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Introduction: A cross-sectional prospective clinical study was done to evaluate the inner ear anomalies in candidates undergoing cochlear implantation. Materials and Methods: Study was carried out over a period of 07 years (Jan 2013 to Dec 2019) at Cochlear Implant Centre, Combined Military Hospital Dhaka. A total 206 deaf candidates, both pre and post lingual, were included in convenient sampling method. Result: The sample consisted of 206 candidates, of whom 117 (56.80%) were female and 89 (43.20%) were male. All candidates had severe to profound bilateral deafness. 182 (88.35%) of them were pre and 24 (11.65%) were in post lingual group. All patients diagnosed audiologically as profound deafness underwent HRCT scan of temporal bone with 3D reconstruction of cochlea and MRI of internal auditory canal & brain. Radiological examination revealed that 36 (17.47%) candidates had ear anomalies. Mondini deformity 14 (06.80%), cochlear ossification 11 (5.34%), large vestibular aqueduct 04 (1.94%), high jugular bulb 04 (1.94%) and anteriorly placed sigmoid sinus 03 (1.45%) were noted. During intervention, 42 (20.39%) candidates had anomalous intra operative findings. Among them CSF gusher 19 (9.23%), ossification of basal turn 12 (5.83%), isolated rotated Cochlea 02 (0.97%), high jugular bulb 04 (1.94%), anteriorly placed sigmoid sinus 03 (1.45%), and very high facial nerve 02 (0.97%) were observed. During surgery, electrode insertion difficulty due to high CSF gusher was experienced in19 (9.23%) cases, full length of electrode insertion was not possible due to ossified basal turn 12 (5.83%), difficult to find out round window membrane due to rotated cochlea 02 (0.97%), prevented direct visualization of the round window due to high jugular bulb 04 (1.94%), difficult to approach round window due to very high facial nerve 02 (0.97%). and approach to round window membrane was compromised due to anteriorly placed sigmoid sinus 03 (1.45%). Most of these difficulties were effectively managed during surgery. Conclusions: This study highlights the importance of preoperative radiological scanning in the assessment of patients undergoing cochlear implantation. It provides vital information on cochlear status and in ruling out non cochlear causes where cochlear implantation is not feasible. Detection of anatomical abnormalities with appropriate evaluation, specially imaging should be mandatory in every patient undergoing cochlear implantation. [ABSTRACT FROM AUTHOR]

Objective: This study was focused on the assessment of patient's improvement in hearing, as measured by pure tone audiometry after stapedotomy for primary otosclerosis. Materials and Methods: This prospective clinical study was performed in a total of 156 patients diagnosed with Primary Otosclerosis, who underwent Stapedotomy at the Department of ENT & Head-Neck Surgery, Combined Military Hospital Dhaka between January 2013 to January 2019. All patients were evaluated as per the candidacy criteria for stapedotomy and selected patients underwent surgery during the study period and were followed up for a period of 12 months in the Otology clinic. Pre and Post-operative audiometric evaluation was done using conventional pure tone audiometry with standard calibrations. Post-operative audiometry was performed at 03 month, 06 months and 12 months. The bone-conduction & air conduction thresholds and the Air-Bone gap (ABG), were documented and analyzed at 0.5 KHz, 1 KHz, 2 KHz and 4 KHz frequencies respectively. The subjective outcomes in hearing were also recorded with a patient satisfaction questionnaire to assess improvement in quality of hearing after stapedotomy. Results: Overall, the frequency specific pre-operative mean averaged Air Conduction thresholds were 63.3dB at 500Hz, 57.5dB at 1 KHz, 55.1dB at 2 KHz and 45.7dB at 4 KHz. The frequency specific post-operative mean averaged Air conduction thresolds were 34.6 dB at 500Hz, 28.9 dB at 1Kz, 30.5dB at 2Kz and 33.3dB at 4Kz.The frequency specific mean average post operative Air Bone Gap (ABG) closure was achieved by 28.7dB at 500Hz, 27.6 dB at 1KHz, 24.6 dB at 2KHz and 12.4 dB at 4KHz by the time of completion of the study at 01 year. A successful closure of AB gap to less than 10dB was achieved in the speech frequencies of 2 KHz and 4 KHz in 83.97% of cases. Overall, the frequency specific bone-conduction thresholds were unchanged postoperatively in all cases except 03, showing that no significant sensori-neural impairment had occured due to the stapedotomy procedure. 04 patients developed post-op severe vertigo which was self-limiting after six weeks. 01 patient developed transient facial weakness which was subsided over a time period of 03 months. Patients included in our study had significant subjective audiological improvement and responded satisfactorily to the questionnaire formulated to assess their hearing quality after stapedotomy. Conclusions: Our case study confirms that stapedotomy is a safe and successful procedure providing long-term hearing improvement in primary otosclerosis. Our study shows that meticulous selection of cases for stapedotomy will result in highly successful audiological outcomes. [ABSTRACT FROM AUTHOR]

In March 2020 WHO declared COVID-19 as pandemic while April 2021 Indian authority concede to declare a significantly increased incidence of "Black Fungus" among the COVID-19 patients. The primary route of infection for Mucormycosis or fungal infection following COVID-19 is inhalation or ingestion resulting accumulation of the agents in nose, para-nasal sinuses and mouth. The spores of black fungus intrude neural and vascular structure, which cause mucosal necrosis due to thrombosis in vasculature. The extension of the disease then increases through further destruction of bones of para-nasal sinus as well as neural and vascular route dissemination. We thought about removing, neutralizing or destroying the culprit fungi from its route of entry zone, i.e. nose and mouth. Povidone Iodine (PVP-I) is a microbicidal agent having effective fungicidal as well as virucidal and bactericidal property. PVP-I can be used in both oral and nasal cavity safely. Efficacy and safety of PVP-I is proved in nose in case of COVID-19. PVP-I is proved effective against different fungi at different concentration at different site. So, we recommend Povidone Iodine nasal spray or irrigation and mouthwash for gargling for these vulnerable group of patients in large scale to prevent post-COVID mucormycosis or fungal infection. [ABSTRACT FROM AUTHOR]