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Background: Tonsillectomy is one of the most common surgeries performed in paediatric otorhinolaryngology. The most common morbidity of the surgery is the post operativepain. As there is increase in trend of tonsillectomy as day care surgery adequate postoperative analgesia becomes a very important issue. Objective: To compare the efficacy of infiltration of ropivacaine 0.2% and bupivacaine 0.25% and topical application of sucralfate in to the tonsillar fossa in postoperative painmanagement. Method: 120 patients aged 5-12 years, undergoing tonsillectomy were enrolled in the study. They were randomized into 4 groups. In group A (n=30) cases were infiltrated with ropivacaine into the tonsillar fossa; in group B (n=30), bupivacaine was infiltratedand in group C (n=30), the fossa was painted with sucralfate solution after the surgery; group D (n=30) was the control group where normal saline was infiltrated to the fossafollowing surgery. Visual analogue scale & Wong Baker facial pain scale were used to measure the intensity of pain postoperatively. Results: At 4h postoperatively, the pain scores of all 3 study groups were significantly lesser (p<0.05) than control group (Group A - 3.53, B - 3.70, C- 3.80, D- 5.20). The VAS & facial pain scores over the entire postoperative period were consistently lower in the study groups than in the control. The reduction of throat pain was significantly lower in the ropivacaine & sucralfate group compared with bupivacaine & control groups. Conclusion: Our study demonstrates that topical sucralfate and ropivacaine are equally effective and safe and improves post tonsillectomy analgesia. They provide better analgesia compared to bupivacaine.

Background /Objectives: Hypertrophied adenoids are the most common cause of refractory sinusitis inpaediatric age. We study 42 cases of patients of chronic adenoiditis with adenoid facies and refractorychronic rhinosinusitis managed by endoscopic assisted adenoidectomy (EAA) and conventionaladenoidectomy (CA). Materials and method: 42 cases of chronic refractory sinusitis with adenoid facies secondary tohypertrophied adenoids were randomized into 2 groups during the study period of 12 months fromAugust 2012 to July 2013. Group A (n=21) underwent endoscope assisted adenoidectomy and GroupB(n=21) underwent conventional adenoidectomy. Result: Endoscopic assisted adenoidectomy proves to be more effective in managing adenoid faciesand chronic refractory rhinosinusitis with adenoid hyperplasia. Conclusion: Visualization of the adenoid mass using endoscope helps complete removal of thediseased adenoids. Endoscopic assisted adenoidectomy is treatment of choice in adenoid facies andchronic refractory rhinosinusitis with adenoid hyperplasia and more effective than conventionaladenoidectomy.

Background: Modified Young's procedure (MYP) was a popular procedure for primary atrophic rhinitis. The classical Young's procedure was not tolerated well since its inceptionand a modification popularly known as the "Modified Young's procedure" was introduced. The complete closure of the nostrils were not well tolerated as most of the patients disliked mouth breathing and also the nasal voice. Material and methods: We report a case series of MYP done in 17 cases of primary atrophic rhinitis under general anaesthesia. Bilateral procedures were done in all patients who tolerated it well. The polythene tube buttons were removed after 7 days. Results: Mean duration of follow up was 15.11 months, with good symptomsimprovement. Recanalization was done in 6 cases with 3 cases had concurrent multisinusitis with severe headaches and CECT PNS confirming it. The 3 patients were operated withendoscopic sinus surgeries after recanalization with minimal decongestant measures and microdebrider drill to remove the sclerosed walls of the maxillary sinuses. Conclusion: Modified Young's procedure is a forgotten entity in rhinology as the incidences are decreasing and the modes of delivery of medications intranasally are becoming easier and compliant. However in resistant and noncompliant patients MYP with periodic nasalendoscopy can be very rewarding.