Dr. T.L. Vasudevan's
ENT Surgical Clinic
"The Nose of Cleopatra, if it had been shorter, the face of whole world would have changed"
- Pascal

In ancient literature the Nose has been used to represent man's character and behaviour, Legend goes that God made man from dust of ground and breathed into his nostrils the breath of life and then man became living soul (Genesis).

Historians quote the earliest examples of plastic surgery of the Nose from India and Egypt. The first recorded treatment of a fractured nose was mentioned in Egyptian Smith Papyrus in 1600 BC. The ancient Hindu practice of chopping off the noses and ears as a mode of punishment offered ample opportunities to the surgeons to master the art of making new noses.

The First description of nasal reconstruction is mentioned in encyclopedic work of Susruta Samhita as early as 6th century BC. Many pioneers like Hippocrates, Galen, Rhazes and Arabic physicians have made frequent references to Susruta. The forehead rhinoplastic reconstruction of the Nose as practiced by Indians centuries ago is known universally as 'Indian Forehead Flap for reconstruction'.

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Cerumen or Ear Wax is a mixture of secretion of the ceruminous glands along with epithelial debris and dirt. It is a normal phenomenon in the ear and can be left alone if it does not occlude the canal and impair the hearing.

Normally the Wax gets propelled externally from the External Auditory Canal due to the Epithelial migration of the cells. But when this mechanism is hampered due to cleaning the car canal with buds, or overburdening the mechanism by putting oil, wax gets accumulated. Wax can get accumulated without many symptoms until water gets inside. It imbibes the water and swells up resulting in pain and obstruction.

Wax can go in for Keratosis Obturans, a complication arsing due to long standing disease. In such a case, removal under General Anaesthesia is warranted.


Wax removal should not be done impromptu. Sufficient time should be given for the Wax to soften by prescribing ear drops for atleast 4 days. When the Wax is soft enough, it can be flushed out by gentle syringing.

Accumulated Wax which is not occluding the entire canal can be gently removed with a Wax curette.

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A Portrait showing the forehead scar and
reconstructed nasal stump along with
plan of reconstruction