Objectives: To assess the pattern and degree of hearing loss in CSOM. Methods: A prospective study was carried out from January, 2007 to December, 2008 at the department of Otolaryngology-Head & Neck Surgery, BSMMU, Dhaka This study included 150 cases with 198 ears of CSOM including both tubo-tympanic and attico-antral variety excluding intracranial complications if any. Results: There were 81.31% cases of tubo-tympanic and 18.69% cases of attico-antral patients. Age of the patients was between 5-60 years, where male were 59.33% and female were 44.67%. Highest number of patients was in the age group of 21-30 years. Out of 198 ears, 102 had unilateral perforation and 96 had bilateral perforation. Most of the patients (53.33%) came from low income family and majority of them used to take their bath in the pond (29.34%) followed by tube-well (24.44%). Most of the patients had cleaning habit with clothes with sticks (53.5%).Majority of them resided in katcha house (52%) with poor hygienic condition. Central melleolar perforations were maximum (41.41%) and anterior central perforations were minimum (18.69%). According to sized of perforation, medium size central perforations were common (26.67%) It was shown that the site and sized of perforation affects the degree of hearing loss. Posterior central and attic perforations had greater hearing loss, 51.5 dB and 57.36 dB accordingly. On the basis of size, subtotal perforation had more hearing loss (54.54dB). It was also shown that posterior central perforation had greater hearing loss (51.5dB) than anterior- central (33.64dB) perforation. Hearing loss was more marked in patients with long duration of disease. In a history of 21-25years of disease, mean air conduction thresholds was 59 dB whereas of 0-5 years were 38.18 dB. Difference between them was statistically significant (t=5.88, p<0.001). Among the pattern of hearing loss, most of patients had conductive type (80.8%) hearing loss followed by mixed (17.17%) and sensorineural types (2.01%). Conclusion: Site of perforation, size of perforation and duration of disease affects the degree of hearing loss in CSOM . Key words: Hearing loss; CSOM; Tubo-tympanic; Attico-antral. DOI: 10.3329/bjo.v16i2.6844Bangladesh J Otorhinolaryngol 2010; 16(2): 96-105

Objectives: To find out the frequency ,indications and effects of tracheostomy in head-neck malignancy.Methods: Total 100 cases of head-neck malignancy that needed tracheostomy were studied in the department of Otolaryngology and Head-Neck surgery of Dhaka Medical College Hospital and Begum Khaleda Zia Medical College and Shahid Sohrawardi Hospital, Dhaka.Results: The mean age of the subjects was 53.60 years. Out of 100 cases male were 86 and female were 14 with male to female ratio 6.14:1. The highest number of the subjects were related to cultivation and majority of the subjects came from poor socio-economic status. Malignancy in head-neck region is multifactorial disease. Regarding habits 71% were smoker, 21% were habituated with chewing betel nut and leaf. Only 2% were alcoholic. In 93% tracheostomy was done on an emergency basis and rest 7% was elective. Carcinoma of larynx was the most frequent indication (65%), which was followed by carcinoma pyriform fossa (28%), carcinoma base of the tongue (3%), carcinoma tonsil 2% and carcinoma thyroid gland 2%. The rate of complications was 41%. Surgical emphysema was the commonest complications (19%), which were followed by haemorrhage (7%), wound infection (4%), tube displacement (3%), tube blockage (3%), crusting (2%), stomal stenosis and subglottic stenosis (1%). No fatality was found in this study.Conclusion: The rate of complication of tracheostomy is high in patients of head-neck malignancy with respiratory distress. Key words: Tracheostomy; Head Neck Cancer. DOI: 10.3329/bjo.v16i2.6847Bangladesh J Otorhinolaryngol 2010; 16(2): 120-125

To determine the various etiological factors, clinical presentation and outcome of traumatic perforation of tympanic membrane (TM) in a rural area of Bangladesh. A retrospective study of 210 cases of traumatic perforation of TM in upazilla health complex, Nangalkot and Muradnagar, Comilla, Bangladesh within the period of March 2013 to February 2014. The study showed middle age people of 20-39 years age group were mostly affected (61.89%), where males are more than females at the ratio of 1.18:1. Domestic violence was a major factor (50%) and husbands are only culprit for 35.13% of housewives and slap was the major mode of injury (52.86%) affecting the left ear mostly (70.95%). Spontaneous healing rate was very satisfactory and it was 88% within 03 months in our study. Traumatic perforation of TM is a common type of injury in rural areas. Unnecessary surgical intervention or unskilled handling should be discouraged. Early appearance and watchful treatment reduces the morbidity.

Objectives: To determine the frequency of thyroid malignancy in clinically and sonographically solitary thyroid nodule in patients undergoing thyroidectomy in Comilla Medical College Hospital. Methods: A cross sectional study was carried out at the Department of Otolaryngology and Head Neck Surgery of Comilla Medical College Hospital during the period from January 2016 to January 2019. This study includes all patients admitted and undergoing surgery with solitary thyroid nodule. Results: Out of 188 patients 146 patients were female and 42 patients were male with female:male ratio of 3.4:1. Out of 188 patients 24 patients were found histologically thyroid malignancy. Among them 14 patients were male and 10 patients were female. Papillary carcinoma was found in all cases. Conclusions: Follicular carcinoma is rare in our country. Histopathological examiners may not efficiently be doing their job to differentiate carcinoma from adenoma.

Objectives: To determine the frequency of thyroid malignancy in clinically or zoographically multinodular goiter in patients undergoing thyroidectomy in Cumilla Medical College Hospital, Bangladesh. Methods: A cross sectional study was carried out at the department of Otolaryngology and Head Neck Surgery of Cumilla Medical College Hospital during the period from January 2016 to January 2019. This study includes all patients admitted and undergoing surgery with multinodular goiter. Results: Out of 146 patients 118 patients were female and 28 patients were male with female male ratio is 4.2:1. Out of 146 patients 13 patients were found histologically thyroid malignancy. Among them 8 patients were male and 5 patients were female. Papillary carcinoma was found in all cases.