ObjectiveTo compare endoscopic assisted powered adenoidectomy with conventional curettage adenoidectomy.MethodsA randomised controlled trial was conducted at a tertiary care teaching hospital. Fifty patients with a symptom complex pertaining to adenoid hypertrophy and requiring adenoidectomy were chosen and divided into 2 groups of 25 each. Patients in group A underwent conventional curettage adenoidectomy and those in group B underwent endoscopic assisted powered adenoidectomy. Comparison was based on the parameters of surgical time, intra-operative bleeding, post-operative pain and completeness of adenoid removal.ResultsThe surgical time was significantly longer with the powered instrument. Mean blood loss was greater in the powered group, but was statistically insignificant. The powered procedure fared significantly better, with lower pain scores and more instances of complete tissue resection.ConclusionA curved microdebrider blade can be used safely and precisely for adenoidectomy under endoscopic vision. It enables complete resection of adenoid tissue. This method also proves to be an excellent teaching aid.

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Objectives/Hypothesis A variety of laryngeal pathologies are increasingly being managed with in‐office KTP laser (IOKTP) endoscopic procedures. The primary goal of this study was to identify patient characteristics and disease‐related features that correlated with tolerance for IOKTP. Study Design Retrospective chart review. Methods The study was a retrospective review of adult patients undergoing office‐based laryngeal laser procedures between November 2016 and December 2019 at a tertiary care center. Two blinded otolaryngologist reviewers scored videotaped recordings of IOKTP procedures and assessed severity and distribution of disease using a modified Derkay score, and evaluated procedure tolerance using a visual analog scale. Results A total of 56 patients who received IOKTP procedures for laryngeal pathology were reviewed, 42 male and 14 female, with a mean age of 61 years. Gender, age, and BMI were not correlated with tolerance. There was a moderate, negative correlation between tolerance and total number of pathological anatomic laryngeal subsites (rs(56) = −0.35, P = .01). There was a weak, negative correlation between tolerance and total modified Derkay score (rs(56) = −0.29, P = .03). The median tolerance score was lower for patients with posterior lesions (Mdn = 6.4) compared with patients with non‐posterior lesions (Mdn = 7.4), P = .04, and lower for current or former smokers (Mdn = 6.5) compared with never smokers (Mdn = 7.3), P = .04. Conclusion Patients with large disease burden or posterior lesions and patients with smoking history may exhibit poorer tolerance of IOKTP procedures, factors which can help guide pre‐procedural counseling and management decisions. Level of Evidence IV Laryngoscope, 131:E2292–E2297, 2021

(1) To compare graft take up of type-1 tympanoplasty with cartilage palisade technique with those of type-1 tympanoplasty using autotemporalis fascia. (2) To compare hearing results of type 1 tympanoplasty with cartilage palisade technique with those of type-1 tympanoplasty using autotemporalis fascia. A prospective clinical study. It consisted of 60 patients divided into two groups of 30 patients each. After randomization 30 patients underwent type 1 tympanoplasty using cartilage palisade technique and 30 underwent type 1 tympanoplasty using autotemporalis fascia. In follow up, pure tone audiogram were carried out at 2nd, 4th and 6th month. Clinical assessment was done at 2nd 4th and 6th month. The graft uptake rate between the group 1 and group 2 are 93.33 and 90% respectively. As value was greater than 0.05 so statistically there is no significant difference between the two group. The post operative air bone gap of the two groups were compared using student test. The pre op mean of group 1 was 32.5 db and pre op mean of group 2 was 30.66 db. The post op mean of group 1 was 21.33, with standard deviation of 3.6984 and standard error of 0.67523. The post op mean of group 2 was 21.09 with standard deviation of 3.29 and standard error of 0.58261. t value was 0.1357. Analysis was done using student test and value was found to be greater than 0.05. value is greater than 0.05 which shows that there is no statistical difference between the two groups. This study establishes the fact that hearing results after performing type 1 tympanoplasty by autotemporalis fascia when compared with type 1 tympanoplasty performed by cartilage palisade technique showed similar hearing gain and post operatively graft take up rate was also similar in two groups. The disadvantage of reducing the mechanical vibration of the tympanic membrane was overcome by the palisade reconstruction of the tympanic membrane. This study definitely emphasizes upon usage of new grafting materials in reconstruction of tympanic membrane, with similar, if not better functional results, without compromising the acoustic transfer characteristics.

The management of juvenile nasopharyngeal angiofibroma has undergone a significant evolution, with more surgeons moving towards the minimal invasive endoscopic approaches. Although considered the standard of care by most, an endoscopic approach may not be sufficient for extensive tumours, as exemplified by the current case of a young man presenting with the largest juvenile nasopharyngeal angiofibroma described in English literature until the present that was eventually excised via an anterior external approach.