Presbycusis is aging deafness, progressive decrease in hearing, high frequency usually associated with tinnitus. This is due to the release of free radicals in cellular metabolism leading to cell death of cochlear hair cells, stria vascularis, and sensorineural degeneration. It also leads to vasoconstriction of end arteries resulting in hypoxia, ischemia, and necrosis of cells. Apart from hair cells, rest all can be regenerated by suitable environment, diet positivity, lifestyle changes, and proper diet along with Yoga and Pranayama. It is a long-run exercise. Since visual integration is a part of hearing, focused concentration, dynamic neurobics, and mid-brain activation also help in rehabilitation. The most important Pranayama is modified Nadi Shodhan (Kumbhak).

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Introduction: The removal of Cholesteatoma remains a matter of debate with varying opinion, but the primary objectives remain complete eradication of the disease and creation of a safe ear. Restoration of hearing is secondary objective. Reconstruction of posterior canal wall can be attempted after complete removal of cholesteatoma with different materials. Aim and Objectives: The aim of the study was to study the outcome of posterior canal wall reconstruction in patients undergoing modified radical mastoidectomy. Materials and Methods: This prospective interventional cross-sectional study has been done on forty patients in the department of otorhinolaryngology and head-neck surgery, in a tertiary care hospital in Western Uttar Pradesh with an enrolment period of 1 year and a minimum of 1-year follow-up. Results: In the present study, the success rate of canal reconstruction was 85%. The most common site of middle ear cleft which was found to be mostly affected by cholesteatoma was aditus in 94.12%, followed by posterior attic, middle ear, and sinus tympani accounting for 91.18%, 82.35%, and 79.41%, respectively. Incus was found to be the most common ear ossicle affected. A statistically significant result was found in the pre- and post-operative average hearing loss and air-bone gap. Conclusion: Canal reconstruction in patients undergoing canal wall down mastoidectomy is a good option in patients presenting with limited disease of squamosal type of chronic otitis media. A candidacy criterion has been proposed for deciding patients in whom canal reconstruction can be tried.

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Introduction: Residual inhibition (RI) is described as a temporary reduction in the loudness of tinnitus as a result of stimulation from a noise. Aim: This study is aimed to determine the efficacy of durational aspects of tinnitus masking on self-reported tinnitus handicapped measures in patients with and without hearing impairment. Sample Size: Sixty participants were included and divided into two groups – Group A (mean age 44.7, standard deviation [SD] 12.02) included tinnitus participants with normal hearing and Group B (mean age 43.81, SD 12.79) included participants with hearing impairment. Methodology: Audiological evaluation was done after a detailed case history visual analog scale (VAS) and tinnitus handicapped inventory (THI) were used pre- and post-therapy to assess the severity of tinnitus. Tinnitus masking was done at the level MML + 20 dB at matched frequency of the tinnitus. Each group had three subgroups of ten participants for masking duration– 15, 20, and 30 min of RI. The therapy was terminated when the tinnitus disappeared or after 1 month (5 days a week). Statistical analysis was performed using Paired t-test, Independent t-test, and ANOVA. Results: There was a significant difference in the effect of tinnitus masking for pre- and post-data among different masking durations measured in VAS and THI irrespective of hearing status. 30-min masking duration can be used as a standardized norm for tinnitus masking. Conclusion: Thus, the study provides a structured temporal course for providing tinnitus masking.

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Introduction: Swellings of pinna are common but various cystic lesions encountered in clinical practice are not reported too often. Management of these lesions if not done at the earliest may lead to disfigurement and change the entire appearance of the face. Aim and Objective: The aim and objective of the study was to determine the clinical presentation, relevant investigations, appropriate treatment, timing of surgical intervention, and prevention of complications. Materials and Methods: Our study comprised 38 cases; male and female patients presented with different types of pinna swellings. Results: A total number of pseudocyst patients were 30 and of which only four were females. Recurrence seen in pseudocyst was 13.33%. Complete resolution was seen after excision in all cases of dermoid and sebaceous cyst. Conclusions: Aspiration and drainage followed by splinting is a simple, safe, and effective surgical treatment of pseudocyst. Simple excision is the most effective surgical treatment of dermoid cyst and sebaceous cyst.

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Background: During repair of central perforations of tympanic membrane, annulus should be visible in a single view. It helps in better placement of graft. To attain this, the bony canal is enlarged. Materials and Methods: Eighty patients with dry central perforation were selected during the period 2010–2020. Sixty patients with dry central perforation underwent tympanoplasty Type 1 with canalplasty and twenty patients were subjected to tympanoplasty Type 1 only. The method, operative procedure, and words of wisdom to give good results and prevent complications are described. Results: Patients with canalplasty had better postoperative results, and the success rate is improved as compared to only myringoplasty. The primary outcome measure of canalplasty with tympanoplasty procedure is complete re-epithelization and provision of a dry ear in 95%, whereas the final outcome without canalplasty was 90%. Conclusion: The aim of the canalplasty is to create a wide, patent, and physiological bony ear canal. Canalplasty helps to have better visualization, better postoperative care, better exposure for ossiculoplasty, time gain during graft placement, prevent lateralization, and promotes healing. It does improve the surgical outcome in tympanoplasty Type I.

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Background: The role of audiology lab and field of audiology in India has expanded exponentially in recent years. However, little is known about the practice trends. The audits allow for changes in service quality to be charted over time both locally and nationally. Audit covers how audiology services should gather information about their service and use that information to improve things for service users. However, such information is currently lacking in India. For this reason, the current audit study is aimed at understanding current audiological practices in India with an intention of identifying areas warranting change. It is important to evaluate our practice trends to identify gaps in services to track quality of practices and possibly in the planning of future services. The current study provides some understanding about the status of current audiological practices in India. This study reports the results of a retrospective audit, which, to our knowledge, is the first of its kind to be conducted in India in the field of audiology. Aims and Objectives: An audit of audiology services at Department of Otorhinolaryngology, AIIMS, Rishikesh. for a period of 5 years (January 2015–December 2019) was conducted to – know number of various types of audiological tests done and to analyse various audiological tests in relation to time spent in minutes/hours per year on individual tests and percentage of average working audiology lab time spent on that particular tests per year to know the ratio of time spent on various audiological tests. Materials and Methods: An observational, retrospective study was conducted as audit of audiology services at Department of Otorhinolaryngology, AIIMS, Rishikesh. for a period of 5 years (January 2015–December 2019). Results: A total of 41,299 audiological investigations were performed during the period of study, i.e., 5 years and it was observed that the most common investigation performed was PTA (20,361; 49.38%), followed by immittance audiometry (10,900; 26.39%), OAE (4306; 10.44%), speech audiometry (2824; 6.84%), special tests (tone decay, SISI, etc.) (1693; 5.0%), and ABR/ASSR (1145; 2.77%). The most commonly performed audiological test was PTA (49.38%), and an average time spent on PTA (at 20 min per test) was 81,440 min/1357.33 h, i.e., 73.44% of total working time of audiology lab per year. (1,10,880 min/1848 h) followed by Immittance audiometry (26.39%), and an average time spent on immittance audiometry (at 10 min per test) was 21,800 min/363.33 h, i.e., 19.66% of total working time of audiology lab per year. (110,880 min/1848 h). Conclusion: The current study provides useful information about the diversity in current audiological practices in India. This study identifies the need for improving clinical practice, as inconsistencies were observed even in performing basic procedures such as PTA. This could greatly improve audiological practice and, thereby, patient outcomes. As per advances in audiology, this study can contribute in planning Telepractice in Audiology: Future Prospects and Challenges.

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Introduction: Thirty percent to seventy percent of skull fractures in adult head trauma patients is due to temporal bone fractures and is caused due to road traffic accidents (RTAs). Temporal bone fractures are more commonly associated with hearing loss. Objective: The objective of this study is to assess the type and the amount of hearing loss in temporal bone fractures. Methodology: A 3-month retrospective study was conducted at the department of ear, nose, and throat in a tertiary care center. Fifty patients, diagnosed as cases of temporal bone fractures with hearing loss were included in the study. The patients with temporal bone fractures were categorized into two groups-otic-capsule sparing (OCS) and otic-capsule violating (OCV) fractures, and hearing loss was evaluated with Pure tone audiogram (PTA). Results: OCS fractures were more common (64%) than OCV. Conductive type of hearing loss was commonly associated with OCS, whereas sensorineural hearing loss was more common in OCV fractures. The average degree of hearing loss ranged from 20 to 68 db. The correlation was statistically significant for temporal bone fractures (OCS and OCV) with respect to hearing loss (P < 0.00001). Other complications such as external auditory canal filled with blood, perforation of tympanic membrane, and hemotympanum were also observed in our study. Conclusion: Temporal bone fractures are most commonly due to RTAs and are frequently associated with severe brain injury. Classifying temporal bone fractures as OCS and OCV fractures correlates well with the severity of hearing loss, and conductive hearing loss was the most common type hearing loss.

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Background: Waardenburg syndrome (WS) is an autosomal dominant inherited genetic condition that manifests with sensorineural deafness and pigmentation defects of the skin, hair, and iris. This genetically and clinically heterogeneous disease accounts for 2% of the congenitally deaf population. Objectives: The aim of our study is to determine epidemiological and clinical characteristics of this group to improve the management, especially for the hearing impairment. Methods: Seven cases were diagnosed during the examination of children with suspected congenital deafness. Results: The age of our children ranged from 1.3 to 5 years, with a median age of 3.6 years, with female predominance; no consanguineous marriage and fetal or perinatal history have been reported; there was family history of premature greying in four cases and deafness in two cases. Two patients had WS Type 1 with a dystopia canthorum, while four cases had WS Type 2. There was one patient with Waardenburg Klein or Shah syndrome. The otoscopy was normal in all children. Evoked auditory potentials, otoacoustic emissions, and tonal audiometry were performed; they had shown a congenital, sensorineural bilateral, and profound hearing loss >100 dB in all cases. All children had received a cochlear implantation followed by speech reeducation. A genetic consultation was carried out for all our children. Conclusion: WS is a relatively common genetic cause of sensorineural hearing loss. Early diagnosis and improvement of hearing impairment are most important for psychological and intellectual development of the children with WS.

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Background: Cochlear implants (CIs) are nowadays a widely accepted treatment for sensorineural hearing loss. Aim: This study aimed to describe the epidemiological characteristics and the surgical approach and to evaluate the outcomes of our experience in cochlear implantation in pediatric population at the Department of Otolaryngology–Head and Neck Surgery of Mohammed VI University Hospital, Marrakech, Morocco. Materials and Methods: A retrospective chart review was conducted on 113 children with severe-to-profound hearing loss who underwent a cochlear implantation between 2007 and 2018. Results: There were 65 females and 48 males with severe-to-profound bilateral deafness, of whom 103 had prelingual deafness. The mean age of pediatric cochlear implantation was 5.25 years. Implantation was unilateral in all patients. The procedure was followed by regular adjustments and speech therapy. The evaluation was carried out by the same team each month during the first 6 months and then every 6 months. The average duration of follow-up was 38.94 months. All patients benefited from their implants with interindividual variability. The good results were correlated with early implantation, significant parental investment, and a steady follow-up of speech therapy. Conclusion: Cochlear implantation has revolutionized the management of severe-to-profound deafness. It is a safe and effective technique when it is aimed at correctly selected populations.

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