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Salivary gland tumors represent 3-10% of all head and neck neoplasms. Most of the tumours are benign with parotid gland being most commonly affected. Surgical intervention in the form of parotidectomy forms the mainstay of treatment. Among the various postoperative complications that may occur after parotidectomy, facial nerve weakness is the most dreaded one for both the surgeon as well as the patient. In the literature, the incidence of transient facial weakness after parotid surgery ranges from 10 to 68%, and long-term dysfunction ranges from 0 to 19%. Apart from injury mechanisms such as nerve division, stretch, thermal injuries, ischemia, several other risk factors such as tumour size, disease duration etc. have also been identified for post parotidectomy facial nerve dysfunction which vary considerably from study to study. Thus, facial nerve injury despite being a common and dreaded complication is also a preventable one. We in our institute conducted a retrospective study from January 2018 to December 2021 to evaluate the incidence of facial nerve weakness and possible predictive factors among 60 patients who underwent superficial parotidectomy for benign tumours and found that when it comes to benign tumours surgical technique rather than tumour factors are more important in preventing nerve injury. Undertaking this study was important in order to emphasize the importance of extensive preoperative planning and better surgical practices among budding head and neck surgeons in our country., Competing Interests: Conflict of interestThere is no conflict of interest between the authors., (© Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

To describe a concept of ideal 'puncture zone' as against any single ideal 'puncture tract' for percutaneous nephro-lithotomy (PCNL) and present our results. Through this narrative, we aim to reduce the gaps in inter-understanding of an erstwhile description of ideal tract and real-life puncture making. The puncture zone principle was applied for our novel puncture making technique during PCNL. The largest imaginary cone that can fit into a respective calyx, with its tip in the pelvis defines the 'puncture zone' for that calyx. This concept allows fine-tuning of the ideal puncture tract based upon the desired corresponding manipulation zone and also shifts the focus of puncture making to infundibulum anatomy from the tip of calyx. The surgical technique and retrospective review of 136 cases done between 2015 and 2021 using this concept are presented. Primary outcome included stone-free rate, pseudo-aneurysm and blood transfusion at 3 months of follow-up. 33 cases had multiple (> 3) stones, 21 only calyceal/infundibular stones, eight partial staghorn and 12 were complete staghorn stones. Mean stone size was 29 ± 15 (Range: 5-53) mm. Complete clearance was achieved in 127 cases, four of which required two tracts. Blood transfusion was required in one case. No pseudo-aneurysms were encountered. The puncture zone concept has provided good results in our hands. It may help easier understanding of PCN puncture making and provides a background for reconciliation between description of an ideal tract and practical puncturing techniques used by different surgeons., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Mastoidectomy forms the main surgical procedure for eradication of disease in chronic otitis media. Such a surgery which contemplates a complete exenteration of all the tympano-mastoid cavities is rightly considered as a difficult one mainly because a large number of vitally important structures are crowded together in the small field of operation and there is always a risk of damaging them. It is therefore, extremely important that the otologist who would undertake this surgery be thorough with the details of the surgical relations of this region. Out of the various structures seen on the lateral surface of temporal bone one very important structure is the suprameatal spine. It is shown to have great variations in shape and size and has been a mystery to researchers due to the implications it is known to have on mastoid region anatomy. In this study we have evaluated the various types of suprameatal spine, prevalence of each type and the effect of each to other landmarks encountered during surgery and also the effect of mastoid pneumatisation on the same., Competing Interests: Conflicts of interestAll the authors declare they have no conflict of interest and have not received any funding., (© Association of Otolaryngologists of India 2021.)

Chronic sinusitis is a common disorder worldwide a significant proportion of which is secondary to fungal aetiology contrary to popular belief that fungal sinusitis is a rare entity, more so in a country like India where warm moist climate in a number of states and ever rising incidence of diabetes mellitus gives the fungal organisms a perfect environment to grow. This study aims to find the incidence and clinical features of fungal rhinosinusitis in chronic rhinosinusitis reinstating the fact that it should be kept as a differential diagnosis in every patient presenting with symptoms of chronic rhinosinusitis. Aim of the study was to find out the incidence and clinical manifestations of fungal sinusitis in chronic rhinosinusitis. A prospective study was conducted in JSS Academy of Higher Education and Research, Mysore during a time period of 37 months i.e. November 2015 to December 2018. Total of 190 patients with chronic rhinosinusitis were evaluated with relevant investigations to reach the diagnosis. All patients were subjected to diagnostic nasal endoscopy and CT scan of paranasal sinuses. Patients were then subjected to functional endoscopic sinus surgery and sample collected was sent for KOH stain and fungal culture with histopathology. Fungal rhinosinusitis is on the rise now and it is important to evaluate all cases with caution and keep an eye out for features suggestive of fungal sinusitis as an accurate diagnosis is the key to proper management., Competing Interests: Conflicts of interestAll the authors declare they have no conflict of interest and have not received any funding., (© Association of Otolaryngologists of India 2019.)