Introduction Tracheostomy is a life saving procedure and its operative principle has withstood the test of time although the operative techniques have evolved. Inferiorly based flap on the anterior tracheal wall (Bjork flap) was demonstrated in 1952. The present study aims to compare conventional tracheostomy with flap tracheostomy. Materials and Methods A Randomized Control Trial was conducted in a tertiary care teaching medical institute comparing conventionally tracheostomised patients (Group A) with the group where flap based method was followed (Group B). Results The study population was comprised of 110 patients with equitable distribution in the groups. Per-operative time to establish an airway was measured and statistically correlated. 9.26% patients of Group A had difficult tube change, with none in Group B. Ease of stomal care by the patient and family members (Visual Analogue Scale), depicted it to be “very easy” in 76.36% of the patients in Group B and 16.36% in Group A. Stomal healing in first week was proper in 61.82% of patients in Group A and 80% of the patients in Group B. Tracheo-cutaneous fistula (TCF) developed in 18.18% of the adult and geriatric patients of Group A undergoing stomal closure. None of the patients in Group B had TCF following stomal closure. Conclusion Establishing Bjork flap tracheostomy is equally quick making the process suited for emergency situations. Flap based tracheostomy has early stomal maturation so, care of the stoma by health assistants and family members is easy.

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Larynx is the second most common site for cancer in the upper aerodigestive tract. One of the dreaded complications following total laryngectomy has been pharyngo cutaneous fistula (PCF). PCF merits special attention due to its significant negative impact on the recovery process. Total laryngectomy profoundly alters speech. Effective voice restoration is essential for the rehabilitation of these patients. Inadequate consensus exists as to the best technique of pharyngeal repair to decrease incidence of PCF and ensure good quality voice following total laryngectomy. 21 patients were included in the study for total laryngectomy with trachea oesophageal voice prosthesis placement. Patients were randomised into 2 groups. Group A had their pharynx repaired in two layers and Group B had it done in three layers. Post operatively the patients were followed up for a period of 12 months to look for incidence of PCF. Subjective and objective evaluation of voice was done. 9.52% of patients developed PCF. All of the cases of PCF were in the group repaired in three layers. In cases with repair by two layers the mean Voice Handicap Index 10 (VHI 10) score was 19.27 and those with three layers pharyngeal repair was 23.20. Average maximum phonation time amongst the study population was 13.09. In three layers and two layers pharyngeal repair the average maximum phonation time was 12.56 and 13.58 respectively. Surgical repair of pharynx in two layers excluding the third layer of pharyngeal musculature reduces the chance of PCF. Two layers pharyngeal repair supplemented by cricopharyngeal myotomy led to significantly better voice outcome.

INTRODUCTION Congenital deafness in a child is often missed. Several distraction tests have evolved over time to diagnose congenital deafness. These are of limited value in the era of Evoked response audiometry. Evoked responses, such as Oto-acoustic emission (OAE) and Brainstem Evoked Response Audiometry (BERA) have played a significant role in early diagnosis of congenital hearing impairment. The study was conducted to compare the result of neonatal hearing screening in high risk and non high risk neonates.   MATERIALS AND METHODS A study was conducted over a time period of three months at a tertiary care institute to screen all live neonates for congenital hearing impairment using OAE and BERA.   RESULT 1182 neonates were screened for hearing impairment. 336 were in High risk group and rest in Non high risk group. Nine neonates turned out to have abnormal BERA result (absence of wave V). Six of them were high risk babies and rest 3 were non high risk.   DISCUSSION 33.33% of congenital deaf population detected by UNHS belong to the Non High Risk group. Studies across the world suggest at least 50% chance of missing out a congenital deaf child if Universal Neonatal Hearing Screening is not practiced.   CONCLUSION In order to ensure that early detection and effective intervention are made on all newborns with hearing impairment, UNHS should be performed. Three stage UNHS protocol using TEOAEs and BERA showed that the implementation of UNHS for congenital childhood hearing loss among all newborns in India feasible and effective.

Context Preauricular sinus (PAS) can lead to severe complications such as facial paralysis, and squamous cell carcinoma may develop from this sinus later in life. Asymptomatic sinus needs no intervention, but symptomatic sinus needs surgical interventions. Aims: This study compares the surgical outcome of microscope-assisted sinus tract excision technique with the supra-auricular sinectomy technique. Settings and Design: This was a retrospective, observational study conducted at a tertiary care hospital in Purulia District, West Bengal, India. Subjects and Methods: Records of patients operated on for PAS were included following the proper inclusion and exclusion criteria. These patients were categorized and followed up based on disease pathology and the type of intervention received. Statistical Analysis Used: Data were collected, tabulated, and analyzed using the standard statistical software. Results: Fifty-two patients were included in our study. About 48.07% of patients were found in the age group of 11–15 years. In the microscope-assisted sinectomy category, recurrence of the disease was seen in 2 out of 15 operated patients compared to 1 patient among 13 in the supra-auricular sinectomy approach for uncomplicated cases. In complicated cases, the supra-auricular sinectomy approach had a nil recurrence rate compared to three patients out of ten operated in microscope-assisted technique (Fisher's exact test - 0.0593). Both the outcomes are not statistically significant. Conclusion: Supra-auricular sinectomy technique has the lowest recurrence rate for preauricular sinus surgery.