<p><strong>Background: </strong>The aim of the study is to compare the efficacy of autologous incus versus allogenic titanium prosthesis in terms of anatomical results, hearing gain after surgery, operative course and complications.</p><p><strong>Methods:</strong> This is a prospective interventional study of 20 patients out of which 10 underwent autologus incus and 10 underwent titanium prosthesis ossiculoplasties performed between April 2018 To April 2019 in Government Kilpauk medical college and hospital, Chennai after ethical clearance. The postoperative improvement of mean air-bone gap and air conduction over same frequencies between the two groups were studied. A improvement in pure tone average more than 10 dB was considered successful.</p><p><strong>Results:</strong> In current study, 10 patients underwent ossiculoplasties using titanium ossicular replacement prosthesis and 10 patients underwent ossiculoplasties using autologous incus. 5 of the patients in each group underwent canal wall up and 5 underwent canal wall down procedure. The average ABG closure was 9.30 dB in incus group and 15.22 dB in titanium group.</p><p><strong>Conclusions: </strong>Titanium ossicular prosthesis ossiculoplasties provide a significant hearing gain and are advantageous because of the easy insertion with pre-sculpted structure yet the cost is a concern. Better results were noted in canal wall up procedures more than canal wall down procedures.</p>
<p class="abstract">Rhino orbital mucor mycosis in covid infected patients presented a challenge in management. We tried analysing comprehensively the manifestations and management and prognosis of post COVID rhino orbito cerebral mucormycosis (ROCM) patients in our institution. Patients with symptoms of ROCM were managed according to the guidelines issued by the directorate of medical education, Tamil Nadu, India. 30 possible ROCM patients were treated so far from May 2021. Patients underwent radiological, microbiological and pathological investigation. In stage 1, nasal cavity alone was involved in 11 patients. In stage 2, paranasal sinus extension was seen in 8 patients. In stage 3, orbital extension was seen in 10 patients. In stage 4, intra cranial extension was seen in 1 patient. 10 patients were probable ROCM without microbiological or pathological evidence. 20 patients had proven ROCM. They were treated with endoscopic debridement. Out of them 10 patients had to undergo orbital decompression and 5 of them had improvement in vision. All proven ROCM patients were treated with 3 weeks of injection liposomal amphotericin B along with oral posaconazole 300 mg for 3-6 weeks. Post-operative histopathology noted fungal invasion of blood vessels in 19 cases and thrombus in 10 cases of orbital involvement. No mortality was reported in the study group. COVID variant associated thrombosis may be the reason for increased incidence of mucor mycosis in post COVID patients. Team work, appropriate guidelines and adequate supply of medications helped in achieving desired outcome.</p>
<p><strong>Background: </strong>Diabetes mellitus (DM) which is prevalent in world is associated with sensorineural hearing loss. Brainstem evoked response audiometry (BERA) is a simple, non-invasive procedure to detect early impairment of acoustic nerve and auditory pathway. The present study is under taken to evaluate the impact of DM on BERA parameters. Aim of the study was to compare the BERA of diabetic patients to those of age and gender matched controls to assess the involvement of central auditory pathway.</p><p><strong>Methods</strong>: A cross sectional study was conducted on 35 diabetic patients, aged 35 to 55 years, who were on treatment for at least 2 years, and 35 age and sex matched control participants, were subjected for BERA at 70,80 and 90 dB. The waveforms, absolute latency of wave I, wave III, wave V and interwave/ inter peak latency of I-III, III-V and I-V were analyzed with respect to both groups.</p><p><strong>Results</strong>: The absolute latency of wave III and wave V, interpeak/ interwave latency of I-III, interpeak/ interwave latency of I-V, III-V and absolute latency of wave V were highly significant at corresponding tested stimuli in the diabetic group compared to the control group.</p><p><strong>Conclusions</strong>: Early involvement of central auditory pathway in diabetic patients, can be detected with fair accuracy with auditory evoked potential studies; if done on a regular basis warrants meticulous glycemic control and prevents further damage.</p>
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