Introduction: Tinnitus, the perception of the sound in the absence of an external acoustic source, disrupts the daily life 1 out of every 200 adults, yet its physiological basis remains largely a mystery. The generation of tinnitus is commonly linked with the impaired functioning of the outer hair cells (OHC) inside the cochlea. Otoacoustic emissions are the objective test used to assess their activity. Objective: The objective of the investigation was to study the features of Distortion product OtoAcoustic emissions (DPOAE) in a group of tinnitus patients with normal hearing and to find out whether there is any difference in DPOAE findings in the tinnitus patients with normal hearing and in persons with normal hearing with no complaint of tinnitus. Materials and Methods: The participants consisted of two groups. The subject group consisted of 16 ears of patients, in which 6 subjects were having tinnitus in both ears while 4 subjects were having tinnitus only in one ear. All subjects were aged between 20 to 60 years with complaint of tinnitus with audiometrically normal hearing. Control group was comprised of 16 audiometrically normal hearing ears of persons who were age and gender matched with the subject groups and had no complaint of tinnitus. Both the subject group as well as control group was subjected for DPOAE test. Findings of both the groups were compared using the unpaired t test. Result and conclusion: It was observed that the amplitudes of DPOAE were significantly lower in tinnitus patients than that of persons without complaint of tinnitus, at a frequency of 1281-1560, 5120-6250, 7243-8837 Hz, which imply that decrease of DPOAEs amplitudes may be related to the presence of tinnitus. It can be concluded that there is association between tinnitus and reduced OHC activity which indicate the OHC of cochlea are involved in the generation of tinnitus.

ABSTRACT Allergic rhinitis is a common condition affecting 5 to 40% of general population and its prevalence is increasing. It is a chronic condition characterized by inflammation of nasal mucosa. As per recent studies, there is an association between serum vitamin D levels and allergic rhinitis status. Vitamin D has major role in the regulation of calcium metabolism. In addition to this, it also has a number of immunological effects and takes part in immunomodulation, which can significantly affect the outcome of allergic responses like in allergic rhinitis. Aims and objectives To establish the correlation between vitamin D3 serum levels and allergic rhinitis. Materials and methods Vitamin D levels were assessed in 23 patients with allergic rhinitis diagnosed clinically by allergic rhinitis and its impact on asthma 2008 criteria and results were compared with vitamin D status in the normal population of same region. Results The levels of serum vitamin D levels were significantly low in the patients of allergic rhinitis. Conclusion Measuring of serum levels of vitamin D could be considered in the routine assessment of patients with allergic rhinitis. How to cite this article Thakkar B, Katarkar A, Modh D, Jain A, Shah P, Joshi K. Deficiency of Vitamin D in Allergic Rhinitis: A Possible Factor in Multifactorial Disease. Clin Rhinol An Int J 2014;7(3):112-116.

Background: Allergic rhinitis (AR) is the most common type of chronic rhinitis, affecting 10-20% of the population. Severe AR has been associated with significant impairments in quality of life, sleep, and work performance. A role for vitamin D in the regulation of immune function was first proposed after the identification of vitamin D receptors in lymphocytes. It has since been recognized that the active form of vitamin D, 1α, 25(OH) 2D3, has direct affects on naïve and activated helper T-cells, regulatory T-cells, activated B-cells and dendritic cells. There is a growing researches linking vitamin D (serum 25(OH) D, oral intake and surrogate indicators such as latitude) to various immune-related conditions, including allergy, although the pattern of this relationship is still yet to establish. Such effects of vitamin D can significantly affect the outcome of allergic responses like in AR. Aims and Objectives: To evaluate nasal symptom scores in patients of AR, pre- and post-treatment with and without supplementation of vitamin D. Materials and Methods: Vitamin D levels were assessed in 21 patients with AR diagnosed clinically and evaluated prospectively during the period of 1 year. Pre- and post-treatment vitamin D3 serum levels measured and documented. They received oral vitamin D (chole-calciferol; 1000 IU) for a given period. The results were compared with the patients having AR - treated conventionally without supplementation of vitamin D. Results: Improvement in the levels of serum vitamin D levels were significant in post-treatment patients (P = 0.0104). As well as clinical improvement in terms of reduction in the total nasal symptom score was also significant in the post-treatment patients (P < 0.05). Conclusion: Supplementation of vitamin D in such patients alters natural course of AR toward significant clinical improvement.

ABSTRACT Foreign body in maxillary sinus is not uncommon. Case reports published worldwide have been reviewed. We present a case which was suggestive of carcinoma of maxillary sinus, but it was foreign body ‘stone’ in right maxillary sinus which was almost 30 years old. How to cite this article Katarkar A, Bhavesh M, Modh D, Shah P. Rare Case of Long Standing Foreign Body in Maxillary Sinus. Clin Rhinol An Int J 2013;6(2):110-112.

Introduction: Foreign bodies in the external auditory canal are very common in children, mostly farm seeds and small stones in farmer. Removal of the foreign body Ear requires skill, and also high accuracy. Failures and traumatic removals often cause lifelong deafness and discharging ear. We report a case of a child who accidentally inserted a stone in ear while playing in farm and two casual removal trials pushed it into the middle ear. Case Presentation: A 4-year-old girl Patient was brought to tertiary care hospital attached with medical college two day after the insertion of foreign body with complaints of severe earache, something present in the ear and history of bleeding from the ear. History of two failed removal attempts in last forty eight hours at two different clinics was present with one attempt under general anaesthesia. We found that the tympanic membrane was ruptured, with granulation tissue in the middle ear and there were multiple lacerations in ear canal and oedema causing severe narrowing .No foreign body was visualised. Further on a CT scan examination stone was located in the middle ear and lodging itself in the hypo tympanum crossing the bony annulus. The foreign body was removed via a post-auricular approach after removal of overlying granulation tissue and widening of ear canal with use of micro motor mastoid drill. The perforated drum was repaired in the primary surgery after inspection of the ossicular chain and middle ear using a temporalis fascia graft. Conclusion: Removal of a foreign body from external auditory canal is an essential skill for emergency care giver as well as otolaryngologists. This particular case focuses the need of utmost carefulness and care in treating such seemingly simple cases. Slightest of error can give the patient lifelong deafness and prolonged morbidity. Whenever possible, primary reconstruction of the ear drum should be done in the same sitting.

ABSTRACT We report a rare case of sessile polypoidal xanthoma of vocal cord in a 38-year-old female, presented with complaint of hoarseness of voice for 3 months. Hopkins telescopic examination showed a sessile polyp arising from the anterior aspect of laryngeal vocal cord. With clinical diagnosis of vocal cord polyp, microlaryngeal surgery was done and tissue was sent for histopathological and culture examination. Histopathological findings showed features of polypoidal xanthoma. Culture was negative. How to cite this article Jain AK, Jain S, Katarkar A, Alam N, Lakum N, Shah P, Modh D. A Rare Case of Sessile Polypoidal Xanthoma of Vocal Cord. Int J Phonosurg Laryngol 2012;2(2): 66-68.

Introduction: The role of sutures in cosmetic cutaneous surgery is to close a wound and promote healthy wound healing with good cosmetic results. The ears are not only one of the most visible parts of the body, but also very fashionable and make a major statement by how they look and what jewellery a person wear. Lobuleplasty is the repair of torn ear lobule. Aim and Objective: To compare long-term results of Plain catgut 5-0 and Vicryl 5-0 suture materials in lobuleplasty of 88 patients from July 2009 to June 2011. Materials and Methods: A retrospective study of 88 patients who underwent lobuleplasty in Department of ENT, from July 2009 to June 2011, using Plain catgut 5-0 in 66 ears and Vicryl 5-0 suture material in 66 ears under local anesthesia as a day care procedure was performed. Observation and Results: All patients in the catgut group and Vicryl group were followed up on the seventh day and after 3 months for evaluation. No patient had wound infection and dehiscence in either group. Twenty-two ears (33%) were having a complaint of itching in the catgut group, whereas 11 ears (16.5%) in the Vicryl group, which is statistically significant by the χ 2 -test. The average score for the scar mark at 3-month follow-up for the catgut group was 5 and for the Vicryl group was 8. Conclusion : The modern cosmetic surgeons have significantly increased a number of suture materials to choose from. When making this decision, it is important to consider the risk of infection, cost, cosmetic result, and wound location. From our study, we conclude that the Vicryl group was having less tissue reaction than the catgut group and appearance of the scar mark was better than the catgut group. Therefore, the Vicryl group can be preferred as a suture material for lobuleplasty.

Background: Oral submucous fibrosis (OSMF) is a premalignant condition. Incidence of OSMF in India is 0.5%, mainly found in southern states and also in Saurashtra region. The pathological changes can involve mucosa, submucosa and the underlying muscles. The changes of tubal and paratubal muscles can affect the eustachian tube function. So, this study was carried out with an aim to determine the effect of OSMF on the eustachian tube function. Materials and Methods: 54 ears of 27 patients with OSMF and 50 ears of 25 normal persons were screened by eustachian tube function test (ETFT) after thorough history taking and clinical examination. Results: Out of the 54 ears in the OSMF group, type A curve was obtained in 42 (77.8%) ears, type B curve in none and type C curve was found in 12 (22.2%) ears, as compared to the normal group in which type A curve was obtained in 46 (92%) ears, type B curve in 2 (4%) ears, type C curve was found in 2 (4%) ears. On testing compliance of the middle ear, no change was observed at -200 daPa in 15 (27.8%) ears in the OSMF group and 5 (10%) ears in the normal group. Conclusion: The data observed were statistically analyzed by chi-square test, which suggested significant association between OSMF and eustachian tube function. Therefore, it can be concluded that eustachian tube function may be affected in OSMF and vice versa. So, while treating OSMF, hearing disability due to eustachian dysfunction has to be kept in mind and vice versa because treatment of hearing disability without taking care of OSMF will not be successful.