To the best of our knowledge, this is the first large sample study of cochlear length in population of this part of the world. A smaller cochlear length in this part of the world as compared to the Caucasian cochlear duct is a significant finding in understanding of the cochlear anatomy and physiology. It would also have great implications on the insertion depth in cochlear implantation.

Chyle leak stopped within 5 days of starting octreotide in the low-output cases and within 7 days in the high-output cases. This permitted early resumption of a regular oral diet and reduced morbidity associated with chyle fistula. The rapid response and minimal side effect profile make octreotide a promising addition to the medical management of a chyle fistula.

To report operative findings, postoperative course, and postimplantation performance in patients with cochlear malformations who underwent cochlear implantation. Seventeen patients with malformations which included enlarged vestibular aqueduct (n = 6), Mondini's dysplasia (n = 5) common cavity deformity (n = 3) and incomplete partition type 2 (n = 3) underwent cochlear implantation with Nucleus 22 straight array device at our center. Operative findings described facial nerve anatomy and cerebrospinal fluid leak. Standard tests of speech perception were used to evaluate the postoperative performance for each subject. Operative findings included cerebrospinal fluid leak (thirteen patients) all of which were repaired successfully with graft. None had abnormal facial nerve anatomy. No surgical complications occurred. All the patients except two with common cavity had complete insertion. Electrode thresholds and discomfort levels were variable for several months after implantation. All patients demonstrated improved performance after implantation. Patients with enlarged vestibular aqueduct fared better than patients with other inner ear malformations. Cochlear implantation can be a successful method of rehabilitation in patients with congenital deafness who have cochlear malformations.

External osteotomy is an easy approach to carryout and makes fracture with high precision along preset lines. The bone stump is stable. The damage to the nasal mucosa is much less. There is reduced bleeding, reduced edema and reduced ecchymosis around eyes. The cutaneous scar at the entry site of osteotome is invisible.

Secretory carcinoma of the breast is an extremely rare subtype of breast cancer characterized by intracellular or extracellular secretion and granular eosinophilic cytoplasm of the neoplastic cells. The disease which was considered to be predominant in younger age group has been recognized in adult population too and tends to show slow growth and indolent behavior. The disease occurs preferentially in females and only 27 cases have been reported amongst males. An optimal treatment for the disease subtype has been debated because of the paucity of data. We report two cases (one female and one male) of this rare disease that underwent treatment at our institution.

a b s t r a c tObjectives: The purpose of this prospective study was to measure surgical outcomes in cases of cerebrospinal fluid gusher in cochlear implant surgery. Materials and methods: Demographic, radiological, neurophysiological and surgical results were evaluated in nine cases of patients with cerebrospinal fluid gusher during cochlear implant surgery, out of 164 unilateral cochlear implant procedures. Review of literature and our management technique is discussed. Results: Nine cases had cerebrospinal fluid leak during surgery. Out of three cases of incomplete partition type II, two had cerebrospinal fluid gusher while one had milder ooze. Two cases with large vestibular aqueduct syndrome had intraoperative cerebrospinal fluid gusher. Four cases of gusher had no predictable risk factors on clinical history, examination or preoperative radiology. All cases were managed with meticulous packing of round window site without any other additional measures such as lumbar drain or use of tissue glue. These cases showed no symptoms or signs of cerebrospinal fluid leak in the follow-up period. Conclusion: We recommend careful meticulous packing of the round window around the electrode using periosteum until cerebrospinal fluid leak is controlled in all cases of cerebrospinal fluid gushers. We also recommend a very conservative approach to managing these patients in the immediate postoperative period.

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