Objectives: To evaluate the usability and effectiveness of tailor made internal and external nasal splints after nasal surgery. Study Design: An observational study. Place and Duration of Study: Combined Military Hospital Kohat, from Nov 2015 to Aug 2017. Methodology: the study was carried out on 523 patients who underwent nasal surgery by the same team of surgeons. Custom made free of cost internal and external nasal splints were used as required. Complications pertaining to the use of nasal splints were recorded. Results: The custom made splints were found to be an excellent and cost effective alternative of commercially available expensive splints. The benefits and pitfalls were comparable. Conclusion: Where these free of cost splints does the job they as well save a lot of money and can be used as an effective alternative to commercially available splints.

Objective: To discuss the presentation stages of Cholesteatoma in patients of various areas of Kohat division. Study Design: Case series study. Place and Duration of Study: Combined Military Hospital Kohat, from Nov 2015 to Nov 2017. Methodology: A total of 60 patients having Chronic Suppurative otitis media with Cholesteatoma were selected from outpatient department. Disease process was evaluated by otomicroscopy as well as radiologically. Perioperative disease spread pattern was also assessed and documented. Results: Out of 28 patients with pars tensa cholesteatoma 28.5% were in stage II and 53.5% were in stage III disease. Out of 32 patients with pars flaccid cholesteatoma, 3.1% presented with stage 1 disease, 37.5% with stage II disease, 50% with stage III disease and 9.3% with stage IV disease. Conclusion: Appropriate measures should be taken for training of general physicians as well as otologists at National level to help early diagnosis and better outcome.