Foreign body in otolaryngology practice is a common scenario. There have been very few documentations of a worm entering the ear through the Eustachian tube. We hereby report a very interesting such case and also discuss the possible cause postulated for such events.

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Objective: The correlation between tympanic membrane perforations and hearing loss was studied. Study Design: Cross sectional prospective study design. Setting: E. N. T OPD, at a tertiary referral center. Materials and Methods: 100 perforated ears in patients of CSOM safe were selected from May 2011 to September 2013. Instruments used for data collection/processing included questionnaires, oto-endoscopy and micro-otoscopy, Pure tone audiometer and image J software. Results: Sixty-three patients (27-males, 36-females), aged 10-56 years (mean age 23.2 years ± 11.8 years) with 100 perforated eardrums were studied. 37(58.7%) had bilateral TM perforations, 7(11.1%) right unilateral and 19(30.2%) left unilateral. The various sizes of perforation and their hearing loss were as follows: Group I (0-8 mm ² ), n=18, with mean hearing loss 29.41 ± 4.39. Group II (8.1-30 mm ² ), n=39, with mean hearing loss 34.69± 4.96. Group III (>30.1 mm ² ), n = 43, with mean hearing loss= 38.79± 3.44. Difference was significant, P value 0.000. The various sites of perforations were Central (69 ears. Mean hearing loss 35.64 dB ± 5.31), Posterior (16 ears, mean hearing loss 39.99 dB ± 2.79) and Anterior (15 ears, mean hearing loss 30.1 dB ± 2.98). Difference was significant, P value 0.000. Lower frequencies were affected more than higher frequencies. Inverted 'V' pattern of audiograms was observed at 2000 Hz. Conclusion: A linear relationship existed between size and degree of hearing loss. Posterior perforations had a higher hearing loss. Lower frequencies were affected more in general. Inverted 'V' pattern of audiograms was observed with turning point at 2000 Hz.

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Introduction: Hearing loss is often thought of as a natural phenomenon of the aging process. However, studies are beginning to show that hearing loss is becoming increasingly more common amongst younger people. Approximately, 20-30 million people between the ages of 20 and 69 years have high frequency hearing loss due to chronic exposure to loud noise above 90 decibels (dB) thanks to the advent of MP3 players and cellphones, according to the National Institute of Deafness. ^[1] If you are one of the millions who enjoys listening to a MP3 player or cellphone music to allay boredom or to pass time, then you might be at risk for hearing loss from headphones or earphones. Studies have shown that most MP3 players today can produce sounds up to 120 dB and that long-term cell phone use to hear music may cause damage in the inner ear. In today's society, these devices are indispensible and are part of day-to-day life. Hence, this study was conducted to create awareness regarding prolonged exposure to loud noise either through an MP3 player or cell phone music. Materials and Methods: A total of 1,000 students from Shri Adichunchanagiri Institute of Medical Sciences and Adichunchanagiri Institute of Technology and Adichunchanagiri Pre-university College were chosen as part of the study. They were divided into four groups, Group A comprising 250 students who had a habit of listening to music through ear phones at least 2 h a day, Group B comprising 250 students who are used to earphone music less than 1 h per day and Group C comprising of 250 students who very occasionally use ear phones, but hear music mostly through speakers and Group D comprising of 250 students who are usually unaware of ear phone music and are not used to it. All the groups were subjected to pure tone audiometry and the audiogram obtained. Results and Observations: The study revealed high frequency hearing loss in 8% of Group A and 2% in Group B; whereas, in there were no hearing impairment in Groups C and D indicating a significant role of prolonged ear phone music as a cause of high frequency hearing loss in students. The thin percentage and absence of hearing loss in Groups B, C, and D suggests the impact of the duration of exposure also has a role in the pathology. Conclusion: This study proves beyond doubt that the prolonged usage of loud ear phone music is harmful to the ears and a simple way of pass time by hearing to ear phone music might cause hearing loss.

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Ceruminous adenoma is a rare neoplasm of the external auditory meatus (EAM) with benign clinical behavior. They demonstrate a dual cell population of basal myoepithelial-type cells and luminal ceruminous cells. Cerumen pigment, cytokeratin 7 (CK7) and p63 can help to distinguish this tumor from other neoplasms that occur in the region. Complete surgical excision results in an excellent long-term clinical outcome. We present a case of histologically confirmed ceruminous adenoma of the EAM in a surgically treated 38-year-old female. She presented with recurrent serosanguineous discharge along with flakes from the right ear along with hearing impairment. She is doing well in last 8 months follow-up.

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Aims and Objectives: This prospective randomized controlled trial was done to study the effect of piston diameter on hearing outcomes after stapedotomy. Materials and Methods: All the patients diagnosed to have otosclerosis were included in the study. A total of 52 patients were studied ranging in age from 18 to 50 years. The subjects were randomized into two groups, that is, 0.4 mm piston (group A) and 0.6 mm piston (group B). The subjects were taken up for small fenestra stapedotomy using either a 0.4 or 0.6 mm piston. The main outcome measures were hearing improvement, air-bone gap closure, and overclosure of air-bone gap. Results: There was no statistical difference in hearing improvement in two different piston diameters, 0.4 and 0.6 mm at speech frequencies. In group A, the air-bone gap improvement in the third follow-up was not significant (P > 0.05), whereas group B showed a statistically significant improvement (P = 0.003). The mean overclosure of air-bone gap was better in patients with 0.4 mm piston at speech frequencies and also at 250 Hz. Significantly, overclosure of air-bone gap at higher frequencies (4 and 8 KHz) was seen only with a smaller sized piston. (0.4 mm). Discussion: We analyzed the effect of piston diameter on the hearing results after small fenestra stapedotomy by using similar surgical procedure and similar prosthesis in all patients. Conclusion: There is evidence to suggest that 0.4 mm piston may be better suited for providing optimum hearing results.

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Aim: To study the opinions of grandmothers of newborns on hearing loss, Newborn hearing screening (NHS) and intervention options. Materials and Methods: 100 grandmothers were interviewed in a tertiary care hospital, using a questionnaire adapted from Olusanya, Luxon and Wirz (2006). The responses were analyzed using frequency distribution. Results: 63% were aware that hearing loss could be congenital. Among the causes studied, more awareness was present for family history (67%), noise exposure (62%), and ear discharge (61%). Less than 50% of the participants were aware of other causes. Majority knew that bewitchment (72%) and ancestral sins (69%) were not a cause for hearing loss. Only 20% were aware that hearing loss could be identified at birth and 12% knew about availability of NHS. 75% thought that intervention is possible for hearing loss, and 33% believed that hearing-impaired children could attend regular school, if intervened. 86% of grandmothers preferred testing soon after birth. 87% preferred OAE compared to BERA (33%) as a screening tool. Hearing aids (92%) and surgery (89%) was widely accepted as intervention for hearing loss. Conclusion: Grandmothers had good awareness on congenital hearing loss. And limited awareness was present on causes of hearing loss, identification of hearing loss at birth, NHS and intervention. Thus, indicating an urgent need to create awareness in the above areas. A demonstration of positive attitude was shown in the results towards NHS and intervention for hearing loss, which will facilitate early identification and intervention.

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Objective: To evaluate the influence of preoperative parameters on the status of ossicles in tubotympanic type of chronic suppurative otitis media. Materials and Methods: A total of 47 patients with mucosal type of chronic otitis media were evaluated for factors that influence ossicular status. A total of 14 preoperative parameters that are generally accepted to influence the ossicular status were examined and recorded. The same patients were subjected to surgery and their ossicular status was observed and noted peroperatively. Influence of each of the parameter on ossicular status was analyzed. P < 0.05 was considered as statistically significant. Results: Out of the 14 parameters that were studied, only 3 had a statistically significant influence on the ossicular status. These were, duration of the disease, adherence of the perforation edges to the promontory, pure tone average (PTA) and the air-bone gap (ABG). Duration of disease was significantly associated with ossicular discontinuity (P = 0.026). Adherence of margin of the perforation was seen in eight patients. A total of four among them had ossicular discontuinity and one among those who did not have this finding had ossicular discontinuity (P = 0.003). The mean PTA was 46.2 ± 20.1 db in patients with intact ossicular chain and 65.7 ± 14 db in patients with ossicular discontinuity (P = 0.04). Mean ABG was 23.9 ± 9.8 db in patients with intact ossicular chain and 35.1 ± 10.3 db in those with ossicular discontinuity (P = 0.001). Conclusion: Of the parameters studied, three were reliable to predict ossicular discontinuity in tubotympanic disease viz. duration of the disease, adherence of the margins of perforation to the promontory, PTA, and the ABG.

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Objectives: The present study was aimed to investigate age related changes on Caloric test, Gaze Test and Vestibular Evoked Myogenic Potential (cVEMP). Materials and Methods: The participants included 50 individuals ranging from 20-70 years having no complaint of dizziness or any major illness. The basic audiological test battery was carried out followed by Caloric test, Gaze Test and the VEMP. Results: There was no consistent pattern seen on the caloric test and gaze test with advancing age while VEMP showed significant increase in latency and decrease in amplitude of both P13 and N23 as the age advances. Discussion: The comparison of the mean SPV values do not show an age related pattern because the caloric test does not challenge the semicircular canal system enough so as to reveal its defects. The age related changes in the cVEMP parameters could be attributed to the age related degeneration in the vestibular sense organ

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Introduction: Mobile phone usage is over 5.6 billion worldwide. India holds second position with about 885 million users, that is, 74% of Indian population (November 2011). The advanced mobiles with the fancy multipurpose gadgets make mobiles a part of us. Chronic exposure to sound of more than 90 dB can result in permanent hearing loss. Mobile phone may not produce a sound as loud in a fraction, but there is possibility of sound exposure for a long-term. Materials and Methods: Hundred subjects were selected randomly from students of a medical college, based upon criteria of the preliminary questionnaire and subjected to clinical examination, to rule out other possible causes of hearing loss and categorized into two groups. (Group 1: Users for <2 h/day and Group 2: Users for >2 h/day). The following noninvasive procedures were done to assess the hearing status: Pure tone audiometry (PTA), distortion product otoacoustic emissions (DPOAE), and brainstem evoked response audiometry (BERA). Results: A variable degree of hearing loss has been found in the mobile phone users in DPOAE and BERA. Further, on gross comparison individuals of Group 1 (<2 h/day) and Group 2 (>2 h/day), loss was found in both; but the proportion is noted to be more in Group 2. Conclusion: Here, most of the study population (73%) was found to use mobile phone at least for 30 min or more for every call and they were assessed having a hearing loss (mild/asymptomatic). Thus, "intensity of hearing loss is found to be directly proportional to the duration of usage and sound exposure of more than that regulated as safe."

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Giant cell reparative granuloma (GCRG) is a benign osteolytic lesion of unclear etiology, commonly affecting the maxilla and mandible. These lesions which may occur as an inflammatory response due to intraosseous hemorrhage following trauma, rarely occur in the temporal bone. Here we present a case of a 38-year-old female patient who presented with a swelling in the left pre-auricular area, involving the squamous temporal bone. She underwent a curettage of the lesion which on histopathological examination led to diagnosis of GCRG. A follow-up of 6 months indicated no recurrence.

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