CSF rhinorrhea secondary to anterior skull base defect may be spontaneous or traumatic (accidental or iatrogenic), spontaneous being common in middle aged, obese females. Nowadays endoscopic technique is gold standard for anterior skull base defect repair. The graft materials available may be autologous (fat, temporalis fascia, fascia lata, septal mucosa, cartilage, middle turbinate), homologous e.g., cadaveric pericardium or allograft e.g. dural substitute. Leukocyte-platelet rich fibrin (L-PRF) is a newer graft material that contain concentrated platelets and doesn't require any exogenous material or chemical in blood. A prospective study including 31 patients was carried out at tertiary care centre in eastern India, over the period of 2 years. All the surgeries targeted for closure of the anterior skull base defect were performed endoscopically under general anaesthesia. 30 out of 31 (96.77%) patients successfully improved after repair and one patient required revision surgery due to recurrence of disease and was cured after revision surgery. Autologous Leokocyte-plasma rich fibrin (L-PRF) is a newer and cost-effective graft material for the CSF leak repair with good healing property and with a success rate of more than 95%.

Foreign bodies ingestion is especially common in the pediatric age group, whereas in adults occur accidently or among those with psychiatric disorders, mental retardation, prisoners and alcoholics, Preexisting GI tract abnormalities, such as previous surgery, strictures, or functional abnormalities, increases the risk of a swallowed foreign body becoming lodged at the site of the abnormality.This retrospective study was conducted in 32 patients with upper aero digestive tract unusual foreign bodies presenting to our department on emergency basis in a duration of one year. This Study was conducted in ENT department tertiary care Centre in duration of 2021-2022, 32 patients presented with unusual FB in upper aero digestive tract were treated in our department on an emergency basis. There were 14 male (43.75%) and 18 female (56.25%) ranging in age from 2 to 62 years. The main symptoms patients complained were difficulty in swallowing and pain. Detailed history with examination of nasal cavity, oral cavity and pharynx by indirect laryngoscopy and finally X-ray or CT scan were the diagnostic tools as required. The location of the FB was in the esophagus, Pyriform sinus, hypopharynx in decreasing order.The treatment consisted of rigid endoscopy and foreign body removal under general anesthesia or sedation. No major complications occurred in procedure except one in with iatrogenic esophageal perforation that was managed conservatively. Endoscopy is a reliable method in the treatment of upper aero digestive tract foreign body (FB) impaction.

Introduction: Pleomorphic adenomas are benign tumors of the salivary gland. In the palate they present as slow growing submucosal mass on hard palate. Most common salivary gland tumor, is also known as benign mixed tumors, because of its dual origin from epithelial and myoepithelial elements. The pros Methods: pective study was conducted in ENT department, tertiary care centre, over a period of one year. This study aims to focus on age, size, clinical presentations, radiological features and management of tumors. After the clinical suspicion FNAC and Computed tomography done in all patients before any surgical intervention. Most common involved age group is 20-40 years Results: , and common symptom is palatal swelling. CT scan shown palatal bone erosion in 2 patients and FNAC report is diagnostic in all cases. Wide local excision done in all cases and no recurrence found in one year of follow up. Conclusion: The incidence of pleomorphic adenoma is high among adults and along with clinical suspicion FNAC is diagnostic tool, CT scan done to rule out any bony erosion. Wide local excision is best treatment.

Period of organogenesis is very precise duration, any factor affecting this period leads to congenital anomaly. Bid tongue is one of the congenital anomalies mostly associated with syndromic cases like Opitz G/BBB syndrome, oral–facial– digital syndrome type I, but isolated bid tongue can also be seen rarely. Here we describe three cases of isolated bid tongue in absence of any intra oral or facial defect.

The modern life style poses new challenges on the normal physiological mechanisms of the human body. Drug abuse, tobacco smoking, and alcohol drinking, as well as lack of exercise may also increase the risk of developing certain diseases, especially older age.To study the relationship between degree of sensorineural hearing loss and serum lipid level (total cholesterol, triglyceride, low density lipoproteins, high density lipoproteins).A cross-sectional study was conducted in 150 patients aged between 15 to 60 years diagnosed with sensorineural hearing loss at Otorhinolaryngology outpatient department at Sir Sunder Lal hospital, IMS, BHU. All the 150 patients were amongst age group of 15 to 60 years who were registered from August 2019 to July 2021.The serum levels of total cholesterol, triglyceride and low-density lipoprotein directly correlate with the severity of sensorineural hearing loss significantly ( p < 0.05) whereas the serum levels of high-density lipoprotein had no direct co-relation with the severity of sensorineural hearing loss. Hyperlipidemic state is a major risk factor for SNHL. Regular screening and monitoring of serum lipid might prevent morbid SNHL and improve patients’ quality of life in long term.

This is a case of a patient with history of ear surgery who visited ENT outdoor, for continuous vertigo which used to get aggravated with loud noise, associated with hearing loss, persistent sensations of right-sided aural fullness/pressure and otalgia for last 2 years. He had history of tympanoplasty with ossiculoplasty using a TORP. On exploration under local anesthesia there was a displaced prosthesis into inner ear, upon removal of which symptoms and severity subsided exponentially.

Tonsillectomy is one of the most common ear, nose and throat surgical procedure, carried out worldwide 1 . Amongst the various method of tonsillectomy (diathermy, laser, harmonic scalpel, radiofrequency cautery cryosurgery and coblation), dissection and snare method is commonest procedure done by otorhinolaryngologist. To compare the post operative complications associated with coblation versus conventional cold-dissection steel tonsillectomy. We carried out the prospective study of complications associated with coblation versus conventional cold steel tonsillectomy in postoperative pain, anesthesia, hemorrhage, fever, pharyngitis, injury of adjacent structure & cautery burn. Average blood loss on Coblation side was 18.74 ml while on conventional side it was 44.2 ml. Post operative pain score, injury to adjacent structure and cautery burn were found to be significantly decreased in coblation. No such difference was observed in pharyngitis and fever in both methods. The use of coblator reduces the post-operative pain, peri or post-operative blood loss, injury to adjacent structure & cautery burn too.

This study aims to comprehend the experience of hearing screening in children with suspected hearing loss at a tertiary care centre of eastern Uttar Pradesh, India using distortion product otoacoustic emission (DPOAE) as a screening modality. This study was conducted at a tertiary care centre of eastern Uttar Pradesh during the period of July, 2021to June, 2022 consisting of 96 children who were referred with suspected hearing loss. They underwent distortion product otoacoustic emissions (DPOAE) testing. Out of 96 children who underwent DPOAE testing, 25 (26.04%) passed the test, 55(57.29%) had “refer” result in bilateral ears whereas 16 (16.67%) had “refer” result in either ear. OAE is a simple, cost-effective and convenient tool for hearing screening in spite of some limitations. Universal new-born hearing screening can be implemented using OAE.

Rosai Dorfman disease is characterised by sinus histiocytosis with massive lymphadenopathy. Here, we present a case report of 33-year female with low grade fever and multiple swellings of variable size in cervical region. Laboratory examinations showed erythrocyte sedimentation rate to be increased up to 40 mm / hour. Histopathological examination revealed a number of histiocytes containing lymphocytes and few plasma cells in their cytoplasm showing emperipolesis of plasma cells and lymphocytes. Immunohistochemistry showed positivity for CD68 with marked sinus expansion by histiocytic cells and emperipolesis. Treatment with tapering dose of systemic corticosteroids over 1 month gave excellent results.

Mucormycosisis an opportunistic infection which is caused by fungus of the order Mucorales most common one is Rhizopus oryzae. These infections are more common in patients which are suffering from diabetes mellitus, malignancy, burn, severe trauma, malnutrition, renal failure, prolong neutropenia, immunosuppressed, long term steroid therapy or immunosuppressive therapy, hematopoietic stem cell transplant and solid organ transplant recipients. Patients with serious illness are 10 times more prone to develop bacterial or fungal secondary infection than secondary viral infection.Commonest form of presentation of Rhino-orbito-cerebral mucormycosis dental pain4, dental loosening, orbital pain, facial numbness, conjunctival suffusion, diminution of vision to complete ophthalmoplegia, blindness, cavernous sinus thrombosis, multiple cranial nerve palsies, edema of eyelids orbital inflammation blepharoptosis, proptosis, acute ocular motility changes, headache and acute vision loss.Management of mucormycosiscomprises of medical and surgical management.Various surgical management are explained.

This study was conducted to evaluate the existence of otoscopic abnormality, hearing status and radiological changes in contralateral ear of patients with chronic otitis media. 300 patients having unilateral Chronic Otitis Media attending OPD in the Department of Otorhinolaryngology, Institute of Medical Sciences, Banaras Hindu University, Varanasi during the period of March 2019 to March 2020 were selected. Otoscopy, Pure Tone Audiometry and Bilateral X-ray mastoids (lateral oblique view) and/or HRCT Temporal bone were done. Contralateral ear was affected in more than 30% cases. Out of 188 patients having Mucosal COM, 58 cases (30.9%) had abnormal TM. Out of 112 patients having Squamosal COM, 48 cases (42.9%) had abnormal CLE. Out of 300 cases, 231 (77.0%) of them had normal hearing in contralateral ear. It was followed by 65 cases (21.6%) with conductive hearing loss. Mixed hearing loss and SNHL were seen in 2 patients each. In contralateral ear of Mucosal COM, pneumatic pattern of pneumatisation was seen in 69.1% followed by Diploic pattern (30.9%). In squamosal COM, X-ray mastoid showed pneumatic pattern (64.3%) followed by Diploic pattern (33.9%) in the contralateral ear. Sclerotic pattern was seen in only 1.8% of cases in contralateral ear. Chronic otitis media as a disease is not limited to one ear. The precise and critical evaluation of both ears does not play a role in prognostic evaluation of the patient only, but it can also serve as a guide for early detection of probable evolution of the disease process in a patient in contralateral ear with unilateral chronic otitis media.

Fungal sinusitis has been increasing in number throughout the world off lately. The classification of fungal rhinosinusitis has evolved drastically. Broadly it is classified in two groups that is invasive fungal rhinosinusitis and non-invasive fungal rhinosinusitis. There are five subgroups to these. The invasive group comprises of acute invasive fungal sinusitis (AIFS), chronic invasive fungal sinusitis (CIFS), chronic granulomatous invasive fungal sinusitis (CGIFS) whereas the non-invasive group consists of fungal ball and allergic fungal rhinosinusitis (AFRS). These five subtypes have specific radiological and clinical features. The treatment strategies and prognoses for the subtypes are also different, and depends on their characteristics features. It is important to understand the different types of fungal sinusitis and knowledge of their particular radiologic features are important for the clinician to use appropriate diagnostic techniques for confirmation. Relevant diagnosis and initiation of adequate therapy are essential to avoid any adverse consequence.

Fungal rhinosinusitis (FRS) once considered a rare disease. This global rise in the burden of fungal disease is a consequence of an increment in the population with weakened immune systems. Increased life expectancy with rise in conditions like diabetes mellitus, medical advancements with invasive interventions, use of steroid, wider uses of broad-spectrum antibiotics, immunosuppressive treatments for transplantation and autoimmune diseases, increased incidence of immune deficiency disease. Fungal infections of the paranasal sinuses are in fact a spectrum of diseases rather than one distinct entity. As such, there has been much published on the classification of fungal rhinosinusitis (FRS). Early classifications of FRS used the causative organism as the descriptor, i.e., aspergillosis, mucormycosis, etc. Rapid diagnosis and prompt treatment may save at least some of these patients. When fever with neutropenia and sinonasal symptoms are seen in patients with impaired immune function maintaining a high index of suspicion is essential, and the appropriate diagnostic work up should involve imaging studies and nasal endoscopy with a possible biopsy so as to initiate treatment in a timely manner. Clinical and histopathologic features of fungal rhinosinusitis are specific to each form, and criteria for diagnosis have been developed. This review of fungal sinus diseases summarizes invasive and noninvasive fungal rhinosinusitis forms but concentrates on AFS because of its high prevalence and the fundamental role the allergist-immunologist plays in its diagnosis and treatment.

Background: Biofilm is an organized bacterial community that may be homogeneous or heterogeneous. It plays a significant role in the pathogenesis of chronic rhinosinusitis, chronic tonsillitis and chronic suppurative otitis media. Biofilms may explain the recurrence and recalcitrant episodes of otorrhea in chronic otitis media (COM). The objective of this study was to detect biofilm formation in chronic suppurative otitis media and compare the pattern of biofilm formation in tubotympanic and atticoantral ear diseases. Methods: This was a prospective cross sectional study at a tertiary care hospital in Varanasi, Uttar Pradesh, India. Patients included in the study ranged from 10 to 65 years of age from both the sexes and varying socioeconomic status. Samples were collected using sterile precautions in cases of tubotympanic as well as atticoantral COM. The collected samples were directly inoculated onto MacConkey and blood agar media. LisaScan® EM microtitter plate reader was used to identify the presence of biofilm. Results: The most common organism was P. aeruginosa and S. aureus followed by Moraxella catarrhalis whereas in cases with tubotympanic COM, most common organism was S. aureus. We found that, in atticoantral type of COM biofilm formation was significantly more common as compared to that in tubotympanic type of COM. Conclusions: Biofilm formation in COM is even higher when atticoantral disease is present.

Pleomorphic adenoma are common benign salivary gland tumours, which are found in majority in major salivary glands such as parotids and submandibular glands. However, Pleomorphic adenoma to originate from dorsum of the nose is a rare entity. In rare cases, it can be found in unusual sites such as upper aero digestive tracts, palate and lacrimal glands. Complete surgical resection is the treatment of choice. Though, the evolution to malignancy and recurrence is not usually encountered, still a long-term follow-up is recommended. Here, we report a 53 year old female , complained of swelling in the left side of dorsum of nose for 10 years with a feeling of heaviness over the left side of face and difficulty in vision on the side of swelling due to the enlarged size of the swelling which gave a feeling of vision disruption , also had a prior history of incision and drainage 4 years ,done elsewhere. On clinical examination, nodular mass was palpated on left side dorsum of nose which was freely mobile, and Skin over the swelling had blackish pigmentation. Anterior rhinoscopy revealed no abnormalities. Complete surgical excision via a lateral rhinotomy incision was performed. Cytological and histological evaluation revealed the presence of pleomorphic adenoma. We observed a decent cosmetic outcome with no evidence of recurrence.

Adenocarcinoma of oropharynx is a rarely encountered entity. It may be primary or secondary as metastasis from a distant site. Secondary adenocarcinoma of base of tongue is even more uncommon, few cases have been reported in the literature till date including one from stomach as a primary site. We are presenting a case of secondary adenocarcinoma of base of tongue metastasised from stomach after one and half years of successful treatment consisting of surgery and adjuvant chemotherapy.

Nasal endoscopy is one of the common out-patient diagnostic procedures in ENT practice. Patients suffering from persistent rhinosinogenic headache which is not responding to standard medical management demand a thorough evaluation that incorporates diagnostic nasal endoscopy (DNE). Rhinosinogenic headache is multifactorial which includes contact point, deviated nasal septum, inferior turbinate hypertrophy, nasal polyposis and sinusitis. To identify the particular cause of the headache is necessary for appropriate management. We conducted a prospective observational study to assess the role of nasal endocopy in diagnosis and management of rhinosinogenic headache persisting for at least 3 months, over a period of one and half year. Thirty patients fulfilling the inclusion criteria were enrolled in the study. We categorized the headache as mild, moderate and severe. After DNE, we found that 93.33% (n = 28) had deviated nasal septum (DNS), 40% (n = 12) had septal spur, 10% (n = 3) had polyp, 50% (n = 15) had contact point, 67% (n = 20) had inferior turbinate hypertrophy (ITH), 26.67% (n = 8) had pneumatised middle turbinate or concha bullosa and 50% (n = 15) patients of sinusitis. After computed tomographic evaluation, 30% (n = 9) patients underwent septoplasty, 20% (n = 6) underwent endoseptoplasty, 40% (n = 12) underwent middle turbinate lateralisation (MTL), 16.67% (n = 5) underwent FESS, 30% (n = 9) underwent FESS with endoseptoplasty, 3.33% (n = 1) Caldwell Luc's operation for unilateral maxillary polyp with sinusitis. Postoperatively we found that, 86.67% (n = 26) had total relief, 6.67% (n = 2) had partial improvement and 6.67% (n = 2) had no improvement of headache. Our study demonstrates that nasal endoscopy has significant role in diagnosis and management of rhinosinogenic headache.