Abstract The tympanic membrane forms a barrier between the external auditory canal and the middle ear. In the inactive mucosal type of chronic otitis media, there is a perforation in the tympanic membrane which is surgically managed by Myringoplasty. Estrogen as a growth factor has been shown to have a mitogenic efect on keratinocytes thus hastening the rate of epithelialization following injury. This property of estrogen is being studied in this study for its role in the outcomes of myringoplasty. This study was carried out from January 2021 to December 2022 in the Department of Otorhinolaryngology, of a tertiary teaching hospital in North India. Patients were assessed by history, examination, otoscopy, Audiometry, and oto-endoscopy. A total of 88 patients were taken out of which 44 patients underwent myringoplasty in which topical estrogen (estradiol valerate solution) was used, and the remaining 44 patients were taken as controls. Patients were then assessed post-operatively based on Audiometry results and graft uptake status. In the estrogen group successful Graft uptake was in seen 40 (90.9%) patients and failed in 4 (9.1%), while in the control group, it was successful in 37 (84.1%) patients and failed in 7 (15.9%), statistically there was no signifcant diference between two groups in terms of graft uptake (p value=0.334). Post-operatively, in the estrogen group, the mean change in Air Conduction (AC) was 15.5 dB, the change in the air-bone gap (ABG) was 11.5 dB and for Bone Conduction (BC) it was 3.2 dB. However, in the control group mean post-operative changes in Air Conduction, Air-Bone Gap, and Bone Conduction were 12 dB, 10.7 dB, and 0.8 dB respectively. Statistically, there was a signifcant diference in postoperative changes in AC (p value=0.011) and BC (p value=0.009) between the two groups. There was no signifcant diference in post-operative changes in Air-Bone Gap (p value=0.571). Topical Estrogen (Estradiol valerate) solution is cost-efective, with enriched growth factors that accelerate tympanic membrane perforation closure following myringoplasty and resulted in signifcant improvement in hearing thresholds both for Air Conduction and Bone Conduction. Keywords Topical estrogen · Myringoplasty · Air and bone conduction · Air-bone gap · Graft success

Epithelial-Myoepithelial Carcinoma (EMC) is a very rarely seen biphasic tumour typically seen in older females and constitutes 0.5–1% of all salivary gland neoplasms. The parotid gland is most often involved and occasionally there may be involvement of submandibular and minor salivary glands. Clinical picture often reveals benign nature of the disease. Computed tomography (CT) and magnetic resonance appearances are non-specific and the cytological diagnosis may be challenging, thus more accurate diagnosis can only be made by histological and immunohistochemical study. There is no consensus regarding the optimal treatment of this neoplasm, largely due to its rarity. Wide surgical excision with a clear margin is the treatment of choice because of the tumour’s tendency to infiltrate locally. Adjuvant radiotherapy is often required in cases of large primary tumours and positive surgical margins. The tumour may commonly recur locally after resection in 30–50% of cases. We herein present an unusual case of a 46-year-old male who presented with cystic swelling of left parotid gland and diagnosed as EMC on histopathology and immunohistochemical examination. The patient was treated with surgical resection followed by post-operative radiotherapy.

1. Facial palsy due to Intraparotid schwannoma invading the stylomastoid foramen.(ACCEPTED)

1. Zygomatico-coronoid   pseudo-arthrosis due to osteochondroma of coronoid process - An unusual cause of restricted jaw opening. (ACCEPTED)

1. Sheikh Abdul Zeeshan, Mehtab Alam, Kamlesh Chandra. Acquired atresia of External auditory canal with canal Cholesteatoma: A Case Report. International Journal of Current Advanced Research Volume 6; Issue 12; December 2017; 8388-92.

Extranasopharyngeal Angiofibroma of Nasal Septum: A Rare Clinical Presentation at an Unusual Site. Volume 21 Issue 5- March 2020 DOI: 10.19080/GJO.2020.21.556075

1. Alam M, Hasan SA, Hashmi SF, Singh PK. Isolated Congenital Midline Upper Lip Sinus in A 5-year-Old Child: A Rarity. Indian J Otolaryngol Head Neck Surg. 2017;69(4):568-570. doi:10.1007/s12070-016-1044-7.

1. Alam M, Aslam M, Singh PK, Hashmi SF, Hasan SA. Giant Primary Sinonasal Mucosal Melanoma: A Rare Malignancy. Gulf J Oncolog. 2017 May;1(24):43-47. PMID: 28798001.

Alam M, Hasan SA, Hashmi SF, Singh PK. Facial Palsy due to Parotid Abscess: An Unusual Complication. Turk Arch Otorhinolaryngol. 2016;54(4):168-171.

Alam M, Hasan SA, Hashmi SF. Unusual Presentation of Hydatidosis - Neck Lump Causing Costo-Vertebral Erosion. Iran J Otorhinolaryngol. 2016;28(88):363-367

Hidayat Ullah, Shakeel Mohammad, Hasan Syed Abrar, Mehtab Alam. Bilateral facial paralysis - Can it be bell’s? Int. Adv. Otol. 2009; 5:(3) 408-411

Mehtab Alam, Satish Chandra Sharma, Syed Abrar Hasan. Does Eustachian tube patency affect the outcome of graft uptake rate and average audiological gain in Intact canal wall and Canal wall down mastoidectomies – A study of 50 patients. Int J Med Sci Public Health. 2017; 6(2): 418-421

1. Alam, M., Beig, S., Sultan, A. et al. Bacteriological and Antibiotic Sensitivity Profile of Cholesteatomatous Otitis Media in Pediatric and Adult Population: Prevailing Scenario in Northern India. Indian J Otolaryngol Head Neck Surg (2020). https://doi.org/10.1007/s12070-020-01956-0.

     Sayeed A, Alam M, Sharma SC, Hasan SA. Mitomycin-C in Post-endoscopic Septoplasty Synechiae: Does it Really Helps? Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 3):2091-2095.