INTRODUCTIONCholesteatoma is a long-standing infection of the middle ear cleft. It is a three-dimensional stratified squamous epithelial sac confirming to the middle ear cleft, containing keratin debris and having the capacity for progressive and independent growth at the expense of the underlying bone, displacing or replacing the middle ear mucosa, and has a tendency to recur after removal.1 It has a destructive nature that erodes the bone and causes rapid bone destruction. Cholesteatoma have characteristics of growth, migration and osseous erosion and are thus locally destructive, the only treatment is their full surgical removal since there is no effective clinical treatment for eradication of the disease so far. 2Chronic ear discharge and decreased hearing are most common clinical presentation in cholesteatoma disease. Other symptoms are tinnitus, earache, ear bleeding. Other warning symptoms are headache, high grade fever, vomiting, giddiness and facial asymmetry suggestive of intratemporal and intracranial complications. ABSTRACTBackground: Cholesteatoma is a long-standing infection of the middle ear cleft having erosive properties. Chronic ear discharge and decreased hearing are most common clinical presentation. Multi-directional tomography of high quality can provide a detailed understanding of the interpretation of anatomical structures visualized by HRCT. Knowledge of the anatomical variations and changes induced by pathology in the temporal bone are the guiding marbles for surgery. Methods: This is a prospective study consisted of 100 cases of chronic suppurative otitis media of unsafe type requiring ear surgery admitted in the E.N.T. department of P.D.U. Civil Hospital Rajkot in 2 years from December 2015 to December 2017. A total no. of 100 patients of both gender between 5 to 80 years has been included in the study. Results: In this study, 58% patients were females while males were 42%. Left ear (46%) was involved more as compared to right ear (40%). Most of the patients belonged to 11-20 (25%) years of age group. Mean age is 24.5 years. Most common symptoms were ear discharge (98%) and decreased hearing (83%). Conclusions: HRCT guides the surgeon on the possible surgical hazards before the surgery and helps in earlier management and operative complications. The use of CT in the case of chronic suppurative otitis media does provide valuable information. HRCT scanning is a unique method of detection of early cholesteatoma as well as detection of cholesteatoma in hidden areas. In addition, HRCT scanning serves as a road map to assist the surgeon during cholesteatoma surgery.

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Otitis media (OM) is a big menace in countries like India. Chronic suppurative otitis media (CSOM) is chronic inflammation of middle ear, which affects the tympanic membrane, middle ear mucosa and other middle ear structures characterised by the presence of persistent perforation or persistent mucoid or muco-purulent discharge for at least 8 weeks. Variety of organisms founds in patients suffering from chronic otitis media like, <em>Pseudomonas</em>, <em>Staphylococcus aureus</em>, <em>Proteus mirabilis</em>, <em>Klebsiella pneumonia</em> and <em>Escherichia coli</em> found. The pattern of organisms varies in different geographical areas. The objectives of the study were to isolate bacteria from patients with ear discharge, to find out antibiotic sensitivity of isolated organisms</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This is an observational cross sectional study done in the OPD department of otorhinolaryngology, at P.D.U medical college and hospital, Rajkot, for a period of six months from January 2017 to June 2017. A total number 200 patients of both gender between 5 to 74 years who visited the OPD department of otorhinolaryngology with chronic ear discharge taken for study.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Out of 200 patients of 5-74 years with chronic suppurative otitis media were examined and out of this Hundred and twelve (54%) of the patients were males with mean age of 33.44. <em>Pseudomonas aeruginosa</em> was the commonest identified organisms the sensitivity pattern highly favoured Pipercillin, Amikacin and Polymyxin B, Cefoparazone. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Chronic otitis media is more prevalent in males than females. Commonest organisms found were <em>Pseudomonas aeruginosa</em> followed by <em>Staphylococcus aureus. </em>Piperacillin, Amikacin, Gentamicin, Polymyxin B and Cefoperazone were found most effective agents against <em>Pseudomonas aeruginosa</em>.</span></p>

<p class="abstract"><strong>Background:</strong> Deep neck spaces infection is a common challenging condition for otolaryngologist in day to day practice even after availability of higher antibiotics. It may leads to considerable morbidity and complications. The aim of the study was to find out prevalence, predisposing factors and changing trend of deep neck spaces infection in this broad spectrum antibiotics era.</p><p class="abstract"><strong>Methods:</strong> This prospective study was carried out at P.D.U. Medical College and Hospital, Rajkot. 120 Patients were studied who came with deep neck space infection.  </p><p class="abstract"><strong>Results:</strong> In this study majority of patient were in the age group of 41-60 year. Odontogenic and oropharyngeal infectionare the most common etiologies. <em>Staphylococcus aureus, Streptococcus, E. colli, Klebsiella</em> and anaerobes were the microorganisms commonly isolated in pus culture and sensitivity test.</p><p class="abstract"><strong>Conclusions:</strong> In spite of availability of broad spectrum antibiotics in present day deep neck spaces infection is the most commonly noticeable condition in developing countries and may lead to considerable morbidity and complications. Inadequate nutritional status, poor oral hygiene and lack of awareness in dental health are common predisposing factors for deep neck spaces infection.</p>

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ENT as a branch no longer has been removing wax, putting grafts or tonsillectomies. In last decade it has grown very fast. Refinement in the surgical techniques with availability of technical innovation has benefitted both surgeons and patients.