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Congenital auriculocervical fistula is a rare occurance and reporting of the challeges in diagnosis andmanagement is not common. Ten cases of congenital first branchial fistula were reviewed. Of these, 8underwent fistulectomy with facial nerve dissection and partial parotidectomy and 2 underwent simplefistulectomy. The inner openings (upper opening) of fistulae lay in the following sites: inferioposterior wallat the junction of cartilaginous and bony segments of the auricular canal and inferior wall of cartilaginousauricular canal. The outer openings (lower opening) lay along the anterior border of uppersternocleidomastoid muscle, at the mastoid tip and posterior to the mandibular angle. Complete fistulaeresection was achieved in all but not one case. Eight cases were followed for 5 year with no recurrence.Recurrence occurred in 1 case 6 months after the primary surgery and revision surgery was performedConclusions Pre-operative radiography for the location and course of the fistula is crucial for successfulfistula resection, especially in cases with past infections. Facial nerve dissection should be done routinelyfor deeply located fistulae.

The aim of this study was to assess hearing improvement after myringoplasty within ten weeks following surgery. The study population consisted of 30 patients who were suffering from CSOM-77". Pre-operative and post-operative eraminations of the patients were conducted clinically as well as audiologically. Pre-and post-operative air-bone (A-B) gap were calculated by raking the averages of bone conduction and air conduction at the frequencies of 300. 1000 and 2000 Hz. Myringoplasty was done with underlay technique under general anaesthesia by postaural approach. Temporal 'muck fascia was used as grafting material for reconstruction of the tympanic membrane. Pre-operatively, air-bone gap of 30 db or more was observed in 39 (78%) patients whereas post-operatively A-B gap of 30 db or mare was observed in only one patient. Using hearings gain exceeding 15 dB as the criterion. 39 (78%) patients had their hearing gain exceeding 15 dB. Using post-operative A-B gap within 20 dB as the criterion. 42 (84%) patients had their A-8 gap within 20 dB. Myringoplasty is a beneficial procedure for hearing improvement. Using the proportion of patients with a post-operative A-B gap of 30 dB as the criterion, in this study. 98% of patients achieved their A-B gap closer within 30 dB. Using hearing gain exceeding 15 dB as the criterion, 78% patient had their hearing gain exceeding 15 dB.

Functional endoscopic sinus surgery (FESS) is the minimally invasive procedure to clear the disease process from nose and pansnasal sinuses like chronic maxillary sinusitis and to restore aeration and normal nutcocilliary function of sinuses. FESS has recently become a popular technique among the otolatyngologists of Bangladesh. The use of endoscope during FESS improves visualization, enables greater preservation of normal structures and reduces the necessity for wide exposure of operation fields. The result suggests that FESS is a safe and effective method in the treatment of chronic maxillary sinusitis. This study of 50 cases was done front January 2007 to December 2007 at Holy Family Red Crescent Medical College Hospital where FESS is routinely done for the management of chronic maxillary sinusitis. In this study, 76% (38) were completely free from symptom, 16% (08) improved, 4% (02) encountered recurrence of symptom and persistence of symptom observed in another 4% (02) cases. Most of the patients (62%) in this series of FESS were operated without facing any difficulties. Majority of the patients (94%) were released from the hospital within two days of FESS. No post-operative complication was found in 62% patients. FESS for inflammatory sinus diseases is now well established but one should be cautious about the complications associated with Otis technique.