Bangladesh Journal of Otorhinolaryngology

Acute Invasive Fungal Rhinosinusitis

Sheikh Hasanur Rahman — Thu, 18 Apr 2024 00:00:00 +0000

Abstract not Available

Bangladesh J Otorhinolaryngology 2023; 29(2): 49-54

Fibrous Dysplasia of Maxilla in a 10 Year Old Boy

Athul Menon, Aditya Yeolekar, Aniket Lathi, Debapriya Das — Thu, 18 Apr 2024 00:00:00 +0000

Abstract Not Available

Bangladesh J Otorhinolaryngology 2023; 29(2): 112-116

Distributive pattern of aero-allergen sensitivity among patients with naso-bronchial allergy in a tertiary care center of North India

Thu, 18 Apr 2024 00:00:00 +0000

Objective: The aims of our study are to determine the pattern of allergen sensitivity among patients with Naso-bronchial allergy and to determine the difference between the pattern of allergen sensitivity among 3 groups- Bronchial asthmas, allergic rhinitis, and bronchial asthma with allergic rhinitis.

Methodology: A total of 50 patients with nasobronchial allergy who had either presented to the OPD of the Department of Respiratory Medicine or were referred from the Otorhinolaryngology Department fulfilling the inclusion criteria were included in this prospective observational study conducted from June 2019 to June 2021. A total of 48 antigens were used on 50 patients for Skin prick testing and results were recorded.

Result: We observed that all allergens showed positive results however significant positive reaction was seen most commonly in House dust mites (37.3%) and insects (26%) followed by Dust (22.6%), and Dander (20%).

Conclusion: Our study concludes that the variation in the prevalence of allergen reactivities in different regions is due to different geo-climatic conditions and adaptation of specific microbiological flora and fauna to a specific climate, pollution, and lifestyle change.

Bangladesh J Otorhinolaryngology 2023; 29(2): 55-66

One Year Audit of Post Tonsillectomy Haemorrhage at Limerick University Hospital, Ireland

Thu, 18 Apr 2024 00:00:00 +0000

Objectives: To assess post tonsillectomy haemorrhage and rate of readmission , their outcomes for patients operated by different consultant surgeons ,using different methods, patients age, use of antibiotics during the period of one year and any relation with post tonsillectomy haemorrhage to these variables.

Study design; A retrospective audit of all tonsillectomies done in one year period by different consultants using different methods. Out comes were measured for post tonsillectomy bleeding using the Flinders modification of Stammberger criteria.

Method: This was a retrospective study and data was collected from theatre log book Limerick University Hospital, Ireland. Total number of patient was 210. Tonsillectomy was done by different surgeons with different methods. Computer database Hype and daily ward round record sheets kept by the NCHD were utilized to collect number of patients admitted with post tonsillectomy haemorrhage.

Results: Out of 210 tonsillectomies done, 24 patients (11.4%) readmitted with post tonsillectomy bleeding and 7 patients (3.3%) returned to theatre. Haemorrhage is more observed in age group 12 or above than age group below 12 (26.4% vs 3.6%) and bipolar diathermy than coblation (25.0% vs 9.4%). There is no statistically significant diffences in length of stay or use of antibiotic related to secondary haemorrhage. 58.3% of the readmitted patients were treated conservatively.

Conclusion: By using Flinders modification of Stammberger criteria, it gives types of haemorrhage and their severity. Prospective audit with introduction of new surgical proforma will allow ease of continual re audit of potential aetiological factors, operative outcomes and adverse events.

Bangladesh J Otorhinolaryngol 2023; 29(2): 67-73

Evaluation of patient factors for surgical site infection in Elective Ear, Nose, Throat and Head-Neck Surgery

Md Soalikin, Sk Nurul Fattah Rumi, Anup Kumar Chowdhury — Thu, 18 Apr 2024 00:00:00 +0000

Background: Surgical site infection (SSI) is one of the most common health care associated infection and still among the most common serious complications of surgery and have serious consequences for outcomes and costs. Different patient factors may be involved for SSI, including advanced age, diabetes, smoking, alcoholism, steroid/ immunosuppressive medication, poor nutritional state, obesity, anemia, jaundice, chronic infectious disease and malignancy. SSI previously called postoperative wound infection, results from bacterial contamination during or after a surgical procedure. SSI are incisional (superficial or deep) and organ space infection. A successful outcome after ENT and Head-Neck surgery is highly dependent on the postoperative complications. There is little information regarding patient factors for surgical site infection in elective ear, nose, throat and head-neck surgery.

Objectives: The aim of our study was to identify risk factors for developing Surgical Site Infections (SSI) among patients having Ear, Nose, Throat (ENT) and Head-Neck surgery. Materials & method: This prospective type of observational study was conducted in ENT and Head-Neck surgery departments of Dhaka Medical College Hospital, Dhaka, during the period of March, 2018 to September, 2018. A total 250 patients were selected after they have enrolled for elective operation in ENT and Head-Neck surgery department. All relevant data was collected from patients’ history, clinical examination, investigations and hospital records and those was recorded in prescribed form (Data collection sheet). After preoperative preparation specific operation was done. All patients were followed up for development of any postoperative wound infection. All information recorded in data collection sheet. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Quantitative data expressed as mean and standard deviation and qualitative data as frequency and percentage.

Result: Mean age of the participants was 32.79 (SD ±18.96) years. Among 250 patients, 7(2.8%) patients developed postoperative SSI. SSI is significantly higher in older age group (p value <0.05). SSI was developed in 3 (10.7%), 1 (0.5%) and 3 (10.0%) among Underweight, Normal weight and Obese patients respectively. Statistically significant higher infection rate was observed in underweight group (p <0.05). Among the diabetic, 13.3% developed post operative SSI, and significant infection was found in lower Hb level (anaemia) (<0.05). Among patients with Chronic infectious diseases (20.0%) and malignancy (3.4%) developed SSI which was statistically significant (p <0.05).

Conclusion: These results support the consideration of older age, anemic, underweight, malnourish and diabetes as an independent risk factor for SSIs. Subtype of infection was found as superficial SSI 4(57.1%) cases, deep SSI 2(28.6%) cases and organ/ space SSI 1(14.3%) cases. As a result of these problems, routine surveillance for hospital acquired wound infections, including surgical wound infections, is recommended.

Bangladesh J Otorhinolaryngology 2023; 29(2): 74-80

The association of serum immunoglobulin E levels on outcomes of maximal medical therapy among patients of chronic rhinosinusitis

Thu, 18 Apr 2024 00:00:00 +0000

Background: Chronis rhinosinusitis (CRS) is one of the highest prevalent diseases affecting a large population with significant impact on quality of life (QoL) and health care burden. It is almost universally accepted that before surgical therapy is considered, maximal medical therapy (MMT) should be used.Serum immunoglobulin E (IgE) level is a valuable diagnostic parameter in the severity of CRS patients. If relationship between outcomes of medical therapy with different levels of pretreatment Ig E levels can be established, then it may be use as a predictive factor to prioritize between medical treatment or surgery among CRS patients.

Objectives: This study aims to see whether the pretreatment serum immunoglobulin E (IgE)levels of patientswith Chronic rhinosinusitis (CRS) have any association on the outcomes of maximal medical therapy (MMT).

Methods: This quasi-experimental study wasconducted in the Department of Otolaryngology-Head & Neck Surgery, BSMMU, Dhaka from March 2017 to July 2019. Seventy cases of CRS were assigned into three groups based on pretreatment IgE level: normal (d”25 IU/ml), moderately raised (>25 to d”149 IU/ml), and high (e”150 IU/ ml). Outcomes were measured by evaluation of changes in Pre- and Post-MMTRhinosinusitis Disability Index (RSDI) and Lund-Mackay (LM) staging of HRCT- PNS.

Results: The pre-treatment and post-treatment mean of RSDI and LM scoring indicated a significant difference between normal and moderately raised groups. But High IgE showed no significant statistical differences between pretreatment and post treatment mean RSDI and LM scoring.

Conclusion: Patients of chronic rhinosinusitis withnormal and moderately raised pretreatment serum IgE levels were significantly responded to maximal medical therapy. Whereas patients with high level of IgE had poorimprovement with maximal medical therapy.

Bangladesh J Otorhinolaryngology 2023; 29(2): 81-88

Prevalence of Noise Induced Hearing Loss among the Textile Workers

AKM Shaif Uddin, Naher L, Rahaman ML, Islam MS — Thu, 18 Apr 2024 00:00:00 +0000

Background: Noise remains a common environmental pollutant in industrial workplaces and has been a constant issue since the industrial revolution. Occupational hearing loss is the dominant cause of preventable sensorineural hearing loss in adults. The degree of NIHL is determined by intensity, duration of exposure, spectral characteristics of the noise, and individual susceptibility

Methods: This cross-sectional study was carried out among theNassa Taipei Textile Mills Ltd. and Nassa Taipei Spinners Ltd in kachpur,Narayangonj.200 Textile workers aged from 18 to 50 years were recruited in this study. Study subjects were interviewed by trained data collector through a structured questionnaire. Environmental sound intensity level in various departments were measured using a sound level meter (Quest sound level meter, Oconomowoc WISCONSIN. Model no: 2400). Pure Tone Audiometry was done by pure tone clinical audiometer (KAMPLEX Audiometer, Model no: AC 30; Calibrated by P.C. Werth Limited in October 2004) with a frequency range of 125Hz to 8000Hzand sound intensity levels of between -10dB to 120dB was used to test each ear of the subject separately. Data was analyzed using Statistical Package for Social Sciences (SPSS) program version 26.

Results: Out of 200 Textile workers whose were recruited in this study, 138(69%) were males and predominant age group was 18 to 27 years (54.5%). The prevalence of NIHL was found to be 14.5%. The most common age group was 28 to 37 years and positive association (p<.05) between hearing loss and long working hours. Non-user of PPD had little bit higher among the workers who developed hearing loss.

Conclusion: The prevalence of NIHL was higher in textile industry workers. This suggests the need to provide protective gear to workers in stations generating loud noise. The prevalence was higher in male, those who experienced prolong exposure and not to used PPD.

Bangladesh J Otorhinolaryngology 2023; 29(2): 89-95

Outcome of Management of Impacted Foreign Body in Upper Aero-digestive Tract

Thu, 18 Apr 2024 00:00:00 +0000

Background: Foreign body ingestion is a serious health problem in pediatric patients causing significant morbidity and mortality. A high index of suspicion and timely intervention can reduce morbidity as well as mortality especially in the pediatric age group. Time lag between the aspiration and expert attention is very important with regard to overall morbidity and mortality. Complications depend on its type, its localization and the duration of impaction. Large objects in the laryngotracheobronchial tree can cause obstruction to air passage leading to life threatening complications.

Methods: This Prospective study was conducted at the department of ENT & head neck surgery, Dhaka Medical College Hospital for six months from December 2020 to May 2021. Patients attending in the study site with complaints of H/O ingestion of foreign body for inclusion of the study and final selection were done in according to the selection criteria inclusion was confirmed following signing written informed consent.

Results: Hundred patients were seen at the study center during the period. All were emergencies patients with foreign bodies in upper aerodiagestive tract come to ENT & HNS dept.Majority of the patients of impacted esophageal foreign bodies represent pain, drooling of saliva. Females (38%) and males (62%), with a male to female ratio of 1.6:1. Sixty five (65%) patients had X-ray of the soft tissue neck (B/V), which was the main diagnostic tool. Ninety five (95%) patients were discharged after an uneventful postoperative recovery except post-operative pain, laceration of mucosa causes mild bleeding, erosion of nasal turbinate, vestibule, septal perforation & pyrexia from either the impacted foreign body or the procedure performed , which were managed by NG tube feeding , I/V antibiotic , medicated nasal pack conservatively. In this study, complication rate of 5% was recorded, about 50% of which was from impacted coin (in GIT). There were no cardiac arrest and death were recorded. Hospital stay ranged from a day to 7 days.

Conclusion: FBs in the aero-digestive tract constitute a constant hazard in all age groups especially in children and elderly, which demands immediate action and management, delayed treatment with observation is not recommended.

Bangladesh J Otorhinolaryngology 2023; 29(2): 96-103

Comparison of Findings of Fine Needle Aspiration Cytology and Histopathological Examination of Thyroid Swelling

Thu, 18 Apr 2024 00:00:00 +0000

Background: Thyroid swellings are very common nowadays. To evaluate the nature of a thyroid disease FNAC is considered as the gold standard diagnostic tool. It plays a key role in determining the treatment plan and its cost-effectiveness makes it more popular. An accurate result in a short period makes FNAC more reliable.

Objectives: The purpose of this study is to compare the FNAC results with the final histopathological diagnosis to determine the accuracy of the diagnosis of thyroid neoplasm based on FNAC results.

Methods: In this study, a total of 100 patients presenting with thyroid swelling or nodules underwent FNAC with subsequent surgery from January 2022 to December 2022 at Green Life Hospital. Cytological diagnosis was classified according to the Bethesda classification. Final histopathological results were compared to find out the accuracy of FNAC.

Results: Of 100 patients with a thyroid nodule or swelling, 74 (74%) were women and 26 (26%) were men between 21 to 70 years of age. On FNAC, we found 70 cases of benign and 30 cases of malignant. After Histopathological examination, we found 58 cases of benign and 42 cases of malignant. The sensitivity and specificity are 64.28% and 94.82%. The accuracy of FNAC in the diagnosis of benign or malignant thyroid lesions was 82%.

Conclusions: FNAC is verypopular, safe, simple, rapid, and cost-effective. It is a minimally invasive procedure. An accurate and reliable cytology report may help to reduce unnecessary surgery in patients with benign thyroid.

Bangladesh J Otorhinolaryngology 2023; 29(2): 104-111