A Simple Technique to Obliterate Canal Wall Down Mastoid Cavity Concurrently in Squamosal Otitis Media: Our Experience.

Chronic suppurative otitis media is a type of otitis media defined as a long standing infection of a part or whole of the middle ear cleft. Squamosal type of CSOM involves parsflaccida characterised by the formation of cholesteatoma. The present study is retrospective analysis of records of patient who underwent canal wall down mastoidectomy with obliteration of cavity using posteroinferiorly based musculoperiosteal flap with autogenous cartilage and bone pate. Study include patients who underwent canal wall mastoidectomy with cavity obliteration at Tertiary care Hospital Yavatmal, Maharashtra, India; during 2 year period of 2016-2018. 41 patients (42 ears) who underwent canal wall down mastoidectomy with cavity obliteration procedure were included and 06 patients were excluded as they failed to follow up. The outcomes were measured by Marchant et al. grading scale. As per the study it was observed that 88% (37 out 42 ears) got adequate control of infection with dry cavity, while 12% (5 ears) failed to attain dry ear. So it's been concluded that canal wall down mastoidectomy is an effective surgical procedure in management of squamosal type of CSOM and mastoid obliteration is proved technique to improve outcomes of canal wall down procedure. Technique used to develop posteroinferiorly based flap to obliterate cavity in our study is simple modification of routine surgical steps commonly practiced by otologist helpful in reducing cavity size and promoting healthy epithelization. Cavity obliteration technique used in study is very effective and simple to develop dry and trouble free cavity in around 90% cases.

Management of tracheobronchial foreign bodies: a retrospective and prospective study.

(1) To study the presenting complaints or complaints suggestive of foreign bodies in the tracheobronchial tract. (2) To study the clinical findings. (3) To study the correlation between clinical and radiological findings. (4) To study different types of foreign bodies. (5) To study the complications caused by foreign bodies. A total of 115 patients presenting with foreign body aspiration in the tracheobronchial tract were included in the study. Patient characteristics, history, clinical, radiographic and bronchoscopic findings were noted. Foreign bodies in trachea and bronchus were removed by rigid bronchoscopy under general anaesthesia. Jackson rigid bronchoscope with a fibre optic light source and venturi technique anaesthesia was used. In the present study, foreign body aspiration was found to be maximum in the 1-3 year old age group. The average time lapse between aspiration of symptoms and presentation was found to be 1-3 days. Positive history was given in only 68% cases. Cough and breathlessness were the most common presenting symptoms. The commonest clinical signs were decreased chest movement and air entry on the affected side. Collapse of the affected side was the most common radiological finding. The commonest site of impaction was the right main bronchus. Majority of the foreign bodies were vegetative, peanut being the most common. The commonest complication following foreign body aspiration was atelectasis of the affected lung. Successful removal of foreign bodies was possible in all the patients. In paediatric respiratory compromise, the presence of unilateral diminished breath sounds, a pathological chest X-ray and a clinical triad of cough, choking and wheezing, is a powerful indicator of tracheobronchial foreign body aspiration. Since no single or combined variables can predict foreign body aspiration with full certainty, bronchoscopic exploration must be performed if tracheobronchial foreign body aspiration is suspected.

Hypohidrotic (Anhidrotic) Ectodermal dysplasia - A rare cause of childhood Atrophic Rhinitis".

Hypohydrotic (Anhidrotic) Ectodermal dysplasia is a rare hereditary genodermatosis characterized by a triad of defects including hypohidrosis hypotrichosis and anomalous dentition. Mainly ectodermal structures are involved such as epidermis and its annexes (hair & nails), although non-ecotodermal tissue may also became involved(1). ENT involvement in such cases is a consequence of the defect involving the eccrine and sebaceous glands. A case of a 3 years old female child suffering from hypohidrotic ectodermal dysplasia with features of Atrophic Rhinitis from infancy & early childhood is reported here. Management of these patients is mainly supportive and otolaryngologist is a vital component of the health care team managing such patients.