Background: Endoscope and microscope are exclusively used in different middle ear pathologies as well as patients with attic cholesteatoma. However, straightforward information regarding surgical advances, postoperative results, and information about in which patients and how this surgical technique should be exclusively used is debatable. Aim: To compare the outcome of primary exclusive endoscopic ear surgery with those of the microscopic ear surgery in two groups of patients with cholesteatoma limited to the attic region. Methods: This prospective observational study was conducted in the Department of Otolaryngology-Head and Neck Surgery, BSMMU, Dhaka, from July 2018 to December 2019, with 26 patients having cholesteatoma limited to the attic region. Patients were divided into two groups. One group of patients were submitted to atticotomy with tympanoplasty via microscopic ear surgery (MES) and a second group to exclusive trans-canal endoscopic ear surgery (EES). All the patients were followed up post-operatively up to 3 months with PTA. Results: Mean bone conduction threshold, air conduction threshold, and ABG has been reduced considerably in both groups (endoscopic and microscopic) at the end of three months postoperatively.There was no significant statistical difference between the two groups in terms of graft uptake success rate and the audiological success rate (p-value >0.05).Postoperatively, pain requiring analgesics wassignificantly lower (p<0.033) in theendoscopic group (23.1%) than in the microscopic group (69.2%). Conclusion: Audiological outcome and graft uptake success rates achieved by the endoscopic ear surgery were similar to the results obtained by the microscopic ear surgery in limited attic cholesteatoma. Bangladesh J Otorhinolaryngol 2022; 28(1): 103-111
Background: Type 1 Tympanoplasty is a widely performed procedure for inactive mucosal COM. Considerable controversy remains in choice of type-1 tympanoplasty in the paediatric patients. Objectives: To assess the outcomes of type-1 tympanoplasty in paediatric patients. Methods: This study was conducted in the Department of Otolaryngology-Head & Neck Surgery, BSMMU, Dhaka, from July 2018 to December 2019, with 44 paediatric patients having an inactive mucosal variety of chronic otitis media. Patients were divided into 10-14 and 15-18 years age group. All patients underwent type-1 tympanoplasty under operating microscope and temporalis fascia used as a graft material. Minimum hearing improvement of 10 dB was regarded as an audiological success and an intact graft at the end of the third month was regarded as graft success. The statistical significance was set to p< 0.05. Results: The graft success rate was 90.9% and audiological improvement was 81.8% in paediatric tympanoplasty. Success rate was higher in 15-18 years age group than 10-14 years of age group which was statistically insignificant. Irrespective of the site, size, duration of discharge showed an insignificant association with outcomes of pediatric type-1 tympanoplasty. Conclusion: Type-1 tympanoplasty showed promising result in paediatric patients. The age of the patients did not significantly affect the postoperative outcome. Bangladesh J Otorhinolaryngol 2022; 28(1): 43-49
Classical and reversal stapedotomy both are exclusively done in otosclerosis but definite information regarding surgical advances, postoperative results, complications and information about how and in which patients these surgical techniques should exclusively be used are a source of continuous discussions. This prospective observational study was conducted in the Department of Otolaryngology-Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka from July 2019 to December 2020 o compare the outcomes of classical and reversal stapedotomy in patients with otosclerosis. Total 28 cases of otosclerosis who underwent stapedotomy were divided in to two groups i.e. Group A (classical stapedotomy) & Group B (reversal stapedotomy) with 14 patients in each group. All patients were followed up post-operatively up to 3 months with Pure-tone audiometry (PTA). There is no significant difference between classical and reversal stapedotomy approach in terms of hearing improvement and complications. Chorda tympani injury was the main complication in both the groups. Regarding hearing gain and complications there was no significant difference between classical and reversal stapedotomy approach. BSMMU J 2022; 15(2): 121-126
Background: Lymphatic metastasis in papillary thyroid cancer (PTC) is common; however, the extent of central compartment lymph nodes dissection (CCD) is controversial and requires the knowledge of pattern for central compartment (level VI) lymph nodes metastasis (CCM). Objective: To determine the frequency of central compartment (level VI) lymph node metastasis in T3 & T4 papillary thyroid carcinoma. Methods: This study was conducted in the Department of Otolaryngology-Head &Neck Surgery, BSMMU, Dhaka, from January 2019 to June 2020. A total of 31 cases of T3 & T4 PTC were selected after obtaining clearance and approval from the IRB of BSMMU; the subjects were included based on the inclusion and exclusion criteria. After taking informed written consent detailed history and examination was done. Ultrasound neck and fine-needle aspiration cytology was taken from all thyroid swelling. All patients had underwent total thyroidectomy with central compartment dissection. The data were analyzed by computer-based statistical software SPSS version 26. Results were expressed as frequency and percentage. Z proportion test was done as applicable. Results: In this study, mean (±SD) tumor size was 3.66 (±1.34) cm. 20 (64.52%) had T3 and 11 (35.48%) T4 PTC. 11 (35.48%) had N0, 20 (64.52%) N1a and 8 (25.81%) N1b. 20 (64.52%) had overall central compartment lymph nodes metastasis. Among T3 papillary thyroid carcinoma, 12 (60%) had overall central compartment lymph nodes metastasis, and inT4 papillary thyroid carcinoma, 8 (72.7%) had overall central compartment lymph nodes metastasis. This difference was not statistically significant. Conclusion: The frequency of central compartment (level VI) lymph node metastasis (CCM) is high (64.52%) in T3 & T4 papillary thyroid carcinoma. So central compartment (level VI) should be dissected in advanced (T3 & T4) papillary thyroid carcinoma. Bangladesh J Otorhinolaryngol 2022; 28(2): 149-156
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