The search for tinnitus mechanisms is a speculative endeavour; a broad number of mechanisms may cause the tinnitus symptom and numerous tinnitus models have been proposed in recent years. There is no objective methods for detecting or evaluating the severity of tinnitus and severe tinnitus is usually defined as a tinnitus that interferes with sleep, work and social life. Patients, who exhibit a strong emotional reaction to tinnitus, a high level of anxiety, and psychosomatic problems, indicate that the limbic and autonomic nervous systems are crucial in clinically relevant tinnitus cases. Tinnitus is only one of the possible clinical aspects concerning disturbed auditory perceptions. The objective of this review was to organize all described disturbed auditory perceptions, with particular reference to the definition and the pathogenesis of a chronic bothersome tinnitus.

Recently Alrwisan et colleagues [1] compares the rates of tympanic membrane (TM) perforation after use of the two available classes of eardrops, quinolones and neomycin, following ear tube surgery. Considering a total of 96,595 children, they found an increased risk of TM perforation requiring tympanoplasty in children which used quinolone eardrops. The adjusted hazard ratios were 1.49 (95% confidence interval [CI], 1.05–2.09) for ofloxacin, 1.94 (95% CI, 1.32–2.85) for ciprofloxacin plus hydrocortisone, and 2.00 (95% CI, 1.18–3.41) for ciprofloxacin. A recent cell culture study showed that treatment of mouse TM fibroblasts with ciprofloxacin, at concentrations similar to those achieved with eardrops in humans, led to marked cytotoxicity and depression in collagen synthesis [2]. These findings, together with the well-known detrimental effect of systemic quinolones on human collagenous tissue [3], raise suspicions about quinolone eardrops, as they could contribute to the development of persistent TM perforations. Clinicians are stuck in a difficult situation, as alternative eardrops with aminoglycosides have been known to cause hearing loss in the presence of TM perforation [4]

Background: allergic rhinitis is an infl ammatory process of the upper respiratory tract with a continuous symptom that last for hour or more with symptom affect patient’s work and quality of life. Methodology: a randomized controlled trial in which we enrolled 284 patients with allergic rhinitis for periods longer than 4 days/week and for more than 4 consecutive weeks divided into two groups. Group A (n=142) received Imipramine 75 mg/day for 90 days .Group B (n=142), the control group, received desloratadine 5 mg / day for 90 days.

Chyle fistula (CF) is a rare complication of neck dissection. The extravasation of chyle can result in potentially devastating metabolic, nutritional and immunologic sequellae. We report the efficacy a protocol for treatment of intraoperative (CF). Hospital length of stay, time to oral alimentation, and type of diet were analyzed. There were 19 patients with thoracic duct injury development following neck dissection (0.08%) The mean age was 62 years and the majority were male with squamous cell carcinoma of the oral cavity. The TDI’s were identified on the left side in 16 patients and on the right side in 3 patients. In all cases TDI were identified intraoperatively, packed with micro-fibrillar collagen and oversewn with monofilamemnt nylon. In one patient required re-exploration and placement of a muscle flap. The mean number of days NPO was 2.5 (range 1 to 13 days, SD ± 2.8). The mean LOS was 4 days (range 2 to 14 days, SD ± 2.7). Only patient number 5 and 12 required MCT administration for 14 and 12 days and no patients required parenteral nutrition.

Introduction: The aim of this study was to evaluate the frequency and clinico-anatomical features of facial skin cancers in an African Black population. Patients and methods: It was a retrospective, descriptive study of all cases of skin cancer localized on the face, seen in our department over a 21-year period. Results: We collected 253 cases of cutaneous cancers, among which 48 cases (19%) were localized on the face. The mean age of the patients was 50 years, with a sex ratio (M/F) of 1.19. Squamous cell carcinoma (SCC) was the most common (54.2%), followed by primary cutaneous lymphomas (18.75%), Basal Cell Carcinoma (BCC) (14, 6%) and Darier-Ferrand dermatofi brosarcoma (4.2%). Melanoma, rhabdomyosarcoma, adnexal carcinoma and angiosarcoma were each observed in 1 case respectively (2%).

Kummoona Chondro-Ossous graft is the most popular graft been used for reconstruction of the temporomandibular joint for restoring growth, repair and remodeling and fore correction of facial deformity in children with restoration of functional activity of the damaged temporomandibular joint (TMJ) and graft work as primary growth center. These graft been studied by experiment on Rabbits as an excellent animal model for viability of the graft. clinically 36 cases were reported, they were 25 children including 9 females and sixteen boys with history of ankyloses of the TMJ and ten children of 4 females and 6 boys suffering from milled hemi facial microsomia or fi rst arch dysplasia syndrome and one female case with traumatic hypoplasia of the condyle.

Glomus tympanicum is a rare tumor of the middle ear which typically present with pulsatile tinnitus, hearing loss and bleeding. Examination may reveal a vascular mass which bleed on contact. Imaging is important prior to surgical resection.

Antrochoanal polyps are benign mucosal lesions emerging from the maxillary sinus. The primary symptoms are nasal obstruction and rhinorrhea. Endoscopic and radiological appearance of the disease is typical. These polyps are usually presented unilaterally, although bilateral presentation is also possible. In this paper, we report a case of atypically giant antrochoanal polyp in a 13-year-old child. The patient’s primary complaint was a sensation of lump in her throat. The examination revealed a mass behind soft palate. The excised polyp had the histological characteristic of an angiomatous antrochoanal polyp. Because of the unusual dimension, the combined transoral and endonasal endoscopic approach was performed for complete polyp excision. We discussed the clinical, histopathological and immunohistochemical characteristics of choanal polyps in comparison to inflammatory nasal polyps, and the applicable surgical techniques for treatment of these polyps.

Introduction: Otomycosis, is one of the most common conditions encountered in a ENT practice. Difference of opinion does exist regarding ideal treatment modality. Aim: Compare the treatment effi cacy of 1% Clotrimazole drops with 1% Clotrimazole Cream in management of otomycosis. Method: Randomized control study was performed over 3 months. 60 patients, clinically diagnosed with otomycosis were included in study. Patients were randomly allotted to treatment arms of either 1% clotirmazole drops or 1% clotirimazole cream. Improvement in symptoms of pain, pruritis and blocked sensation on one and two weeks follow up was recorded. External auditory canal was evaluated for improvement in otomycotic debris. All patients were asked the opinion about preferred modality of treatment.

Introduction: Carcinoid tumor of the middle ear (ME) is exceedingly rare and thus its diagnosis is frequently delayed. It is also hard to differentiate between middle ear carcinoid from the middle ear adenoma. Definitive diagnosis is made by identifying neurosecretory tumor cells using immuno histochemistry and electron microscopy.

Introduction: Most educational hospitals teach the tonsil surgery just with head lights and without any magnification device. This prospective clinical trial focuses on the additional workload when using a microscope or magnifying glasses for tonsillectomy.

This case reports a rare case of accidental metal spoon swallowed by a normal adult which was successfully removed without complication under local anesthesia using a McGill forceps via laryngoscope. Aerodigestive foreign bodies are almost always managed by the otolaryngologist. This is the rarest foreign body of the metal spoon being swallowed by a normal adult by accident. Early removal is mandatory as this may lead to devastating complications.

Objectives: To report one institution’s experience with 22 cases of the Riedel procedure in order to establish a profi le for those patients with chronic frontal sinusitis who develop chronic osteomyelitis. Study Design: Retrospective review. Methods: Review of all patients undergoing the Riedel procedure at one institution with analysis of demographic data, indications for procedure, technical aspects of performing the procedure, outcomes and complications. Comprehensive review of the literature was performed as well.