENT OPD vmkvmch Salem in last 2 years with symptoms of hard of hearing, ear ache, ear block sensation. These patients underwent necessary ENT examination, diagnosed as TMwere selected for study and surgery done for these cases depending upon the grades of TM retraction which included Grommet insertion, Cartilage Tympanoplasty, Cortical Mastoidectomy + cartilage tympanoplasty. They were followed up for1, 3 and 6 months post operatively and evaluated based on hearing assessment after surgery and successful graft uptake. Results: Surgical interventionwas donedepending upon the stage of retraction.  Grommet insertion done in stage 1, cartilage tympanoplasty in stage 2whereas stage 3 cortical mastoidectomy +cartilage tympanoplasty done. Hearing improvement seen after 1 month 76%,3 and 6months is 84% and 96%. The success rate in stage 1 retraction is 90 %, stage 2 84% and stage 3 81%.