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TB prevalence in HIV-infected PWID was 15 times higher than in the general adult population. As a screening symptom, cough has low diagnostic value.

Objective: Ossicular discontinuity may result from chronic suppurative otitis media and is usually detected intraoperatively. Our objective is to determine whether a preoperative audiogram can preoperatively predict the presence or absence of ossicular discontinuity. Methods: A cross-sectional study was prospectively run on our patients, aged 12-75 years, ultimately operated on for chronic suppurative otitis media. Preoperative audiograms were analyzed to measure frequency-specific air-bone gap (ABG) cutoff values. Intraoperatively, ossicular chain integrity was carefully checked. Logistic regression analysis was done to obtain a predictive model. Results: A total of 270 patients (306 ears) were included. Frequency-specific ABG cutoff values can predict ossicular discontinuity, namely: high ABGs at 1,000 Hz (>27.5 dB) and 2,000 Hz (>17.5 dB) are the most reliable variables associated with ossicular discontinuity. Conclusion: Preoperative audiograms can predict the presence of ossicular discontinuity in chronic suppurative otitis media. Large ABGs at both 1,000 and 2,000 Hz can predict ossicular discontinuity with a great degree of certainty.

Instrument fracture during procedure is not uncommon for dental surgeons, especially in root canal surgeries, usually inside the root canals. In rare instances, high-speed rotary instruments can be fractured and can be dislodged in key anatomical areas of face. In our case report, a high-speed dental burr most probably penetrated the root and was seen in the left maxillary sinus during a likely routine dental procedure. The work-up and endoscopic surgical management of the case is described. Practitioners should be in great care during dental procedures and endodontic treatment to avoid unexpected complications by introducing foreign bodies into maxillary sinus. Any patient presenting with recurrent unilateral facial pain or unilateral sinus symptoms with/without previous history of sinusitis should raise the suspect of a foreign body in the paranasal sinus regardless of any previous history of dental procedure.

Objective To show the efficiency of using transmastoid atticotomy (TMA) endoscopy on the outcome of ossiculoplasty in patients with cholesteatoma. TMA is often performed as part of the surgical management of patients with middle ear cholesteatoma extending to the epitympanum. TMA can also be used as an access for endoscopic view to confirm the right alignment and stability of the ossicular prosthesis because the reconstruction of the tympanic membrane will obscure the visualization of the prosthesis. Methods A retrospective study was done at a tertiary referral institute, including 133 ears with cholesteatoma that underwent canal wall‐up tympanomastoidectomy (CWU) with ossicular reconstruction using titanium prosthesis between August 2013 and August 2015. Post packing of the ear canal and position, stability, and axis of the prosthesis were checked using endoscope positioned in the attic through TMA. A postoperative pure‐tone average air–bone gap (ABG) of 20 dB or less was considered as a successful hearing result. Results are compared with historical control groups. Results Of the 133 ears, 88 patients underwent reconstruction with partial ossicular replacement prosthesis (PORP), whereas the rest (45 patients) had total ossicular replacement prosthesis (TORP). A postoperative ABG ≤ 20 dB was obtained in 77.4% of all the patients (79.5% for PORP; 73.3% for TORP). Conclusion Endoscopic assessment of the ossicular prosthesis via the attic, after repositioning of the tympanomeatal flap and packing the ear canal, decreases the risk of immediate ossiculoplasty failure and improves the functional outcome after ossicular chain reconstruction in cholesteatoma surgery. Level of Evidence 4 Laryngoscope, 129:2754–2759, 2019

No abstract

Chemical closure of tympanic membrane perforation is a commonly practiced office-based otological procedure, which is labeled to be effective and safe. In this paper, we report a case of a young lady with disastrous complications following an attempt of chemical cauterization of her perforated tympanic membrane.