Objectives: To determine the degree and pattern of hearing impairment among patients attending audiology department of a tertiary level hospital.
Methods: This was a cross sectional observational study which was carried out in the department of audiology of National Institute of ENT(NIENT) during the period of March 2015 to June 2017. A total number of 8338 patients complaining hearing impairment were included in this study. The clinical diagnosis was established by history, detailed clinical examination including otoscopic examination and all findings were recorded. Hearing assessment was done by different hearing tests according to age and need of patient. Pure Tone Average (PTA) was done on averaging the hearing threshold at 0.5, 1 and 2 kHz.
Results: In this study majority of patients (30.1%) were within 25-40 years of age and most of the patients (61.27%) were male. Mild degree of hearing loss was found to have higher prevalence (40.9%) compared to other degrees of hearing losses and more than half (52.5%) of our study population had conductive hearing loss.
Conclusion: Mild degree of hearing impairment and conductive type of hearing impairment are more prevalent. Audiological evaluation especially in suspected hearing impaired patient should be a priority.
Bangladesh J Otorhinolaryngol; October 2017; 23(2): 115-121
To evaluate the hearing outcome in canal wall down mastoidectomy with middle ear reconstruction, prospective longitudinal study was done at National Institute of ENT, Dhaka from March 2015 to September 2016. Total 22 patients were included in the study undergoing canal wall down mastoidectomy with 6 months postoperative followup. Hearing outcomes were observed and compared with the preoperative hearing tests. Among the 22 patients 9 (39.1% of subjects) patients had hearing gain, 12 (52.2%) had hearing loss and 1 (4.3%) had no change in hearing postoperatively.Although disease clearance is the main objective in canal wall down mastoidectomy, hearing gain can be achieved if combined with ossiculoplasty and tympanoplasty. The hearing gain or loss depends upon the extension of disease and status of the ossicular chain. Most patients usually experience hearing loss more than the preoperative period due to removal of ossicle or ossicles for the sake of disease clearance.
Bangladesh J Otorhinolaryngol; October 2017; 23(2): 195-198
Objective: The objective of this study is to determine the pattern of nodal metastases of papillary thyroid carcinoma to regional lymph in patients who have clinically positive nodes. Study design: Cross sectional study. Methods: Between January 2008 and December 2009, a total of 50 consecutive patients (15 male and 35 female) with clinical evidence of cervical lymph node metastases of papillary thyroid carcinoma was analyzed. Patients those with previous neck dissection for non thyroid malignancies and those neck node with follicular and medullary thyroid carcinoma were excluded from the study. Results: The predominant site of metastases was level III (82%), followed by level IV (62%), level II (48%), level VI (18%) and level V (16%). So, patients in the anterolateral group (level II, III and IV) were the greatest risk of metastatic disease, with level III nodes consistently the most frequently involved. No patient exhibited in level I involvement, multiple level involvement was found in 74% (37 of 50) patients. Conclusion: The high incidence of metastatic disease found in level III and IV. The level V and VI involvement were also reasonably high. Which supports the recommendation for posterolateral and anterior neck dissection for patients with papillary thyroid carcinoma with clinically positive nodes. DOI: http://dx.doi.org/10.3329/bjo.v19i1.14862 Bangladesh J Otorhinolaryngol 2013; 19(1): 46-52
Objectives: To determine the best surgical approach of myringoplasty regarding healing of tympanic membrane and improvement of hearing.
Methods: This was a cross sectional comparative study carried out in the departments of Otolaryngology and Head-Neck Surgery of Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital, Sir Salimullah Medical college Mitford Hospital and Shaheed Suhrawardy Medical College Hospital during the period of July’2009 to March 2011. A total number of 75 patients of age 15-45years having inactive mucosal chronic otitis media with central perforation were included in this study. All patients has undergone myringoplasty and patients were divided into three groups according to surgical approach such as postaural, transcanal and endaural. All patients were followed up postoperatively and all postoperative findings were recorded. The three groups were compared with regard to healing of tympanic membrane and improvement of hearing.
Results: The success rate in this study was 80% . graft take rate in postaural, transcanal and endaural approaches were 92.5%, 66.67% and 63.64% respectively. Improvement of mean airbone gap in postaural, transcanal and endaural approaches were 19.04dB, 10.02dB and 11.36dB
Conclusion: Graft take rate and hearing improvement is significantly higher in postaural approach than other approaches.
Bangladesh J Otorhinolaryngol; April 2016; 22(1): 21-25
Objective: To observe Post-operative complications of Total Laryngectomy in advanced Laryngeal Carcinoma Patients.
Methods: This prospective observational study was conducted in National Institute of ENT, Tejgaon, Dhaka. Study duration 3 years, from January 2015 to December 2017. 17 patients were selected who underwent total laryngectomy for histologically proven advanced carcinoma larynx. Patients were followed up monthly for 3 months & then after 6 months for life long.
Results: The age of the patients ranged from 39 to 66 years. The mean age was 47 years. Most of the cases are supraglottic carcinoma 12 (70.59%), Glottic carcinoma in 5 (29.41%) & no subglottic carcinoma. In this study, out of 12 supraglottic cases, 4 patients were presented in stage III & 8 in stage IV. Among the glottic cases 1 patient presented in stage I, 2 in stage III & 2 patients presented in stage IV. Patients were followed up monthly for 3 months & then after 6 months for life long. 2 patients (11.76%) developed pharyngocutaneous fistula within 7th to 15th post-operative day & these patients were managed conservatively which involved adequate drainage, frequent dressing & fresh blood transfusion. With these conservative management fistula healed completely within 3 to 4 weeks. 3 patients (17.65%) developed wound infection. Wound swab was sent for culture & sensitivity and antibiotics changed accordingly. Wound healed within 2-3 weeks with conservative treatment & adequate aseptic dressing. 1 patient (5.88%) developed postoperative hematoma which was drained immediately. This patient developed wound infection later on & was managed conservatively. 2 patients (11.76%) developed stomal recurrence 4 months after surgery, which was confirmed by biopsy. The cases were inoperable & were sent for radiotherapy. 2 patients (11.76%) developed dysphagia due to pharyngeal stenosis 4 months after surgery.
Conclusion: The most frequent troublesome immediate complication is pharyngocutaneous fistula all of which have been treated conservatively with satisfactory result. Preoperative radiotherapy is an important risk factor for the development of pharyngocutaneous fistula in total laryngectomy.
Bangladesh J Otorhinolaryngol; April 2019; 25(1): 10-18
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