The primary aim of surgery for cholesteatoma is to eliminate the disease, to produce a safe and dry ear which is self cleansing, modify the anatomy of the tympanomastoid compartment so as to prevent recurrent disease and wherever possible to reconstruct the hearing mechanism. The advances in medical technology and the medical expertise gained over a period of time have greatly influenced the results in cholesteatoma surgery. The aim of the present study was to assess the intraoperative findings during revision mastoid surgery for atticoantral disease and to ascertain the preventable factor that could reduce recurrence. A retrospective analysis of all clinical data and operative notes of patients who had undergone revision surgery for recurrent cholesteatoma, in our unit in a tertiary care centre in south India over a period of 3 years from July 2007 to July 2010 was done. 33 patients had undergone revision mastoid surgery for cholesteatoma. Most patients presented with symptoms and sign of disease about 2 years after the first surgery. The commonest complaint was recurrent foul smelling ear discharge. The most frequent site of recurrent cholesteatoma was the tip cells (72%) and the most important cause for failure of surgery with recurrence of disease was inadequate meatoplasty (70%). In our study, recurrent disease was likely due to cholesteatoma in the tip cells left uncleared and inadequate meatoplasty. Both these issues reflect faulty techniques in performing good meatoplasty or the tip cell are not adequately reduced into the external auditory canal. Bone work is generally taught well in all temporal bone workshops but no emphasis is laid on soft tissue work hence the failure and recurrence. Thus we emphasize the need to teach the budding otologists the importance of and proper technique of meatoplasty.

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<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Inverted Papilloma of the sinonasal tract is a benign neoplasm with unique locally destructive capacity, tendency to recur and a propensity for malignant change. Despite varied studies, there seems to be a lack in consensus with regards to its etiology, predictors of recurrence and malignant transformation. The aim of our study is to analyse the clinical profile, management and outcome of histopathologically proven Inverted Papilloma of the nose and paranasal sinus at our institute. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Retrospective chart review of 17 patients of histologically proven Sinonasal Inverted Papilloma over a period of 2 years from May 2013 to May 2015. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The majority were in their 5th and 6th decade of life (47%) with a male to female ratio of 15:2. All had been managed surgically with 10 patients undergoing endoscopic assisted polypectomy, 6 requiring partial maxillectomy &amp; 1 requiring total maxillectomy for complete surgical clearance. All patients had been followed up for a minimum duration of 1 year and recurrence was found in 41%. 2 patients had been diagnosed with malignant transformation during follow-up, out of which 1 underwent right partial maxillectomy along with concurrent chemotherapy and other patient underwent left total maxillectomy with concurrent chemotherapy and intensity modulated radiation therapy. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Inverted Papilloma of the sinonasal tract is a locally aggressive disease requiring careful endoscopic and radiological assessment. Adequate surgical management can ensure complete clearance of disease. A strict long term follow-up protocol will facilitate identifying recurrence and malignant transformation.</span></p><p> </p>

Cholesteatoma is a non-neoplastic cystic lesion arising in the middle ear cleft with the propensity to spread and recur after surgery, but it is unusual to find cholesteatoma invading sternocleidomastoid muscle after 15 years of modified radical mastoidectomy and presenting as Bezold abscess. In this report, the authors highlight the fact that cholesteatoma recurrence if neglected can present as a Bezold abscess with the invasion of cholesteatoma from the mastoid tip into the sternocleidomastoid muscle. This requires complete excision of the cholesteatoma sac along with the surrounding soft tissue.

To assess the functional and radiological outcome of Nonunion medial mallolar fractures treated surgically with cc screw fixation and bone grafting. Materials and Methods:A prospective type of study conducted in our institute with 23 patients, 15 male and 8 female from august 2019 to September 2021. patients who has no signs of union radoilogically with severe disabling symptoms that affects their day to day activities with history of trauma to the ankle before 3 months were assessed clinically and confirmed radiologically as medial malleolar nonunion and were treated surgically with corticocancellous screw fixation and bone grafting postoperatively patients were regularly assessed clinical as well as radiologically outcome was measured using AOFAS and OMAS scoring. Results: Out of 23 patients who were taken up for final study 18 patients got excellent results, 3 patients with good and 2 patients with fair outcome. AOFAS score of 96.53 and OMAS score of 94.86 Conclusion: We conclude from our study that good functional outcome can be obtained for medial malleolus nonunion treated by open reduction with corticocancellous screw fixation and bone grafting followed by regular postoperative follow up and physical therapy.