Serum Antistreptolysin O (ASO) titre is raised when there is infection of any organ of the body, by Group A beta haemolytic streptococci (GABHS), Group C or Group G streptococci [1]. Increased serum ASO titre should not be the only deciding criterion for tonsillectomy if GABHS is not present in the palatine tonsils. In this study, we evaluate the rationality of performing tonsillectomy in raised serum ASO titre only, in absence of GABHS in palatine tonsil. The study was designed as a prospective cohort study in which the main out come measure is to find out: The main outcome measure is to find out whether only the raised serum ASO titre is to be considered to perform tonsillectomy or not. Fifty consecutive patients (both children and adults) clinically diagnosed to have chronic tonsillitis were included in this prospective cohort study. Throat swab culture, tonsilar core tissue culture and Serum ASO titre tests were performed in all the patients. The results showed that out of the 50 patients 45 had raised ASO titre and 5 patients had normal ASO titre. GABHS was found in 5 cases (10 %) in throat swab culture and 8 cases (16 %) in FNA of tonsil core culture. The sensitivity of throat swab culture as compared to FNA Tonsil core culture was 62.5 % and positive predictive value was 100 %. The sensitivity of ASO titre as compared to core culture was 100 % and positive predictive value was 17.8 %. Specificity was only 12 %. From the results of this study, it is evident that FNA culture of the tonsil core is a valid and a reliable test for the diagnosis of bacterial micro flora in recurrent tonsillitis. One should perform throat swab culture and FNA culture from tonsil core along with ASO titre before doing tonsillectomy in absence of any other indications. Identifying GABHS in the tonsil by FNA test and/or in the throat swab culture along with high serum ASO titre may be one of the ideal indications for tonsillectomy.

Introduction Otitis media with effusion (OME) is a multifactorial disease and the treatment options for it are limited and controversial. The aim of the present study was to compare the efficacy of intratympanic steroid injection and conventional medical treatment  in resistant cases of OME with hearing loss. Materials and Methods A comparative study was conducted among 20 patients of OME with hearing loss, resistant to conventional medical treatment between December 2019 to November 2020. ‘Intratympanic dexamethasone injection’ (ITDI) was given every week for 3 consecutive weeks to one group and the other group continued to receive medical treatment. Hearing was assessed by performing pure tone audiogram before every ITDI and also at 12 weeks follow up after completion of treatment. Results Hearing improvement was found to be better in the group which received ITDI (Mean AC-PTA hearing gain = 22.88 dB) than the group where conventional medical treatment was continued (Mean AC-PTA hearing gain = 6.83 dB). Conclusion Intratympanic dexamethasone injection has significantly better outcome in term of improvement of hearing loss in resistant cases of OME than conventional medical management, and is an effective and safe therapy.

<p class="abstract"><strong>Background:</strong> The aim of the study was to establish the usefulness of preservation of the stapedius tendon and the incudo-stapedial joint during the surgical procedure for the treatment of otosclerosis, to find out the advantages of neo-stapedotomy over standard stapedotomy and to compare the hearing improvement in neo-stapedotomy and stapedotomy.</p><p class="abstract"><strong>Methods:</strong> A prospective, randomised, controlled study with a sample size of 150 patients (ears) presented with pure conductive deafness, paracusis willisii and tinnitus was done. The patients were divided in to group A (n=60) &amp;and group B (n=90), where neo-stapedotomy and standard stapedotomy procedure were performed respectively. Pure tone audiometry and tympanometry were done both pre and postoperatively. Speech discrimination score (SDS) and loudness discomfort levels (LDL) were measured at 3 months postoperatively.   </p><p class="abstract"><strong>Results:</strong> Postoperative hearing improvement in both groups was almost identical. Improvement in middle ear compliance was marginally more in group A patients. Stapedial reflex could be elicited in 72 % of the patients in group A, but remained absent in group B, at 3 month post-operatively. The SDS became worse with more than 20 dB suprathreshold sounds in group B patients whereas it was maintained even with 80 dB in most patients of group A. Post-operative mean LDL for both pure tone and speech frequency in group A patients were higher than those in group B.  </p><p class="abstract"><strong>Conclusions:</strong> The difference of SDS and LDL between two groups were statistically significant. Hence, neo-stapedotomy is a better procedure, as no postoperative pseudo-recruitment ‘rollover’ observed and also dynamic range of hearing increased.</p>