Aim: The fundamental aim of this study is to determine the factors affecting the audiological, speech, and language-related short-term outcomes achieved by the recipients of cochlear implants (CI) and to assess the category of auditory performance (CAP), speech intelligibility rating (SIR), and meaningful auditory integration scale (MAIS) scores on various factors to calculate the outcome. Materials and methods: This study was a hospital-based retrospective cum prospective study carried out in the Department of Otorhinolaryngology, Government Medical College (GMC), Kota, from May 2018 to June 2020 in a sample size of 15 patients who underwent CI with satisfying inclusion and exclusion criteria with written informed consent and follow-up for 12 months. Three scoring systems are used for evaluation: revised CAP score, SIR of ODonoghue, and MAIS. A total of six factors are considered, and for all, the relationship with outcome postimplant is calculated using three scores (CAP, SIR, and MAIS). The statistical tests applied are the Chi-square test, Fisher's exact test, Spearman's rho test using Statistical Package for the Social Sciences (SPSS) software and tables are computed using Microsoft Excel. Results: Factor 1: relationship with a common cause of sensorineural hearing loss (SNHL)—children having a history of postnatal infection shows significant (p-value = 0.01) poor outcome. Factor 2: relationship with an abnormality of the inner ear shows significant (p-value 0.03, 0.077, and 0.033 for CAP, SIR, and MAIS scores, respectively) poor outcome. Factor 3: relationship with a duration of implant use—with time, CAP, SIR, and MAIS scores improve significantly (p-value 0.001, 0.0169, and 0.001 for CAP, SIR, and MAIS scores, respectively), with the best score at 12 months postimplant. Factor 4: relationship with parent's education level—no significant (p-value 1.0, 0.70, and 0.33 for CAP, SIR, and MAIS scores, respectively) difference seen. Factor 5: relationship with speech rehabilitation—no significant (p-value 0.833, 0.833, and 0.467 for CAP, SIR, and MAIS scores, respectively) difference seen. Factor 6: relationship with rural vs urban population—no significant (p-value 0.837, 0.782, and 1.02 for CAP, SIR, and MAIS scores, respectively) difference seen. Conclusion: Patients with a history of postnatal infection and inner ear abnormality had a poor outcome which improved with time post-CI. Clinical significance: This study concludes on the factors which affect the outcome post-CI and thus help to improve the results of cochlear implantation.

Background and aim: Parathyroid adenoma-induced hypercalcemia and acute pancreatitis are known but rare. Case description: We report a case of 30 years male patient, nonalcoholic with acute pancreatitis associated with hypercalcemia as the first manifestation of primary hyperparathyroidism (PHPT). A parathyroid nuclear scan suggested parathyroid adenoma of the left inferior parathyroid gland. Initially, acute pancreatitis was treated conservatively. The patient subsequently underwent surgical resection of the parathyroid adenoma. Postoperatively, his clinical symptoms of pancreatitis did not subside with no improvement in ultrasonography. He was readmitted and a surgical cystogastrostomy was performed. Conclusion: Some mechanisms have been proposed for its pathophysiology. We aim to treat the causative factor. Clinical significance: Therefore, the cause of hypercalcemia should be identified at the earliest followed by appropriate treatment.

Background: Rhinoliths are masses of calcified nature seen in the nasal cavity. It is a rare condition caused by gradual deposition of calcium and magnesium over an object which could be thick mucus plug or a piece of paper or seed. In such conditions the symptoms usually develop over the years causing persistent unilateral nasal discharge which could be foul smelling or bloodstained associated with nasal obstruction. Case description: We report one such case of a 39-year-old woman who presented with similar complaints in the right nostril, on evaluating her we were surprised to see the huge bizarre shaped rhinolith. Conclusion: A relatively rare condition is rhinolith, suspicion needs to be given in cases who present with unilateral foul-smelling rhinorrhea with bony hard mass seen in nasal cavity during examination. Computed tomography will help in planning the procedure. In cases with huge irregular rhinolith bleeding needs to be anticipated hence general anesthesia should be considered. Clinical significance: Suspicion of rhinolith needs to be given in cases who present with long-standing unilateral foul-smelling rhinorrhea after excluding other differential diagnoses by doing a computed tomography of paranasal sinuses.

We are highlighting an unusual presentation of parapharyngeal acinic cell carcinoma. The patient presented with jaw pain, trismus and a peritonsillar bulge diagnosed as peritonsillar abscess. Medical management was initiated but failed. Magnetic resonance imaging (MRI) was done which revealed abscess formation. Incision and drainage was performed without resolution. Further evaluation led to the diagnosis and surgical management of parapharyngeal acinic cell carcinoma.