Objective: Aim of current study was to determine the causes of hearing impairment among patients visited to hospital. Study Design: Observational study Place and Duration: Frontier medical college, Abbottabad, May, 2021 to April, 2022. Methods: Total 122 patients of both genders had complained of hearing impairment were included. After obtaining informed written consent detailed demographics were recorded. An extensive history, thorough E.N.T. examination, and pertinent radiological and audiological tests were performed. Frequency of causes for hearing impairment was assessed. SPSS 20.0 was used to analyzed all data. Results: Among all cases, 68 (55.7%) patients were males and 54 (44.3%) were females. Mean age of the patients was 17.5±11.50 years. 72 (59.02%) cases were from rural areas and 75 (61.5%) cases had poor socio-economic status. We found that conductive hearing loss was the most common found in 63 (51.6%) cases, followed by mixed hearing loss in 35 (28.7%) cases and sensorineural hearing loss found in 24 (19.7%) cases. Chronic Suppurative Otits Media was the most common cause of hearing impairment found in 61 (50%) cases, followed by infection, physical trauma, prenatal causes, postnatal causes, drug related and other problem. Conclusion: We concluded in this study that COSM was the most common cause of hearing impairment among all cases. Most common hearing loss was conductive, mixed and sensorineural. It is possible to reduce the incidence of sensorineural hearing loss by preventing variables that occur both during and after pregnancy. Keywords: Hearing Loss, Hearing Impairment, COSM, SNHL

Objective: The purpose of the research was to determine the rate of sensorineural hearing loss that is associated with chronic otitis media. Study Design: A Descriptive Cross-sectional study Place and Duration: Frontier Medical College, Abbottabad, from June, 2021 to November, 2021. Methods: Total 87 patients of both genders had age 15-55 years were presented. All the included patients had chronic suppurative otitis media clinical symptoms. Patients were enrolled after getting informed written consent from the patients. Through the use of a pure tone audiogram, we were able to determine the mean threshold of voice frequencies for sick as well as normal contralateral ears. In sick ears, a mean of more than 25 dB was considered to represent a positive case of SNHL. SPSS 24.0 was used to analyze all data. Results: We found that 49 (56.9%) patients were males and 38 (43.1%) patients were females. 17 (19.5%) cases had age 15-25 years, 35 (40.2%) patients had age 26-35 years, 25 (28.7%) patients had age 36-45 years and 10 (11.5%) patients were aged between 46-55 years. Majority of the cases 51 (58.6%) were from urban areas. There were 50 (57.5%) cases had chronic otitis media duration <10 months and remaining had disease duration >10 months. Frequency of sensorineural hearing loss was found in 47 (54.02%) cases. Among 47 cases SNHL, 32 cases were aged between 31-55 years. Conclusion: We concluded in this study that patients with chronic otitis media had significantly higher number of sensorineural hearing loss, Among SBHL cases, patients were mostly aged between 31-55 years and disease duration was >10months. Keywords: Otitis Media, Sensorineural Hearing Loss,

Objectives: To analyze the occurrence of malignancy in nose and paranasal sinuses and to identify the common type of nose and paranasal sinuses tumor. Study Type: Analytical study Place and Duration of Study: ENT Outpatients Department, Rai Medical College Teaching Hospital, Sargodha from 1st April 2017 to 31st March 2021. Methodology: Fifteen patients with nasal endoscopy performed for the diagnosis of tumors were enrolled. Lesion site and extent were determined through computed tomography imaging. Biopsy of each patient was performed under local anesthesia and histopathological findings were documented. Results: The mean age of patients was 55.3±3.3 years. Tumors of nose and paranasal sinuses were more common in the males (66%) than in the females (34%). It is revealed that majority of cases were diagnosed with squamous cell carcinoma 12 (80%) cases, 2 (13.3%) cases were diagnosed as adenocarcinoma and 1 (6.7%) case was diagnosed as adenoid cystic carcinoma. Conclusion: Squamous cell carcinoma was the main histopathological category of nose and paranasal sinuses tumor. Keywords: Sinonasal malignancies, Paranasal malignancies, Squamous cell carcinoma, Nose, Wood dust

Objective: The goals of this research were to (1) assess the efficacy of free flap reconstruction in patients with early and recurrent head and neck cancers, and (2) investigate the variables associated with these surgeries that increase the risk of problems. Study Design: Retrospective Study Place and Duration: Frontier Medical College, Abbottabad, from March, 2022 to August, 2022. Methods: Total 200 patients of head and neck cancer were included in this study. Patients were both males and females with primary and recurrent cancer types were underwent for free flap reconstruction. After receiving informed written consent, in-depth demographic information about the cases that were enrolled was recorded. Patients were divided in two groups. Hundred patients of recurrent cancers were included in group I and 100 patients of primary cancers were included in group II. Surgical outcomes among both groups were assessed and compared. SPSS 24.0 was used to analyze all data. Results: We found that 87 (87%) patients in group I and 81 (81%) patients in group II were males. Mean age of the patients in group I was 49.8±11.37 years and in group II mean age was 51.4±7.42 years. Majority of the patients had tumor stage 5. Smoking, betel nut and alcohol were the most common causes found in all cases. Anterior lateral thigh (ALT) and anterior medial thigh (AMT) were the most common flap types among both groups. We found that free flap reconstruction had higher success rate in primary cancers found in 96 (96%) as compared to recurrent cancers group in 92 (92%). There was no any significant difference found among both groups in terms of post-surgery complications. Conclusion: This study's findings suggest a greater failure rate for free flap reconstruction in the recurrent group compared to the primary group, however this finding may be attributable to the varied patient characteristics between the two groups.