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Clinical Presentation of Thyroglossal Cysts and Sinuses 甲状腺骨囊肿和窦的临床表现
IF 0.1 Pub Date : 2022-07-20 DOI: 10.3329/bjo.v28i1.60792
GM Faruquzzaman, Md. Aminul Haque, Md Nazmul Islam, Md Nazrul Islam, M. Kamruzzaman, D. Hossain
Objective: To see the clinical presentation of thyroglossal cysts and sinuses. Methods: Observational type of Cross sectional study. Department of ENT & Head-Neck Surgery in Sher-E-Bangla Medical College Hospital, Barishal from September 2014 to February 2015. All patients attended in the Department of ENT and Head Neck Surgery in Sher-E-Bangla Medical College Hospital, Serum TSH, USG of thyroid swelling and FNAC were done for diagnoses and for evaluation. Results: Thyroglossal cysts and sinuses were found in 23(63.9%) and 13(36.1%) cases respectively. The mean age of presentation was found 16.6±11.3 years in cysts group and 15.5±7.2 years in sinus group. Regarding the site of cysts 4(17.4%) cases was suprahyoid, 11(47.8%) infrahyoid and 8(34.8%) at the level of hyoid. Regarding the site of sinus 1(7.7%) case was suprahyoid, 9(69.2%) infrahyoid and 3(23.1%) at the level of hyoid. All the patients had normal thyroid gland in both group, all of them had normal serum TSH level. FNAC was done in all cyst patients and shows normal cystic lesion with no malignancy. But in sinus patients only one FNAC was done and reported as cystic lesion. Conclusion: Thyroglossal cysts and sinuses were more common in 2nd decade and male predominant. Majority of the cysts are Infrahyoid and on the right side of midline and majority of sinuses are Infrahyoid and on the right side. Development of sinuses is due to operation following abscess formation in majority of cases. Bangladesh J Otorhinolaryngol 2022; 28(1): 7-15
目的:探讨甲状舌囊肿和舌窦的临床表现。方法:观察型横断面研究。2014年9月至2015年2月在巴里沙尔Sher-E-Bangla医学院医院耳鼻喉科及头颈外科工作。所有在谢尔- e -孟加拉医学院附属医院耳鼻喉科和头颈外科就诊的患者,均进行血清TSH、甲状腺肿胀USG和FNAC的诊断和评估。结果:甲状腺舌囊肿23例(63.9%),舌窦13例(36.1%)。囊肿组平均发病年龄为16.6±11.3岁,窦性组平均发病年龄为15.5±7.2岁。关于囊肿部位,舌骨上4例(17.4%),舌骨下11例(47.8%),舌骨水平8例(34.8%)。舌骨上窦1例(7.7%),舌骨下窦9例(69.2%),舌骨水平窦3例(23.1%)。两组患者甲状腺功能均正常,血清TSH水平均正常。所有囊肿患者均行FNAC检查,显示囊性病变正常,无恶性肿瘤。但在鼻窦患者中,仅进行了一次FNAC,并报告为囊性病变。结论:甲状舌囊肿和舌窦多见于第二十年,以男性为主。大多数囊肿位于舌骨下,位于中线右侧,大多数鼻窦位于舌骨下,位于右侧。在大多数情况下,鼻窦的发展是由于脓肿形成后的手术。孟加拉国[J] otorhinolyngol 2022;28 (1): 7 - 15
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引用次数: 1
Cochlear Implantation in Advanced Otosclerosis: Rising to the Challenges of Surgery and Decision making 晚期耳硬化症的人工耳蜗植入术:应对手术和决策的挑战
IF 0.1 Pub Date : 2022-07-20 DOI: 10.3329/bjo.v28i1.60835
Shalabh Sharma, S. Singh, Anandita Gupta, A. K. Lahiri, Meenakshi Wadhera
Introduction: Cochlear implantation as well as stapedotomy followed by use of hearing aid are acceptable modes of surgically rehabilitating patients with far advanced otosclerosis. Surgical challenges of CI include difficulties associated with electrode insertion and facial nerve stimulation. Improvement in speech discrimination scores and overall satisfaction with stapedotomy and hearing aid use are reportedly poor in many patients, yet being a low cost procedure it may be used as initial management in a subset of patients. Case Report: 46 year old patient with diffuse confluent retrofenestral otoscerosis underwent cochlear implantation. He was mapped using behavioral thresholds as despite intracochlear electrode position no neural response was recordable per-operatively as well as in the postoperative period. Perimodiolar electrodes and sodium flouride therapy were used to overcome problems of FNS. 18 months post CI the patient has good audiologic outcomes (CAP 7) without any FNS. Conclusion: High resolution computed tomography, air bone gap and speech discrimination scores are important in formulating treatment plan in patients with far advanced otosclerosis. Early cochlear implantation can be considered in patients with poor speech discrimination scores and extensive cochlear lesions. Facial nerve stimulation can be prevented by adequate pre-operative planning. Bangladesh J Otorhinolaryngol 2022; 28(1): 112-117
耳蜗植入术和镫骨切开术加助听器是晚期耳硬化症患者可接受的手术康复模式。CI的手术挑战包括电极插入和面神经刺激相关的困难。据报道,在许多患者中,镫骨切除术和助听器的使用在言语辨别评分和总体满意度方面的改善很差,但作为一种低成本的手术,它可能被用作一小部分患者的初始管理。病例报告:46岁弥漫性融合性耳膜后硬化患者行人工耳蜗植入术。使用行为阈值对患者进行定位,因为尽管耳蜗内电极放置,术中和术后均未记录到神经反应。使用磨牙周围电极和氟化钠治疗来克服FNS问题。CI后18个月,患者听力学结果良好(CAP 7),无任何FNS。结论:高分辨率计算机断层扫描、气骨间隙和言语识别评分对制定远晚期耳硬化患者的治疗方案具有重要意义。言语辨别评分差、耳蜗病变广泛的患者可考虑早期人工耳蜗植入术。充分的术前计划可以防止面神经刺激。孟加拉国[J] otorhinolyngol 2022;28 (1): 112 - 117
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引用次数: 0
Demographic Distribution of Head-Neck Carcinoma of ENT Oncology Department of NICRH in 2020 2020年NICRH耳鼻喉肿瘤科头颈癌人口统计学分布
IF 0.1 Pub Date : 2022-07-20 DOI: 10.3329/bjo.v28i1.60827
Md Abdul Karim, Md Khalid Mahmud, Md Saif Rahman Khan, Md Hasan Zafar, Mohammad Ali
Background: Head and neck cancer (HNC) comprises a diverse group of oncological entities, originating from various tissue types and organ localizations, situated in the topographical regions of the head and neck (H&N). This single institution retrospective study was aimed at establishing the HNC patient geographic & demographics and categorizing the individual incidence of H&N malignancies, regarding their organ of origin. Objectives: To identify the age Distribution, Occupation, Disease Specific Gender Distribution, Disease Incidence of different types of Head-Neck Cancer according to geography of Bangladesh. Methods: This retrospective data analysis to asses age, occupation, Disease Specific Gender Distribution, Disease Incidence of different types of Head-Neck Cancer diagnosis, using medical records data of 3047 Head & Neck Cancer patients from National Institute of Cancer Research & Hospital designated cancer center in Bangladesh in 2020. All new cases of Head- Neck Cancer patients attend in ENT Oncology Department included in this study. Old cases, who were attend for follow up excluded from study. Results: Total 3047 new patients were included. Thyroid Carcinoma 365(12%), Sinonasal 212(7%), Salivary gland Carcinoma 121(4%), Oral Cavity 303(9.9%), Oropharyngeal Carcinoma 243(8%), Hypopharynx 457(15%), Larynx 761(25%), Nasopharyngeal Carcinoma 91 (3%), Carcinoma Unknown Primary 304(10%), Lymphoma 154(5.1%), Others 36(3.2%). Male: Female 3:2. Conclusion: Head & Neck Cancer (HNC) is common cancer in Bangladesh. Functional & cosmetic deformities occur in head & neck cancer. The reported single institution results appear representative of the national incidence and characteristics of HNC. Bangladesh J Otorhinolaryngol 2022; 28(1): 68-77
背景:头颈癌(HNC)包括一组不同的肿瘤实体,起源于不同的组织类型和器官定位,位于头颈(H&N)的地形区域。这项单机构回顾性研究旨在确定HNC患者的地理和人口统计数据,并根据其起源器官对HNC恶性肿瘤的个体发病率进行分类。目的:了解孟加拉国不同类型头颈癌的年龄分布、职业、疾病特定性别分布和发病率。方法:采用孟加拉国国家癌症研究所和医院指定癌症中心2020年3047例头颈癌患者的病历资料,回顾性分析不同类型头颈癌诊断的年龄、职业、疾病特定性别分布、疾病发病率。本研究纳入所有在耳鼻喉肿瘤科就诊的头颈部肿瘤新病例。未参加随访的老病例排除在研究之外。结果:共纳入3047例新患者。甲状腺癌365例(12%),鼻窦癌212例(7%),唾液腺癌121例(4%),口腔癌303例(9.9%),口咽癌243例(8%),下咽癌457例(15%),喉癌761例(25%),鼻咽癌91例(3%),原发癌304例(10%),淋巴瘤154例(5.1%),其他36例(3.2%)。男:女:3:2。结论:头颈癌(HNC)是孟加拉国常见的癌症。头颈癌导致功能和美容畸形。报告的单一机构结果似乎代表了HNC的全国发病率和特征。孟加拉国[J] otorhinolyngol 2022;28 (1): 68 - 77
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引用次数: 0
Surgical and Non-Surgical Treatment Outcome Assessed by Voice Handicap Index of Patients with Vocal Fold Nodule 用嗓音障碍指数评价声带小结手术与非手术治疗效果
IF 0.1 Pub Date : 2022-07-20 DOI: 10.3329/bjo.v28i1.60796
Chirangib Singha Palash, M. Uddin, Kazi Shameemus Salam, S. Ahmad, Md Jaber Al Sayied, Md Hasanul Haque
Background: Vocal nodules are a frequently occurring type of laryngeal disorder. Vocal fold nodules are usually bilateral swellings of variable size (< 3mm) found at the mid-part of the membranous vocal cords. Vocal abuse, misuse and overuse are frequently claimed to be the causes of vocal nodules and mostly affect professional voice users. It has important public health implications and impact on patient quality of life (QoL). Voice handicap index (VHI) is an important tool for quality of life assessment and outcome of intervention in voice disordered patients. Objective: To compare the outcome of Voice handicap index (VHI) score after surgical and non-surgical intervention of vocal cord nodule. Methods: In this prospective study 30 patients with vocal nodules refractory to the first session of voice therapy were diagnosed by fiber optic laryngoscopy. After simple random allocation management was done either by voice therapy or surgery. VHI (Voice Handicap Index) was applied as outcome measures for assessing the efficiency of intervention between surgical and non-surgical groups. Results: The mean value of Voice handicap index total (VHIt) was 54.40 (± 8.56) before voice therapy which significantly changed to 25.80 (± 6.23) after voice therapy in non-surgical group(n2). Bangladesh J Otorhinolaryngol 2022; 28(1): 29-36
背景:声带小结是一种常见的喉部疾病。声带小结通常是双侧大小不等的肿胀(< 3mm),见于声带膜部中部。声音的滥用、误用和过度使用经常被认为是导致声带小结的原因,并且主要影响专业的声音使用者。它具有重要的公共卫生意义和影响患者的生活质量(QoL)。嗓音障碍指数(VHI)是评价嗓音障碍患者生活质量和干预效果的重要工具。目的:比较声带小结手术与非手术治疗后的语音障碍指数(VHI)评分。方法:在这项前瞻性研究中,30例首次语音治疗难治的声带小结患者通过纤维喉镜诊断。在简单的随机分配后,通过语音治疗或手术进行管理。采用VHI (Voice Handicap Index)作为评价手术组与非手术组干预效果的指标。结果:嗓音障碍指数(VHIt)在嗓音治疗前均值为54.40(±8.56),非手术组嗓音治疗后均值为25.80(±6.23),差异有统计学意义(n2)。孟加拉国[J] otorhinolyngol 2022;28 (1): 29-36
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引用次数: 0
Comparison of Uncomfortable Loudness Level in Stapedotomy with or without Stapedial Tendon Preservation 足趾肌腱保留与不保留足趾肌腱切开术中不适响度的比较
IF 0.1 Pub Date : 2021-11-01 DOI: 10.3329/bjo.v27i2.56357
Tamanna Nawshin, K. L. Saha, Shah Sohel, Sabyasachi Talukdar, Sheikh Mohammad Tanjil Ul Alam
Background: Otosclerosis is one of the commonest diseases of the ear mostly involves the otic capsule. Most often otosclerotic foci appear in stapes region leading to stapes fixation, predominantly affect the adolescence female. The most common presenting symptom of clinical otosclerosis is conductive deafness. The mainstay of treatment for otosclerosis is surgery. Surgical options include stapedectomy, stapedotomy with or without stapedial tendon preservation. The latter being is the procedure of choice.Aim: The aim of this study is to compare the outcome of uncomfortable loudness level in stapedotomy with or without stapedial tendon preservation.Methods: A prospective observational study was conducted in the Department of Otolaryngology-Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka for 18 months in patients with otosclerosis. Total 30 subjects were selected based on the inclusion and exclusion criteria. All patients were assessed pre-operatively by clinical examination, otoscopy and microscopic examination. Hearing was assessed by pure tone audiometry. Uncomfortable level and stapedial reflex threshold were tested in all cases. The selected cases were placed into two groups. Stapedial tendon resection in Group-I and stapedial tendon preservation in Group-II. Post-operative follow up was done at 3 months and 6 months. Hearing and uncomfortable loudness level were evaluated with PTA during follow up by calculating the average of 500Hz, 1000Hz, 2000Hz and 4000HZ. The data were calculated manually. The statistical significance was set to P< 0.05. Results of the study were expressed as mean, standard deviation (± SD), frequency and percentages. Means and standard deviations were reported for continuous variables. Frequencies and percentages were reported for categorical variables. Unpaired Student’s t test was done to compare the continuous variables and Chi Square test was done to compare the categorical variables.Results: In this study preoperative average ABG for group I and group II were 35 ± 4.57 dB and 34 ± 4.17 dB respectively. In group I, post operative average ABG after 3 months and 6 months were 14 ± 3.7 dB and 13±3.3 dB respectively. Post operative average ABG after 3 months was 13 ± 5.7 dB and was 12 ± 4.4 dB for group II. But the hearing improvement between two groups was not statistically significant. In case of preoperative mean UCL was 95 ± 1.8 dB and 96 ± 2.5 dB for group I and group II respectively. Postoperative mean UCL after 3 months was 96 ± 3.57 dB and after 6 months was 99 ± 6.28 dB in group I. For group II, postoperative mean UCL after 3 months and 6 months was 107±4.2 dB and 113 ± 3.2 dB respectively. Here mean UCL was on average 11 dB higher for group II in 3 months and additional 6 dB improvement noted after 6 months, but show minimal change in group I. This finding was statistically significant.Conclusion: Preservation of the stapedial tendon is the choice in the surgical treatment o
背景:耳硬化是耳部最常见的疾病之一,主要累及耳囊。耳硬化灶多出现在镫骨区,导致镫骨固定,多见于青春期女性。耳硬化最常见的临床表现是传导性耳聋。治疗耳硬化的主要方法是手术。手术选择包括镫骨切除术,保留或不保留镫骨肌腱的镫骨切除术。后者是选择的过程。目的:本研究的目的是比较保留或不保留镫骨肌腱的镫骨切除术中不舒服的响度的结果。方法:在达卡Bangabandhu Sheikh Mujib医科大学耳鼻喉头颈外科对耳硬化患者进行为期18个月的前瞻性观察研究。根据纳入标准和排除标准共选择30例受试者。术前通过临床检查、耳镜检查和镜下检查对所有患者进行评估。采用纯音测听法测定听力。所有病例均检测不适程度和镫骨反射阈值。所选病例分为两组。第一组镫骨肌腱切除,第二组镫骨肌腱保留。术后随访时间分别为3个月和6个月。通过计算500Hz、1000Hz、2000Hz和4000HZ的平均值,用PTA评价随访期间的听力和不舒服响度水平。数据是人工计算的。差异有统计学意义,P< 0.05。研究结果以平均值、标准差(±SD)、频率和百分比表示。报告了连续变量的均值和标准差。报告了分类变量的频率和百分比。连续变量的比较采用Unpaired Student’s t检验,分类变量的比较采用卡方检验。结果:ⅰ组和ⅱ组术前平均ABG分别为35±4.57 dB和34±4.17 dB。I组术后3个月和6个月平均ABG分别为14±3.7 dB和13±3.3 dB。术后3个月平均ABG为13±5.7 dB, II组为12±4.4 dB。但两组之间的听力改善没有统计学意义。术前I组和II组平均UCL分别为95±1.8 dB和96±2.5 dB。i组术后3个月平均UCL为96±3.57 dB, 6个月平均UCL为99±6.28 dB。II组术后3个月和6个月平均UCL分别为107±4.2 dB和113±3.2 dB。在这里,第二组的平均UCL在3个月内平均提高了11 dB, 6个月后又增加了6 dB,但第一组的变化很小,这一发现具有统计学意义。结论:保留镫骨肌腱是耳硬化症手术治疗的选择,既能改善功能,又能给中耳提供更多的生理保护。镫骨肌腱恢复的患者术后不适阈值水平增加。孟加拉国J otorhinolyngol 2021;27 (2): 117 - 123
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引用次数: 0
Outcome of Total Laryngectomy in Regional Hospitals of Bangladesh 孟加拉国地区医院全喉切除术的效果
IF 0.1 Pub Date : 2021-11-01 DOI: 10.3329/bjo.v27i2.56360
M. Islam, Md. Shahjahan Kabir, Md. Abdullah Yousuf Al Harun, Md. Abdur Razzak, Mohosana Khanam, A. S. Uddin, A. Sobhan, M. Matin
Objectives: To analyze post operative complications, local recurrence, functional outcome of speech & swallowing and survival rate following total laryngectomy.Methods: This prospective observational study was done in four major tertiary care medical college hospitals of Bangladesh from July 2000 to December 2019. All operations were done by a single surgeon, one of the authors of this study based on the personal experience. 45 patients were selected who underwent total laryngectomy for biopsy proven advanced (T3 and T4) laryngeal cancer as primary case & recurrent cases following radiotherapy. Patients were followed up monthly for three months and then six monthly for two years and yearly for rest of their life.Results: Age of the patients ranged from 42 to 80 years with mean age 56.7 years. In postoperative period 03 (6.6%) patients developed wound infection, 03 (6.6%) stomal stenosis, 03 (6.6%) stomal recurrence, 02 (4.4%) seroma, 02 (4.4%) pharyngo-cutaneous fistula and 01 (2.2%) case developed pharyngeal stenosis. In post laryngectomy voice rehabilitation 33 (73.3%) cases used esophageal voice, 07 (15.5%) cases used electrolarynx and 05 (11.1%) cases used bloom singer valve. Out of oesophageal speech, 2 patients had poor speech, Regarding swallowing all patients had very good swallowing except one patient who got pharyngeal stenosis, needed dilation. 3 patients died in subsequent 2 years follow-up and overall survival was 93.3%.Conclusion: Outcome of total laryngectomy depends on site and size of tumour, nodal metastases, recurrent cases and co-existing co-morbidities. Total laryngectomy with or without radiotherapy offers significantly higher local control and survival benefit with advanced laryngeal cancer, compared to radiotherapy only.Bangladesh J Otorhinolaryngol 2021; 27(2): 139-144
目的:分析全喉切除术后的并发症、局部复发、言语和吞咽功能结果以及生存率。方法:这项前瞻性观察性研究于2000年7月至2019年12月在孟加拉国四所主要的三级护理医学院医院进行。所有的手术都是由一名外科医生完成的,这项研究的作者之一基于个人经验。选择45例经病理证实为晚期(T3和T4)喉癌症的患者进行全喉切除术,作为放疗后的原发病例和复发病例。患者每月随访三个月,然后六个月随访两年,余生每年随访一次。结果:患者年龄42~80岁,平均56.7岁。术后有03例(6.6%)患者出现伤口感染,03例(6.6%)口腔狭窄,03例复发,02例(4.4%)浆膜瘤,02例咽皮瘘,01例(2.2%)出现咽狭窄。在喉切除术后的语音康复中,33例(73.3%)使用食道音,07例(15.5%)使用电喉,05例(11.1%)使用bloom-singer瓣膜。在食道言语之外,2名患者的言语能力较差。关于吞咽,除了一名患者出现咽部狭窄,需要扩张外,所有患者的吞咽能力都很好。3例患者在随后的2年随访中死亡,总生存率为93.3%。结论:全喉切除术的结果取决于肿瘤的部位和大小、淋巴结转移、复发病例和合并症。与仅接受放疗相比,接受或不接受放疗的全喉切除术对晚期癌症的局部控制和生存益处显著更高。孟加拉国耳鼻喉科杂志2021;27(2):139-144
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引用次数: 1
Study of Antibiotic Sensitivity of Aural Swab and Aetiological Factors of Chronic Otitis Media-Active Mucosal Type 慢性中耳炎活动性粘膜型耳拭子抗生素敏感性及致病因素的研究
IF 0.1 Pub Date : 2021-11-01 DOI: 10.3329/bjo.v27i2.56356
Md. Nesar Uddin, M. S. Islam, Mohammad Delwar Hossen, Mohammed Iftekharul Alam, M. K. Hossain
Background: Chronic otitis media (COM) refers to chronic inflammation of mucoperiosteal lining of middle ear cleft resulting in aural discharge and deafness. The objective of this study is to evaluate the antibiotic sensitivity and aetiological factors of COM.Methods: This cross-sectional study was conducted from July 2017 to June 2018 for duration of one year among the patients who attended with COM- active mucosal disease at Department of ENT & Head Neck Surgry, Combined Military Hospital (CMH) Chattogram. Total 50 cases were isolated and among them 5 cases had been suffering from bilateral COM. Aural swab was taken from 55 ears and a predesigned data collection sheet was duly filled up with the information of socioeconomic status of the patient. The laboratory records of every case was systematically organized. The data were analyzed with simple manual analysis using percentage and frequency.Results: About 24% patients were in 31-40 years age group. Out of 50 patients 62% were male. 44% patient lived in barrack. Ear cleaning habit shows, 32% has got the cleaning habit with cloth and stick. Out of 50 patients 5 had bilateral COM. So out of 55 ears, Culture & sensitivity test viewed that Pseudomonas aeruginosa was the most predominant organism - 41.8% followed by S. aureus- 30.9% Antibiotic sensitivity profile shows, 80% cases showing sensitivity to Amikacin then gentamycin-73.3% Resistant 5 cases showed 100% sensitivity to Tazobactum. Again out of 19 cases of Gram positive organism 78.9% were sensitive to Amoxyclav. 3 resistant cases showed 100% sensitivity to Meropenem.Conclusion: By studying this topic we hope to able to make an idea about the aetiological and predisposing factors and antibiotic sensitivity of COM-active mucosal variety.Bangladesh J Otorhinolaryngol 2021; 27(2): 111-116
背景:慢性中耳炎(COM)是指中耳裂粘骨膜衬里的慢性炎症,导致耳分泌物和耳聋。本研究的目的是评估COM的抗生素敏感性和病因因素。方法:本横断面研究于2017年7月至2018年6月在联合军事医院耳鼻喉科头颈外科就诊的COM活动性粘膜病患者中进行,为期一年。共有50例病例被隔离,其中5例患有双侧COM。从55只耳朵中提取耳拭子,并在预先设计的数据收集表中填写患者的社会经济状况信息。对每个病例的实验室记录进行了系统的整理。使用百分比和频率对数据进行简单的手动分析。结果:约24%的患者年龄在31-40岁之间。在50名患者中,62%为男性。44%的病人住在营房里。耳朵清洁习惯显示,32%的人有过用布和棍子清洁耳朵的习惯。在50例患者中,5例患有双侧COM。因此,在55耳中,培养和敏感性测试显示,铜绿假单胞菌是最主要的生物体,占41.8%,其次是金黄色葡萄球菌,占30.9%。抗生素敏感性谱显示,80%的病例对阿米卡星敏感,然后是庆大霉素73.3%。耐药的5例对他唑巴坦敏感。在19例革兰氏阳性菌中,78.9%对阿莫敏感。3例耐药病例对美罗培南的敏感性为100%。孟加拉国耳鼻喉科杂志2021;27(2):111-116
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引用次数: 1
Complicated Paediatric Bronchial Foreign Body: A Novel Extraction Technique 复杂小儿支气管异物:一种新的取出技术
IF 0.1 Pub Date : 2021-11-01 DOI: 10.3329/bjo.v27i2.56365
Fathiyah Idris, Zaid Nailul Murad, Boon Chye Gan, K. B. Noh, Y. Yi, Ong Fei Ming, Ng Siew Peng, Z. Zahirrudin, G. See
A paediatric bronchoscopy procedure for foreign body inhalation is indeed a highly challenging procedure due to multiple risk factors such as lower physiological functional residual capacity and adverse pulmonary function effects by anaesthetic agents in addition to concurrent active lungs infection. Here we elucidate a novel technique of foreign body removal located at the distal airway in a paediatric patient and in a situation where a paediatric flexible bronchoscopy with built-in working channel is not available. A 1-year 7-months-old boy presented with acute respiratory distress syndrome following a one-week history of active respiratory infection. On examination, he was tachypnoeic with audible soft inspiratory stridor and intermittent barking cough despite being supplemented with 3 liters /minute oxygen mask. Chest x-ray showed right upper lobe collapse. He was referred to the otorhinolaryngology team after a suspicious history of foreign body aspiration obtained from his mother. Bedside flexible nasopharyngolaryngoscopy showed granulation tissue at the junction of laryngeal surface of epiglottis and anterior commissure. He underwent emergency direct laryngoscopy, tracheoscopy, bronchoscopy, excision of granulation tissue and removal of foreign body under general anaesthesia. Herein, some of complicated bronchoscopy demand critical thinking of alternative or modified techniques to achieve a successful and safe surgery.Bangladesh J Otorhinolaryngol 2021; 27(2): 177-183
小儿支气管镜手术治疗异物吸入确实是一项极具挑战性的手术,因为存在多种危险因素,如生理功能残余容量降低、麻醉药对肺功能的不良影响以及并发活动性肺部感染。在这里,我们阐明了一种新的技术,异物清除位于远端气道的儿童患者,在这种情况下,儿童柔性支气管镜内置工作通道是不可用的。1岁7个月大的男孩在一周的活动性呼吸道感染史后出现急性呼吸窘迫综合征。经检查,患者呼吸急促,可听到柔和的吸气性喘鸣,间歇性吠叫咳嗽,尽管补充了3升/分钟的氧气面罩。胸片显示右上肺叶塌陷。在从他母亲那里获得可疑的异物吸入史后,他被转介到耳鼻喉科。床边柔性鼻咽喉镜检查显示会厌与前连合喉面交界处有肉芽组织。全麻下行急诊直接喉镜检查、气管镜检查、支气管镜检查、肉芽组织切除及异物取出。在此,一些复杂的支气管镜检查需要对替代或改进的技术进行批判性思考,以实现成功和安全的手术。孟加拉国J otorhinolyngol 2021;27 (2): 177 - 183
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引用次数: 0
Comparison of Reinforcement Cartilage Graft and Temporalis Fascia Graft in Type 1 Tympanoplasty 强化软骨移植与颞筋膜移植在1型鼓室成形术中的比较
IF 0.1 Pub Date : 2021-11-01 DOI: 10.3329/bjo.v27i2.56355
Md Mainul Islam, K. L. Saha, H. Talukder, Md Khalid Mahmud, Riashat Azim Majumder, Md Hasanul Haque, Abirvab Naha
Background: Chronic otitis media (COM) is the long-standing infection of a part or whole of middle ear cleft characterized by ear discharge and perforation. It is the commonest ear problem in adult and children. Most common presenting symptoms are ear discharge, mild to severe hearing loss, sometimes tinnitus even vertigo. Treatment of COM is mainly operative. Inactive mucosal variety of COM presents with the perforation in tympanic membrane with non-inflamed middle ear mucosa. The treatment of inactive mucosal variety of COM is Type 1tympanoplasty. It can be done by conventional temporalis fascia or cartilage graft. Both have some merits and demerits.Objective: To compare the the outcomes between reinforcement cartilage graft and temporalis fascia graft in type -1 tympanoplasty.Methods: 86 (43 patients in each group) patients with COM (inactive mucosal) who were admitted in the department of Otolaryngology – Head and Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2018 to June 2019, and had fulfilled the inclusion and exclusion criteria were selected for the study. History, examinations, investigations were done. All patients underwent type 1 tympanoplasty. Prior to surgery relevant investigations were done and informed written consent was taken from all patients. In Group-A reinforcement cartilage tympanoplasty cases and in Group-B temporalis fascia tympanoplasty cases were placed. Post-operative graft uptake rate and hearing gain were compared in two groupsResults: The surgical outcomes between reinforcement cartilage tympanoplasty in comparison with temporalis fascia tympanoplasty showed no significant difference of graft uptake rate and hearing gain.Conclusion: Cartilage tympanoplasty has been practised for reconstruction of perforated tympanic membrane in COM since long with variable results. Graft uptake rate in cartilage reinforcement is comparatively better than temporalis fascia graft. So, reinforcement cartilage graft can be adopted as an alternative to temporalis fascia graft in type- I tympanoplasty.Bangladesh J Otorhinolaryngol 2021; 27(2): 104-110
背景:慢性中耳炎(COM)是指中耳裂的一部分或全部长期感染,其特征是耳朵分泌物和穿孔。它是成人和儿童最常见的耳朵问题。最常见的症状是耳朵分泌物,轻度至重度听力损失,有时耳鸣甚至眩晕。COM的治疗以手术为主。COM的非活动性粘膜多样性表现为鼓膜穿孔,中耳粘膜未发炎。无效粘膜型COM的治疗方法为1型淋巴成形术。它可以通过传统的颞筋膜或软骨移植来完成。两者都有一些优点和缺点。目的:比较1型鼓室成形术中强化软骨移植和颞筋膜移植的效果。方法:选择2018年1月至2019年6月入住达卡Bangabandhu Sheikh Mujib医科大学耳鼻咽喉头颈外科并符合纳入和排除标准的86名COM(每组43名患者)患者进行研究。进行了历史、检查和调查。所有患者均接受了1型鼓室成形术。手术前进行了相关调查,并取得了所有患者的知情书面同意。A组为强化软骨鼓室成形术例,B组为颞筋膜鼓室成形术病例。比较了两组患者术后移植物吸收率和听力增益。结果:加强软骨鼓室成形术与颞筋膜鼓室成形术的手术结果显示,移植物吸收速率和听力增益没有显著差异。结论:软骨鼓室成形术长期应用于COM鼓膜穿孔重建,效果参差不齐。软骨强化的移植物吸收率相对高于颞筋膜移植物。因此,在I型鼓室成形术中,可以采用强化软骨移植物代替颞筋膜移植物。孟加拉国耳鼻喉科杂志2021;27(2):104-110
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引用次数: 0
Transoral Laryngeal Microsurgery 经口喉显微外科
IF 0.1 Pub Date : 2021-11-01 DOI: 10.3329/bjo.v27i2.56354
K. Tarafder
Abstract not availableBangladesh J Otorhinolaryngol 2021; 27(2): 100-103
摘要不可用,Bangladesh J Otorhino喉2021;27(2):100-103
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引用次数: 0
期刊
Bangladesh Journal of Otorhinolaryngology
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