The objective abnormality and subjective symptoms in Eustachian tube dysfunction may represent two distinct pathological processes, which may nevertheless influence and exacerbate each other.

Objectives: To profile the use of personal music devices (PMDs) in the study cohort, evaluate their output levels, and assess the users with regard to listening habits, symptomatology and hearing thresholds. Study design:A randomised prospective study including 500 individuals aged between 16 and 30 years. Methods:A questionnaire-based assessment included their demographic profile, PMD usage history and symptomatology and then they were classified into high (286) and low risk (214) groups. Results:The average weekly usage of PMDs was 5.39 days/week, mean volume was 4.88, which increased to 5.9 in noisy areas, and average output used was 66.04 dB. Evaluation by pure tone audiometry (PTA) showed average hearing loss of 21.35 dB in the high risk group. Conclusions:In total, 57.2% of the individuals included in this study demonstrated high risk behaviour for use of PMDs. Those with risky listening behaviour showed audiometric evidence of early noise-induced hearing loss (NIHL).

Glasgow Benefit Inventory scores were higher in all domains for endoscopic cases compared to open and combined cases (Table 1).

Tonsillitis and peri-tonsillar abscess are common conditions which account for a large proportion of hospital admissions. They may present in a similar way to supraglottitis and retropharyngeal collection. With adequate antibiotic coverage, admissions for tonsillitis have decreased compared to cases admitting with complications. This report shows an unusual presentation of necrotising fasciitis in the neck of a 71-year-old male who presented initially with tonsillitis and later developed into supraglottitis with retroand parapharyngeal abscess complicated by necrotising fasciitis extending into pleural cavity. The patient required a prolonged stay in the Intensive Care Unit, with airway support including tracheostomy, and underwent repeated surgical drainage followed by sequential debridement (10 times). Radiological investigation and nasopharyngolaryngoscopy plays an important role in contributing to early diagnosis. Agressive debridements and necrotic tissue removal with antibiotic cover are mainstay of treatment. ARTICLE HISTORY

The study was done to review postoperative hearing gain of patients with different Middle Ear Risk Index (MERI) undergoing Tympanomastoidectomies with titanium prostheses reconstruction. A Retrospective chart review was performed from September 2009 to December 2011. Of the 17 cases, 9 had moderate MERI while 8 had severe MERI. 9 patients underwent Tympanomastoidectomy with Total Ossicular Reconstruction Prostheses (TORP) and 8 with Partial Ossicular Reconstruction Prostheses (PORP). Hearing gain of 25.31 dB was achieved in cases with moderate MERI compared to 29.37 dB in severe MERI. Less than 20 dB average air-bone gap was achieved in 75% of PORP and 77.77% of TORP reconstructions. In developing countries with limited resources, decision regarding ossicular reconstruction should be made taking into account MERI, intra operative findings and type of surgery. Best results are achieved in cases of CWD with TORP and ICW with PORP.