Greetings from Chettinad Health City! I have the privilege of writing the editorial for this issue of the journal. The greatest strength of the Journal, I believe resides in the ability of the editorial team to plan “Inclusive growth” and take the journal to newer heights. The current issue focuses on the field of Otolaryngology.

A large number of patients with intact membrane and conductive hearing loss continue to remain undiagnosed. An endoscopic tympanotomy provides an alternative technique for diagnosis and also facilitates treatment, thus proving a more cost effective approach.

Allergic rhinitis and vasomotor rhinitis are effectively treated by vidian neurectomy but it is presently seldom used because of its high incidence of complications like dry eye, cheek and gums, numbness and eye movement disturbances. This emergence the endoscopic posterior nasal neurectomy for rhinorrhea patients, in which resection of the postganglionic parasympathetic nerve fibres (posterior superior nasal nerve) are done under clear vision using aid of endoscope without any major complications. This technique gives equal effective result as of vidian neurectomy.

Parapharyngeal space tumors accounts for only 0.5% of Head & Neck Neoplasms. Parapharyngeal space tumors usually present with a neck mass or an intraorally submucosal mass displacing the lateral pharyngeal wall, tonsils and soft palate.CT & MRI predict the origin, location and size of tumors in parapharyngeal space. Surgery is the best treatment for parapharyngeal space tumors.Approach usually depends on the size of location of the mass .In our case we used combined transcervical and transoral approach. Transoral removal of the mass with Transoral Scervical- vascular control in the neck would be safer.

In clinical practice, airway hematoma is commonly occurs following trauma to the neck. A 51 year old gentleman with respiratory difficulty presented to our casuality. He was a cardiac patient on oral anticoagulants. On examination he had extensive supraglottic and neck hematoma. At admission his INR showed no coagulation. The patient was managed conservatively with Vit.K, FFP and steroids. He improved dramatically within a couple of days. We want to share our experience of this interesting case with a controversial management protocol.

Disturbances during tooth development can be manifested as enamel hypoplasia, diffuse or demarcated enamel opacities or enamel hypomineralization. These defects can be the result of hereditary factors or environmental factors. Enamel Hypoplasia is an exclusive ectodermal disturbance, related to alterations in the organic enamel matrix which can cause white flecks, narrow horizontal bands, lines of pits, grooves and discoloration of the teeth varying from yellow to dark brown. This case report describes a treatment modality for Turner’s hypoplasia done with a conservative approach for the esthetic problem of the defect.

In this case report, we describe a rare case of acquired intracavitary shunt from the left ventricle to the right atrium that was found four months after aortic valve replacement surgery. This comprises less than 1% of all congenital heart defects.

In this case report, we describe a rare case of acquired intracavitary shunt from the left ventricle to the right atrium that was found four months after aortic valve replacement surgery. This comprises less than 1% of all congenital heart defects.

Reading a scientific article is a complex task. The importance of this herculean task of keeping up to date with current information cannot be understated. One study quotes that to keep up with any given 10 leading clinical journals one might be expected to read 200 articles and 70 editorials per month! The biomedical literature is expanding at a rate of 6- 7% per year!1 . This article is for the clinician on roller blades who hasn’t had the time to catch up with his reading!.

The congenital hindbrain herniations are known as Chiari malformations and include 4 types. The type II Chiari malformation is better known as Arnold-Chiari malformation. Here is a brief historical account of Chiari and Arnold and how these malformations came to be described.

Otosclerosis is a hereditary localized disease of the otic capsule which is characterized by alternating phases of bone resorption and formation, as a result of which there is removal of mature lamellar bone by osteoclasts and the subsequent replacement by woven bone of greater thickness, cellularity and vascularity in the active stage, and later this is followed by sclerosis and hardening, leading to ankylosis of the stapes foot plate and conductive deafness. The surgical management of this condition has been the subject of much debate and several controversies over the course of more than a century of study, with several stalwarts of the field of Otorhinolaryngology taking opposing points of view in regard to this. Beginning with Kessel in the late 1800s, stapes surgery began with the era of stapes mobilization, which progressed to the era of stapes fenestration following the introduction of the operating microscope into otologic practice, and finally reached the era of stapedectomy in the 1950s. Advances in surgery have come as a result of the introduction of laser, microdrills and now, robotics into the field of stapes surgery and brought us to where we are now. Even still, the basic principles of stapes surgery deduced by the pioneers of the profession still hold true today, albeit with few changes.

Vertigo is one of the commonest disorders, affecting 20-30% of the general population. It may arise due to pathology in the inner ear, brainstem, cerebellum or due to psychological causes. Vertigo is a distressing symptom for anyone to experience and a challenging task to treat. Pharmacotherapy plays a predominant role in the management of vertigo. The classes of drugs used in vertigo include histamine analogues, vestibular suppressants, anti emetics, steroids, antibiotics, beta blockers, GABA modulators, calcium channel blockers, selective serotonin reuptake inhibitors (SSRI), potassium channel blockers, diuretics and ginkgo biloba. As each class has its own merits and demerits, the selection of drugs suitable for a particular patient depends on the physician’s choice. This review attempts to highlight the characteristics of each group of drugs which would help in rational therapy of vertigo.

Vestibular schwannoma also called Acoustic neurinoma is the commonest tumour occurring in the cerebello-pontine angle and accounts for about 80 to 90% of the cases. Cerebellopontine angle is formed by the petrous part of the temporal bone, pons and cerebellum and floor of the space is formed by the middle cerebellar peduncle.

Osseointegrated implants have become a routine solution for treating patients who are either completely edentulous, partially edentulous, or missing a single tooth. Studies have confirmed that dental implants have a favorable long-term prognosis as compared to conventional fixed prosthodontics. Although the use of short implants seems to be an obvious alternative in cases where conventional implants are not an option without additional procedures, short implants have been associated with decreased implant success rates. On the other hand, many authors have shown similar success rates with short implants as compared with conventional length implants and attribute these similar success rates to the improvement in both surgical/restorative technique and implant material. The use of short implants has been proposed as a viable alternative in patients with resorbed posterior regions unwilling to undergo ridge augmentation procedures. In addition to the avoidance of additional surgery, some studies have shown that the benefits of short implants include an easier fixture insertion, a simplified osteotomy preparation, and a decreased potential for overheating the alveolus.

Biodentine is a new class of dental material which could conciliate high mechanical properties with excellent biocompatibility, as well as bioactive behavior. It exhibits same biological property as MTA. Micromechanical bonding, resistance to acidic environment and resistance to microleakage makes it a better choice for its clinical usage as dentin substitute. Its excellent biocompatibility and bioactivity allows application as pulp capping agent and root end filling material. This paper reviews the setting reaction, physical, chemical and mechanical properties of Biodentine and its applications, advantage and disadvantages.

Who were the greatest inspirations that stimulated your success and current line of thought? My teachers, my mother and my patients and students. But primarily, I would say the credit goes to my elementary school teachers and my Headmaster. I still vividly remember those years where everyone got 4 shots of the small pox vaccine. My headmaster used to apply a paste of Tulsi leaves on 3 areas to subdue the violent reaction it used to produce. Though he did not have any major medical knowledge this very dynamic imaginative and confident attitude inspired me to question various issues in the medical field and do research on the less explored areas and techniques, what I call as refutative research.

Author index

Pelvic Organ Prolapse (POP) is a worldwide problem, affecting women of all race and creed. The life time risk of requiring surgery for POP is around 11 %. More importantly, the need for a repeat surgery following primary prolapse repair is quoted around 29%1 . With increase in life expectancy, the need for techniques which provide long-term anatomical and functional success is important in prolapse surgery.