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Osteopetrosis is a rare hereditary metabolic disease associated with a myriad of otolaryngological presentations. Three cases with varying otolaryngological presentations are described here. A brief review of the radiological changes of interest to the otorhinolaryngologist is being made.

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Tracheostomy in infants and children has been the subject of controversy in the medical literature, but decannulation in the paediatric patient is even more controversial. Various approaches and techniques have been used for decannulation, however in spite of all efforts it continues to be a problem. The objective of our study was to assess the role of polysomnography (PSG) in predicting readiness for decannulation. All subjects (n = 31) of the study were less than 12 years of age, and tracheostomized for periods of at least six months to ensure a minimum period of dependence on the tube. All had clinical, radiological and endoscopic clearance before PSG was performed. Twenty-one out of 22 patients with favourable PSG data were successfully decannulated. Attempts to decannulate all the nine patients with unfavourable PSG failed. The conclusion of the study was that PSG is a useful adjunct to the many methods of evaluating readiness for decannulation in children with long-term tracheostomy tubes.

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A case is described in which a middle-aged male presented with a large tracheocele in the neck arising from the right postero-lateral aspect of trachea at the level of T2 vertebra. It was not associated with any predisposing factors and except for the swelling in the neck the patient was asymptomatic. It was excised completely through the cervical approach and there has been no recurrence in two years follow-up.

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Bronchial foreign bodies are often clinically encountered especially in small children. We report a case of an unusual foreign body in an adult bronchus showing migratory movements.

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Foreign body ingestion is a clinical emergency requiring prompt action to ensure speedy recovery and minimise the complications. We report here a case of a neglected foreign body which remained within the oesophagus of a child for 6 years before the diagnosis was made and appropriate treatment given.

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A series of 31 cases of tuberculous laryngitis is reviewed to assess the diagnostic features of the disease. The condition generally presents in males of late middle age who have pulmonary tuberculosis. It presents in a manner similar to laryngeal carcinoma except that painful dysphagia is a prominent symptom. Histological examination of biopsy material is usually the diagnostic procedure. Stroboscopy was able to document a number of abnormalities which included abnormalities of laryngeal configuration, vibratory asymmetry, reduction of amplitude and mucosal wave. Symptoms responded well to antituberculous chemotherapy.

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Considerable controversy surrounds the subject of tympanoplasty in children. This prospective study looked at the results of type-I tympanoplasty in children. Forty-five children in the age group of five to 14 years were selected for the study. All these cases had a central perforation without any evidence of cholesteatoma. The ear to be operated had to be dry for at least six weeks before surgery. Type I tympanoplasty was performed on these patients with autograft temporalis fascia by either the underlay or overlay technique. The overall success rates in 45 operations evaluated one year post-operatively was 91.1 per cent. The age of the patient had no influence on the success rate. The two factors which adversely influenced the success rate were the presence of near total perforation and bilateral perforations. It was concluded that type-I tympanoplasty has a good chance of success in children regardless of age.

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We studied the auditory brainstem responses of 50 high risk neonates from NICU and compared with those of 25 normal neonates in order to determine the percentage of significant auditory impairment in NICU and correlated it to various risk factors. Infants with the risk factors of low birth weight, hyperbilirubinemia, asphyxia, septicemia and meningitis were included in the study group. All the 150 ears were tested at 4 intensities 30 dB, 46 dB, 60 dB and 75 dB. The study recorded prolongation of latency of wave V and I-V Interwave interval in the study group with a statistically significant difference denoting an impaired condition. Incidence of significant auditory impairment was 18%. On follow up at 6 months incidence of persistent auditory abnormality was 4%. On the basis of this study it is suggested that all high risk neonates should undergo screening for hearing impairment.

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We present two cases of Pott's lower cervical spine with retro-pharyngeal abscess presenting at an unusually young age. These children presented with a life threatening respiratory distress; one of them had neurological deficit in the form of paraparesis. External drainage of abscess without anterior cervical fusion was adequate as a surgical measure for their prompt recovery while these cases were on conventional anti-tubercular therapy.

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Leukaemic cell infiltration of the nose as a first manifestation of the disease is extremely rare. We report a case of a three-year-old child who had presented with a swelling at the root of the nose for one month and proptosis of the right eye for one week. CT scan revealed a mass infiltrating the nose and nasal cavity along with infiltration of the retro-orbital region. Biopsy showed it to be myeloid cell deposits. Patient was put on antileukaemic chemotherapy but died two months after the first appearance of the symptoms.

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Two cases of congenital cyst of larynx which is a rare condition, are reported.

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A 12-year-old male child had spontaneous, recurrent bouts of profuse bleeding from the nose for 15 days. On examination of the nose a purplish polypoidal mass, which bled at touch filled the entire right nasal cavity. On lateral rhinotomy, a soft, greyish, cheesy mass was found, choking the maxillary, frontal, ethmoidal sinuses and the nasal cavity on the right side. It was completely excised. The histopathology report was vascular hamartoma (haemangioma).

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A case of granulomatous osteomyelitis of the maxilla, probably due to tuberculosis is reported, and the literature reviewed. Excision of the diseased tissue with antitubercular treatment forms the most effective line of treatment.

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