Aims: Sudden hearing loss is defined as a sensory neural hearing deafness of at least 30 dB in three consecutive speech frequencies that as occurred within the 3 days. It is a medical emergency and the treatment should start as soon as possible; up to now therapies are empirically addressed to improve hearing. Materials and Methods: We have evaluated 558 patients with a diagnosis of sudden hearing loss. In our study, we have investigated possible prognostic factors of hearing loss and their influence on the recovery of the pathology. Results and Discussion: Sudden hearing loss requires an immediate therapeutic intervention. The corticosteroid therapy remains the most accredited one at which are reported the most satisfactory results. We have recognized as negative prognostic factors hearing loss on acute frequencies in the audiometric exam, the presence of a severe-deep hearing loss and a delay in starting therapy. Conclusion: The sudden hearing loss is an otologic emergency which requires an immediate therapeutic intervention. The most accredited therapy remains the corticosteroid therapy. Frequencies we have recognized as negative prognostic factors hearing loss on acute frequencies. The presence of a severe-deep hearing loss, and a delay in starting therapy.

Introduction: Ocular Vestibular evoked myogenic potentials (oVEMPs) are sensitive in diagnosing clinical population with vestibular dysfunction. Aim: We aimed at comparing the oVEMP responses of normal, evoked by 500, 1000, 2000, and 4000 Hz short duration tone burst stimuli. Materials and Methods: A total of 60 subjects underwent the oVEMP testing using 500, 1000, 2000, and 4000 Hz. Single channel electrode montage was used with analysis time of 50 ms, bandpass filter of 1-1000 Hz and 200 stimuli averaging. Intensity of 99 dB normalized hearing level (nHL) evoked the responses. Results and Conclusion: oVEMP response showed no significant difference in latency of n1-p1 across the frequencies. However, the peak - peak amplitude of n1-p1 at 500 and 1000 Hz was greater than 2000 and 4000 Hz frequencies. Thus, 500 and 1000 Hz short duration tone burst stimuli can be accountable for the diagnosis of clinical population with good morphology.

Background: This study examines the concealed phenotypic variations in carriers of non-syndromic recessive hearing loss, using fine structure distortion product otoacoustic emissions (DPOAEs). As genetic tests were not feasible to validate the recessive trait in the participants, an inclusion criterion was followed, where in normal hearing parents with two or more hearing-impaired children and a positive consanguinity were assumed to be probable carriers. Materials and Methods: The amplitude of fine structure DPOAEs from 27 ears of probable carriers was compared with 62 normal control ears. The primaries were presented at 65/55dBSPL, maintaining a frequency ratio of 1.2, covering 20 points per octave across 1-4 kHz. A comparison between the octaves 1-2 kHz and 2-4 kHz was also made in all the participants to observe if the deviant functioning of the hair cells predominated the higher or the lower frequencies. Results: The overall fine structure amplitude was significantly reduced in the probable carrier group across the frequencies. There was a significant difference between 1-2 kHz and 2-4 kHz in both non-carriers and probable carriers. The higher frequencies had a lower amplitude and the lower frequencies had a higher amplitude. The probable carrier group had a relatively significant amplitude reduction in the higher octave when compared to the control group. Conclusion: Carriers of hearing loss do exhibit subtle functional changes in the ear, in spite of having a normal hearing sensitivity. This study throws light on the scope of fine structure emissions to emerge as a very good diagnostic tool in the field of audiology.

Aim: The present study is a prospective study that looks into the prevalence of chorda tympani nerve injury and related symptoms following varying degrees of trauma to the nerve during four common types of middle-ear operations; namely, Tympanomastoid operations, myringoplasty, Tympanoplasty and Exploratory tympanotomy. Materials and Methods: 178 patients who underwent middle ear cleft surgery were included in this prospective study. Childrens below 20 years and patients with other potential cause of taste disturbance were excluded. Patients were given a single questionnaire, so as to assess their post-operative taste disturbance. Patient name, Age, Sex, Type of middle ear surgery, side of surgery were recorded. Any change in sense of taste immediately (after 2-4 weeks) or delayed (2-3 years)were recorded. Results: The number of patients with Chorda tympani nerve-related symptoms varied widely between these four groups. Increased occurrence of the nerve related symptoms were observed in Tympanomastoid and Myringoplasty, and a prolonged recovery time were observed in the tympanomastoid group. Stretching of the nerve produced more symptomatic cases than thermal injury or drying. Conclusion: It is important to inform patients about the possibility of Chorda Tympani Nerve injury during middle-ear operations, and it should also be emphasized that symptoms related to Chorda Tympani Nerve injury can occur irrespective of the type of damage to the nerve.

Aims: To study the efficacy of mometasone furoate monohydrate topical nasal spray in the treatment of otitis media with effusion (OME) in children aged between 4 and 15 years. Thus, by comparative analysis of results, at 0 and 6 weeks of using mometasone nasal spray, its efficacy in improving the clinical and audiological status of children with OME is assessed. Materials and Methods: A prospective, clinical study carried out on 22 children aged between 4 and 15 years who had attended our Department of Otolaryngology in a tertiary care hospital from January 2008 to May 2009. Results: The efficacy of mometasone furoate monohydrate topical nasal spray in the resolution of middle ear fluid in children aged between 4 and 15 years with OME in this study group was observed to be significant (52.7%). A significant improvement in the overall symptoms was seen in the treatment group. There was good improvement in the audiological status also. Conclusion: Topical steroids can be an alternative to surgery in controlling OME. However, these results are only short-term; a long-term follow-up is necessary. Topical intranasal mometasone furoate therapy can be considered a good therapeutic option to OME. Nasal administration of this steroid is safe, reproducible, easily performed, and well tolerated by pediatric patients.

Objectives: To review the clinical signs, symptoms, diagnosis, treatment, bacteriology, and outcome of patients treated for lateral sinus thrombosis (LST). Materials and Methods: A retrospective review of nine patients treated with an intraoperatively confirmed diagnosis of LST. Nine patients presenting with LST of otogenic cause were included in this study. All charts related to clinical presentation, operation records, investigations, and other pertinent data were reviewed and analyzed. Results: All the patients were children aged 7-12 years. Computed tomography scan revealed the diagnosis of LST. None of the patients responded to initial conservative management. Patients underwent canal wall down mastoidectomy with evacuation of infected thrombus. Cholesteatoma was present in all the ears. Infected thrombi grew gram-negative organisms (Psuedomonas-6, Enterobacter-1, Klebsiella-1, and no growth in the other). Conclusion: In children with suppurative otitis media, clinical presentation of ear ache/headache, neck pain, or swelling with papilledema should warrant an evaluation to rule out LST and associated intracranial complications.

Background: Widespread concerns have been raised about the possibility that exposure to the radio frequency fields from mobile telephones or their base stations could affect people's health. Materials and Methods: Effect on hearing in 120 mobile phone users and nonusers between age group of 18-30 years were studied over 3 years. Group 1 using mobile phone more than 1 hour per day for more than a year and group 2 no usage or less than 1 hour per day for less than a year. Results: Those using phones for 2-3 hours daily, loss of 5 dB in 10%, 10 dB in 3.3%, and 15 dB in 1.6% were noted. Also loss of 5 dB in 6.6% and 10 dB in 3.3% were noted in those using 3-4 hours daily. Sensorinueral hearing loss was seen in 26.6% of the subjects in study group and 3.3% in control group. Conclusion: Our study did not show any significant hearing loss in mobile phone users.

Aim: The aim of the present study was to find out the measurement of real protection of ear muffs and as well ear plugs along with comparison of the efficacy of different hearing rotection devices (HPDs) in attenuation of stimulus levels for various stimuli by real ear attenuation at threshold method. Materials and Methods: Subject group consisted of ten males with the mean age of 20 years having normal hearing sensitivity (pure tone audiometry (PTA) less than 25 dB). Sound field measurement of thresholds was carried out for various stimuli, that is, warble tone, narrow band noise, and speech noise. Frequencies from 250 Hz to 12 KHz were tested in a sound treated room. For comparison, experimenter personally fitted the HPDs, that is, ear muff using experimenter fit method. Occluded threshold levels, that is, threshold of audibility for the test signals were measured in exactly same way as was done for open thresholds. The same procedure was followed for ear plugs also. Measurements were summarized at each frequency in terms of grand mean and a standard deviation of the protection values for both HPDs. Results: In all cases the mean attenuation was similar to optimum figures suggested in the literature, but the standard deviation was relatively high. Ear plugs produce more attenuation for low as well as high frequencies of warble tone and narrow band noise, but ear muff are better attenuators at mid frequencies for both warble tone and narrow band noise and also for speech noise stimulus. Conclusion: The attenuations provided by different types of HPDs vary across various nature and frequencies of that noise. This is to be kept in mind while suggesting for appropriate type of Hearing Protection Devices [HPDs] for optimal benefit.

Background: In the present study, otitis media with effusion (OME) or "glue ear," is serous or mucoid, but not mucopurulent, fluid in the middle ear. Children usually present with hearing impairment and speech problems. Hearing impairment is usually mild and often identified when parents express concern regarding their child's behavior, performance at school, or language development. There are many medical treatment options in OME such as systemic antibiotics, oral or topical steroids, anti-histaminics, and decongestants however, there actual role and efficacy is controversial. Topical nasal steroids are one of the better treatment options because of its fewer side-effects compared to oral steroids. Objective: To assess effectiveness of topical nasal steroids (mometosone nasal spray) in hearing loss associated with OME in children. Materials and Methods: One hundred and six children of age group 2-8 years with otoscopy and tympanometry diagnosed cases of OME were enrolled for this study and randomly allocated into two groups, children in the study group were treated with topical nasal steroids (mometosone nasal spray) for period of 3 weeks and children in control group (no treatment) were observed without treatment. On a total of 106 children, 14 lost to follow-up and were excluded from study and the rest of 92 children were studied in this study. Outcome of treatment was measured with closure of air bone gape on pure tone audiometery done after 3 weeks of treatment, 3 weeks after tapering treatment and 3 weeks after stopping treatment. Results: Demographic comparison was insignificant between the two groups. Patients in study group showed significant closure of air bone gape on pure tone audiogram after 3 weeks of treatment, and 3weeks after tapering treatment. Study group patients showed improvement in hearing 3 weeks after stopping treatment but that improvement was not statistically significant. Conclusion: The present study suggested that topical nasal steroids has a role in treatment of OME and can be used as a short-term treatment option until long-term treatment option like myringotomy and ventilation tube insertion is planned and accomplished.

Aims and Objectives: The objective of this study was to assess the prevalence and patterns of hearing loss after concomitant radiochemotherapy in patients enrolled in a larynx preservation protocol. Materials and Methods: The study comprised of audiological evaluation of 30 patients prior to and at 1, 3, and 6 months after treatment using pure tone audiometry and impedance audiometry. Results: At the end of 6 months, 43.33% suffered sensorineural hearing loss (SNHL), 8.33% conductive hearing loss, 16.67% mixed hearing loss, and 6.67% showed improvement in hearing. Discussion: The possible mechanism for hearing loss are discussed and compared with the result of such studies in literature. Conclusion: There exist a small but definite potential risk of hearing loss after concomitant radiotherapy and chemotherapy in patients with head and neck cancer.

Objectives: Chondrodermatitis nodularis chronica helicis (CNH) is a painful nodule affecting the pinna. The etiology of the disease is unknown. We devised to show a correlation between CNH and systemic health problems of the patients. Materials and Methods: This study included 17 patients with CNH and the other lesions of the ear that incoming differential diagnoses of CNH, including basal cell carcinoma, squamous cell carcinoma, verruca vulgaris, neurofibroma, fibroepithelial polyp, seborrheic ceratose, and cystic lesions, a total of 131 patients that were diagnosed between 2011 and 2012 in the Clinics of Dermatology and Pathology of Çankırı State Hospital. Cardiovascular problems of the patients were queried meticulously and recorded. Results: With 17 patients 12.97% of the 131 patients were CNH. The mean age of the patients was 47.41 and the age range of the CNH patients was 32-79 years, with a mean age of 54.9 years (SD ± 13.23 years). The mean diameter of the lesions was 4.57 mm for CNH patients. The lesions were located at the right air mostly (85.71%) and all of them were located at the helix of ear. The laboratory results of the CNH patients showed that most of them (88.2%, 15 patients) have high cholesterol and lipid levels. By the way six of them (35.2%) also had cardiac problems. Conclusion: Our results showed that the main problem is the defect of arterial blood supply of the pinna. Also we detected that12.97% of the lesions were CNH, while cystic lesions take the first place among all other ear lesions.

Exophytic osseous lesions are rare in the bones of skull and face. The exophytic lesions like, osteochondroma or extra-osseous (soft tissue) osteoma may not be differentiated by imaging alone. We report a case of pedunculated osseous lesion arising from the retro-auricular mastoid bone that turned out, histopathologically, to be fibro-osseous lesion.

In the present study, Congenital cholesteatoma is a rare entity in routine clinical practice. Secondary otitis media makes it difficult to diagnose. Chances of congenital cholesteatoma increase when it is associated with atretic ear. Appropriate imaging technique helps to diagnose and delineate the extent of congenital cholesteatoma. Computed tomography also plays a pivotal role in planning the surgery and grading the outcome of the surgery in congenital aural atresia. We had come across three such cases of congenital cholesteatoma with canal atresia along with conductive hearing loss and ear discharge. Meatoplasty with tympanomastoidectomy was carried out in these cases with hearing improvement confirmed by pure tone audiometry. Histopathology of soft-tissue material in all three cases showed cholesteatoma. Review of literature reveals that these conditions are rare.

Foreign bodies in external auditory canal in pediatric age group are quite often encountered by otolaryngologists in emergency as well as in outpatient. We report here a case of asymptomatic unnoticed unusual foreign body in external auditory canal which was removed by post-aural approach in a child admitted in the pediatric surgery ward of the hospital.

Verrucous carcinoma is a variant of squamous cell carcinoma. It is of low grade malignancy and rarely present with distant metastasis. Oral cavity is the commonest site of this tumor, other sites are larynx, oesophagus, and genitalia. Verrucous carcinoma in external auditory canal is extremely rare. This is the presentation of a 45-year-old woman who came to the ENT and Head Neck Surgery department of Delta Medical College with discharg from left ear and impairment of hearing on the same side for 7 years. Otoscopic examination showed that the skin of external auditory canal was thickened, papillary and blackish. External auditory canal bone was found eroded. Cytology from external auditory canal scrap showed hyperkeratosis and parakeratosis. Excision of the external auditory canal mass was done under G/A. Whole skin from external auditory canal was excised under microscope. Split thickness skin grafting was done in external auditory canal. The specimen was sent for histopathological examination which revealed as verrucous carcinoma. Subsequently, she was treated by radiotherapy. Six months follow-up shows no recurrence.