Objectives: This study evaluates the incidence, Frequency and risk factors of complications in patients submitted to thyroidectomy for various benign and malignant lesion and to corroborate the results in relation to the extent of surgery in a Tertiary level hospital. Study design : An analytical study of 100 consecutive patients who underwent thyroidectomy for benign and malignant thyroid lesion. Material s and methods: The study was carried out at Department of ENT and Head-Neck surgery in Dhaka Medical College Hospital over a period of 1.5 years from January 2017 to June 2018. Data were collected from 100 patients who underwent thyroidectomies for various thyroid diseases at this center. Results: There were 80 females (80%) and 20 males (20%) with female-to-male ratio of 4:1, and The age range of the patients were 15 to 80 years, the mean age was 39.29 years. Preoperative diagnosis of benign and malignant pathologies was made in 86% and 14% cases respectively. Most common pathological diagnosis was colloid goiter 46%,nodular of cases, whereas papillary carcinoma accounting for 11% was the commonest malignant lesion .The types of thyroid operations done were as follows (Table-II). The commonest operation performed was hemithyroidectomy (45%). The overall postoperative complication rate was 17%.Temporary and permanent RLNI occurred in 3% and 2% respectively. The less common complications were wound hematoma, seroma formation, and superior laryngeal nerve injury. There was no mortality observed in this study. Conclusion: In conclusion, extent of resection, surgical technique and thyroid pathologic condition had a greater impact on the rates of postoperative complications. By developing understanding of the anatomy and the ways to prevent each complication, the surgeon can minimize each patient’s risk and can handle complications expediently and avoid worse consequence. J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 108-113
Background: To study the incidence, clinical presentation and to observe comparison of different sinonasal masses. Materials and Methods: This Prospective study was carried out from January 2017 to December 2018. Data were collected from 100 patients presented with sinonasal masses. This study is based on history, clinical, radiological, laboratory and histopathological examination. Results: During the study period, 100 patients presented with sinonasal masses (male 60, female 40; age group 8-70 years).Nasal polyploid masses were non-neoplastic in 70 (70%) subjects, and neoplastic in 30 (30%) cases. Nasal obstruction was the most common (95%) presenting complaint, followed by rhinorrhoea (48%), hyposmia (30%), intermittent epistaxis (17%), headache (15%), facial swelling (10%) and eye-related symptoms (10%). The most common site of origin of polyploid masses was the middle meatus (54%) followed by the lateral wall of the nasal cavity (15%) and superior meatus (11%). unilateral nasal masses was present in 49% patients, while the remaining patients had bilateral nasal masses. Allergic (60%) and inflammatory (28.5%) polyps were the most common non-neoplastic mass, inverted papilloma (41.17%) and haemangioma (35.29%) were most common benign neoplastic mass; 92.3% of all malignant masses were squamous cell carcinoma. Surgery was the major mode of treatment. it included Caldwell-luc operation (7%), polypectomy (10%), excision of mass (25.0%) and functional endoscopic sinus surgery (44%). Malignancies were treated with radiotherapy or Surgery followed by radiotherapy or Chemoradiotherapy. Conclusions: The masses in nasal cavity, paranasal sinuses, and nasopharynx encompass a wide spectrum of common and rare diseases and are very common lesions encountered in clinical practice. Endoscopic examination and advanced imaging technique help to reach a presumptive diagnosis but histopathological examination remains the mainstay of final definitive diagnosis. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 49-53
Tracheostomy is a life saving and important surgical procedure throughout the world from long since. Minimum number of study were conducted on tracheostomy in our setting. Based on number, probably Dhaka Medical College Hospital is one of the top institute in the world, where highest number of tracheostomy is being operated (3-10 per day). So, our purpose of this study is to describe our own experiences, regarding indication, complication , decanulation, morbidity and mortality following tracheostomy and to compare the results with the institutes of other countries of the world. Methods It is a prospective observational study, conducted at Dhaka Medical College Hospital from July 2014 to June 2019. Data were collected from the Registers of emergency and elective operation theatre, indoor, intensive care unit (ICU) and medical record room (where file of all patients are being kept for long time). SPSS software was used for data processing and analysis. Prior to the study ethical approval was obtained from Ethical review committee. Results Total 257 patients were selected for the study. Among them 210 (81.71%) were male and 47 (18.29%) were female. Most of the patients were elderly, above sixty years. Commonest indication for tracheostomy were upper airway obstruction due to laryngeal or other head neck cancer in 70.04% of patients. Next important indication was upper airway obstruction due to trauma in 24.9% cases. Most of the time (82.88%) we had to perform Emergency tracheostomy. Longitudinal or
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