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introductionCholesteatoma is a nightmare for the otologist, whose excision needs a high level of surgical expertise and skill. Its pathogenesis has been debated in depth in the past. This includes theories such as metaplasia, invagination, migration, hyperplasia, etc. [1,2] Foreign body (FB) of external auditory canal (EAC) is a well-known entity in pediatric age group. However, there are very few instances of middle ear FB. PubMed search engine yielded no results for cholesteatoma developing following an FB in the middle ear. Here we are reporting a case of multiple FB in an 18-year-old male who presented to us with foul smelling ear discharge and earache. On examination granulation, polyp was seen occluding the EAC. He did not respond to any oral antibiotics. He was taken up for middle ear and mastoid exploration surgery. During which multiple FB was seen within the middle ear. Extraction of FB revealed the cholesteatoma sac in the middle ear and mastoid. Patient was treated by canal wall down mastoidectomy with tympanoplasty. Here, we are emphasizing the role of FB of middle ear in the development of extensive cholesteatoma in this patient. cAse reportAn 18-year-old male presented to us with the chief complaint of throbbing type of right earache since 5 days. It was ABstrAct Garag, et al.: Foreign body of middle ear masquerading cholesteatoma

<p class="abstract"><strong>Background:</strong> Tympanic membrane perforation in chronic otitis media exposes the middle ear mucosa to exogenous source of infection and also produces conductive hearing loss. To overcome this problem various surgical techniques of tympanoplasty using different graft materials have been tried with varying degrees of success rate. The purpose of this study was to compare anterior tucking and cartilage support tympanoplasty with respect to graft uptake and hearing outcome.</p><p class="abstract"><strong>Methods:</strong> This prospective study comprised of 50 consecutive patients with chronic otitis media of tubo tympanic type during October 2015 to September 2017, which were divided into two groups. Group A (25 patients) underwent type 1 tympanoplasty with anterior tucking method, Group B (25 patients) underwent type 1 tympanoplasty with cartilage support. The primary result was measured in view of graft uptake &amp; hearing capacity outcome at 6 months post operatively by performing pure tone audiometry.  </p><p class="abstract"><strong>Results:</strong> In anterior tucking tympanoplasty group out of 25 patients, the graft uptake was good in 22 patients and 23 patients showed good improvement in hearing, while in cartilage support tympanoplasty group all the 25 patients the graft uptake was good and all showed good hearing improvement postoperatively. In our study both the groups have significant hearing improvement and in cartilage support tympanoplasty results were better.</p><p class="abstract"><strong>Conclusions:</strong> The aim of tympanoplasty is to treat middle ear and tympanic membrane defects. In this study we subjected the patients for anterior tucking and cartilage support tympanoplasty for two different groups respectively and both methods showed significant hearing improvement.</p>

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<p class="abstract"><strong>Background:</strong> The objective of the study was to assess the role of corticosteroid given preoperatively in decreasing intraoperative bleeding during functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis.</p><p class="abstract"><strong>Methods:</strong> This is a retrospective study conducted in a tertiary care hospital for patients undergoing FESS for chronic rhinosinusitis from January 2016 to December 2016. In this study 120 patients of FESS were enrolled. Their data was analyzed for preoperative corticosteroid given and intraoperative grade of bleeding.  </p><p class="abstract"><strong>Results:</strong> There were 62 patients out of 120 who received preoperative corticosteroid. Among these 41 had grade 0-1 bleeding and 21 had grade 2-5 bleeding. Similarly in non-corticosteroid group 30 had grade 0-1 bleeding and 28 had grade 2-5 bleeding. Based on these p values was calculated using fisher exact test which showed that to be non-significant.</p><p class="abstract"><strong>Conclusions:</strong> Preoperative corticosteroids do not have control on intraoperative bleeding during FESS. They help in reducing the size of polyp and thus more effective in cases of CRSwNP.</p>

Background: Lesions of the frontal sinus (FS) are always a surgical challenge. Conventional endonasal endoscopic techniques do not provide complete access inside the FS. This is especially true with laterally placed lesions like mucocele or post-traumatic cerebrospinal fluid (CSF) leak from FS. Standard procedures like osteoplastic flap and endoscopic modified Lothrop are not feasible for these smaller unilateral lesions with normally functioning contralateral sinus.Study design: Retrospective case study of laterally placed posterior table CSF leak and frontal mucocele were evaluated for their clinical presentation, radiological, operative findings and follow-up. Conclusion:Complete external approaches to the lateral lesion of FS are associated with high morbidity. Ability of the endoscopes to visualize lateral and posterior extents of the FS directly through the brow incision helps in complete repair/ excision of these lesions without any difficulty.