M. A. Azad, B. Siddiquee, A. Asaduzzaman, F. Mohsin, M. Hasnat
Introduction: Total laryngectomy is the gold standard treatment for advanced laryngeal cancer. Sacrifice of voice is one of the most important shortcomings of the procedure. Possibility of achieving good quality voice is greater with prosthesis compared to other method. Post laryngectomy voice rehabilitation with prosthesis yield excellent outcome in most of the cases. Swallowing, pulmonary and olfactory rehabilitation should be managed by multidisciplinary team for better quality of life (QoL). Objectives: The purpose of this study was to observe the outcomes of voice, swallowing pulmonary and olfactory rehabilitation and QoL following total laryngectomy. Methods: This cross sectional retrospective clinical study was conducted at the Head & Neck Oncology Unit, Combined Military Hospital (CMH), Dhaka. Total 57 candidates were selected. Diagnosis was done by thorough clinical examination, Fibre Optic Laryngoscopy. Contrast Enhanced Computed Tomography (CECT) scan of neck was done except few cases where MRI of neck was done for subtle cartilage erosion was suspected. Examination under anaesthesia, direct larangoscopy and biopsy was done for every cases. Candidates were post chemo-radiated/ radiated biopsy proven recurrent cases, clinically nonfunctional larynx with aspiration and radiologically evident of cartilage erosion. In all cases artificial voice prosthesis was used. All the laryngectomees underwent voice, swallowing, pulmonary and olfactory rehabilitation in laryngectomy club of head & neck oncology unit, CMH Dhaka for a period of 3 months as per standard protocol. 1. Classified ENT Specialist & Head-Neck Surgeon, Dept of ENT and Head-Neck, Surgery, Combined Military Hospital, Chattogram. 2. Professor & Chief, Head & Neck surgery Division, BSMMU, Dhaka. 3. Classified ENT Specialist & Head Neck Surgeon, Dept. of ENT and Head-Neck Surgery, Combined Military Hospital, Cumilla. 4. Classified ENT Specialist & Head – Neck Surgeon, Dept. of ENT and Head-Neck Surgery, Combined Military Hospital, Barishal. 5. Graded ENT Specialist & Head – Neck Surgeon, Dept. of ENT and Head-Neck Surgery, Combined Military Hospital, Bir Uttam Shaeed Mahbub Senanibash, Kholahati, Parbatipur. Address of correspondence: Lieutenant Colonel (Dr.) Muhammad Ali Azad, Classified ENT Spl & Head Neck Surgeon, Dept. of ENT and Head-Neck Surgery, Combined Military Hospital, Chattogram, Bangladesh. Mobile: +8801714056245, E-mail: aliazad101052@gmail.com Introduction: Total laryngectomy is still indispensable procedure in treating advanced or recurrent cancer of larynx and hypopharynx. The larynx has important functions in olfaction and respiration and is more than just an organ of voice production. Its removal requires rehabilitation of all three systems. Perhaps loss of voice is the most distressing to the patients as they loss power of communications and establishment of an acceptable voice is critical for successful psychological adjustment. Multidisciplinary team effort is m
前言：全喉切除术是治疗晚期喉癌的金标准。牺牲声音是该程序最重要的缺点之一。与其他方法相比，使用假肢实现高质量语音的可能性更大。在大多数情况下，喉切除术后使用假体进行语音康复会产生良好的效果。吞咽、肺部和嗅觉康复应由多学科团队管理，以提高生活质量。目的：本研究的目的是观察全喉切除术后语音、吞咽、肺部和嗅觉康复的结果以及生活质量。方法：这项横断面回顾性临床研究在达卡联合军事医院头颈肿瘤科进行。共选出57名候选人。诊断是通过彻底的临床检查，光纤喉镜检查。对颈部进行了对比增强计算机断层扫描（CECT），但少数病例怀疑颈部有轻微软骨侵蚀而进行了MRI检查。所有病例均采用麻醉检查、直接喉镜检查和活检。候选病例为化疗后放射/放射活检证实的复发病例、临床上无功能的喉误吸和放射学上明显的软骨侵蚀。所有病例均使用人工语音假体。根据标准方案，所有喉切除术者在达卡CMH头颈肿瘤科喉切除术俱乐部接受了为期3个月的语音、吞咽、肺部和嗅觉康复。1.联合军事医院耳鼻喉科头颈外科分类专家和头颈外科医生，Chattogram。2.达卡BSMMU头颈外科教授兼主任。3.Cumilla联合军事医院耳鼻喉科和头颈外科分类专家和头颈外科医生。4.巴里沙尔联合军事医院耳鼻喉科头颈外科分类专家和头颈外科医生。5.联合军事医院耳鼻喉科和头颈外科，Bir Uttam Shaeed Mahbub Senanibash，Kholahati，Parbatipur。通讯地址：Muhammad Ali Azad中校（博士），分类五官科Spl和头颈外科医生，联合军事医院耳鼻喉科和头颈外科，孟加拉国查图姆。手机：+8801714056245，邮箱：aliazad101052@gmail.com引言：全喉切除术在治疗晚期或复发性癌症和下咽癌中仍然是必不可少的手术。喉在嗅觉和呼吸方面具有重要功能，它不仅仅是一个发声器官。它的拆除需要恢复所有三个系统。也许失声对患者来说是最痛苦的，因为他们失去了沟通的能力，建立一个可接受的声音对成功的心理调整至关重要。多学科团队的努力是强制性的，以实现最佳结果和良好的生活质量。在Singer和Blom（1980）发表的原创文章1之后，喉切除术患者声音的修复康复变得流行起来。随后又推出了Panje2、Groningen3等几种高质量的人声假体并成功使用。与食道音相比，使用该假体获得良好嗓音的可能性更大。现在，provox语音假体是最常用的假体。瑞典阿托斯医疗公司于1990年制造的第一个provox语音假体。迄今为止推出了几个版本的provox。2009年推出了带有智能插入器的第三代provox-vega。在我们的研究中，使用了provox语音假体和vega语音假体4-6。材料和方法：对2013年1月至2020年1月在达卡联合军事医院耳鼻喉科接受全喉切除术的晚期癌症患者进行横断面回顾性研究。候选病例为化疗后放射/放射活检证实的复发病例、临床上无功能的喉误吸和放射学上明显的软骨侵蚀。结果：57例患者中42例使用了人工发音器，迄今为止未出现任何并发症。声音康复在伤口愈合后开始，并在大约6周内发展出有意义的声音。在近3个月的时间里，观察到了令人满意的言语和语音结果。语音质量通过多变量统计分析进行评估。优音38例，良音12例，尚可音05例，差音02例。
{"title":"Surgical Outcome and Quality of Life After Total Laryngectomy in Advanced Laryngeal Cancer- A Study in Combined Military Hospital, Dhaka","authors":"M. A. Azad, B. Siddiquee, A. Asaduzzaman, F. Mohsin, M. Hasnat","doi":"10.3329/BJO.V27I1.53199","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53199","url":null,"abstract":"Introduction: Total laryngectomy is the gold standard treatment for advanced laryngeal cancer. Sacrifice of voice is one of the most important shortcomings of the procedure. Possibility of achieving good quality voice is greater with prosthesis compared to other method. Post laryngectomy voice rehabilitation with prosthesis yield excellent outcome in most of the cases. Swallowing, pulmonary and olfactory rehabilitation should be managed by multidisciplinary team for better quality of life (QoL). Objectives: The purpose of this study was to observe the outcomes of voice, swallowing pulmonary and olfactory rehabilitation and QoL following total laryngectomy. Methods: This cross sectional retrospective clinical study was conducted at the Head & Neck Oncology Unit, Combined Military Hospital (CMH), Dhaka. Total 57 candidates were selected. Diagnosis was done by thorough clinical examination, Fibre Optic Laryngoscopy. Contrast Enhanced Computed Tomography (CECT) scan of neck was done except few cases where MRI of neck was done for subtle cartilage erosion was suspected. Examination under anaesthesia, direct larangoscopy and biopsy was done for every cases. Candidates were post chemo-radiated/ radiated biopsy proven recurrent cases, clinically nonfunctional larynx with aspiration and radiologically evident of cartilage erosion. In all cases artificial voice prosthesis was used. All the laryngectomees underwent voice, swallowing, pulmonary and olfactory rehabilitation in laryngectomy club of head & neck oncology unit, CMH Dhaka for a period of 3 months as per standard protocol. 1. Classified ENT Specialist & Head-Neck Surgeon, Dept of ENT and Head-Neck, Surgery, Combined Military Hospital, Chattogram. 2. Professor & Chief, Head & Neck surgery Division, BSMMU, Dhaka. 3. Classified ENT Specialist & Head Neck Surgeon, Dept. of ENT and Head-Neck Surgery, Combined Military Hospital, Cumilla. 4. Classified ENT Specialist & Head – Neck Surgeon, Dept. of ENT and Head-Neck Surgery, Combined Military Hospital, Barishal. 5. Graded ENT Specialist & Head – Neck Surgeon, Dept. of ENT and Head-Neck Surgery, Combined Military Hospital, Bir Uttam Shaeed Mahbub Senanibash, Kholahati, Parbatipur. Address of correspondence: Lieutenant Colonel (Dr.) Muhammad Ali Azad, Classified ENT Spl & Head Neck Surgeon, Dept. of ENT and Head-Neck Surgery, Combined Military Hospital, Chattogram, Bangladesh. Mobile: +8801714056245, E-mail: aliazad101052@gmail.com Introduction: Total laryngectomy is still indispensable procedure in treating advanced or recurrent cancer of larynx and hypopharynx. The larynx has important functions in olfaction and respiration and is more than just an organ of voice production. Its removal requires rehabilitation of all three systems. Perhaps loss of voice is the most distressing to the patients as they loss power of communications and establishment of an acceptable voice is critical for successful psychological adjustment. Multidisciplinary team effort is m","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":"27 1","pages":"5-11"},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45904950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Congenital cholesteatoma is a mass of squamous epithelium located medial to an intact tympanic membrane without previous history of tympanic membrane perforation, otorrhoea or otological surgery. We described a 24 year old gentleman with a left postauricular discharging fistula for 3 years with recent history of gradual hearing loss, tinnitus and recurrent episodes of positional vertigo. Clinical examination noted left postauricular fistula opening and otoscopy showed a whitish mass medial to a bulging intact tympanic membrane. High-resolution computed tomography of temporal bone was suggestive of cholesteatoma. Left modified radical mastoidectomy was done and he recovered with resolution of symptoms.
{"title":"Congenital Cholesteatoma in Adult: Is it Still Possible?","authors":"H. Tan, A. Idris, C. Ong, A. Asma","doi":"10.3329/BJO.V27I1.53214","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53214","url":null,"abstract":"Congenital cholesteatoma is a mass of squamous epithelium located medial to an intact tympanic membrane without previous history of tympanic membrane perforation, otorrhoea or otological surgery. We described a 24 year old gentleman with a left postauricular discharging fistula for 3 years with recent history of gradual hearing loss, tinnitus and recurrent episodes of positional vertigo. Clinical examination noted left postauricular fistula opening and otoscopy showed a whitish mass medial to a bulging intact tympanic membrane. High-resolution computed tomography of temporal bone was suggestive of cholesteatoma. Left modified radical mastoidectomy was done and he recovered with resolution of symptoms.","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":"27 1","pages":"96-99"},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44400903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kazi Shameemus Salam, S. Quadir, M. Uddin, Syed Farhan Ali Razib, A. Sattar, M. Uddin, B. Siddiquee
Background: Parapharyngeal tumours are rare accounting for 0.5-1.5% of all head neck tumuors. The anatomy of the Parapharyngeal space (PPS) is responsible for a wide variety of tumours arising from PPS. Objective: Evaluation of the strategy for parapharyngeal tumor surgery based on preoperative symptoms, clinical signs, imaging investigations and histopathology. Methodology: This retrospective study was carried out in the Department of Otolaryngology and Head Neck surgery in Bangabandhu Sheikh Mujib Medical University (BSMMU) included 32 patients were underwent surgery for primary parapharyngeal tumors between January 2018 and December 2019. Informed written consent was obtained from the patients prior to their inclusion in the study. In regard to histologic type there were 21 cases salivary gland origin tumors and 11 of neuro-genic tumors. The following data were evaluated preoperative symptoms, histological type, surgical approach and complications patients were evaluated following a laboratory investigations. Results: The most common symptoms of these tumors were a neck swelling. Total of 18 tumors were located in the prestyloid and poststyloid space cases were located 10(31.25%) and 4(12.50%) in the pre and poststyloid. Majority 12(37.50%) was found pleomorphic adenomaof deep lobe of parotid gland followed by 6(18.75%) were schwannoma,4(12.50%) were neurofibroma, 3(9.38%) were ectopic salivary gland tumor,2(6.25%) were mucoepidermoid carcinoma, 2(6.25%) were adenocarcinoma. First bite syndrome and lower lip palsy were common post operative complications. Transcervical approach was the most often performed approach in this study (56.25%). 1. Associate professor, Department Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. 2. MD (Radiology and Imaging), Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh. 3. Classified ENT Specialist and Head and Neck surgeon, CMH, Jashore cantonment. 4. Associate professor, Department of Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. 5. Professor, Department of Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. 6. Professor, Department of Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. 7. Chief, Head and Neck Surgery Division & Chairman, Department of Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Address of Correspondence: Dr. Kazi Shameemus Salam, Associate professor, Department of Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. e-mail: drkssalam@gmail.com. Mobile: 01711-846700
{"title":"Surgical Outcome of Parapharyngeal Tumour","authors":"Kazi Shameemus Salam, S. Quadir, M. Uddin, Syed Farhan Ali Razib, A. Sattar, M. Uddin, B. Siddiquee","doi":"10.3329/BJO.V27I1.53209","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53209","url":null,"abstract":"Background: Parapharyngeal tumours are rare accounting for 0.5-1.5% of all head neck tumuors. The anatomy of the Parapharyngeal space (PPS) is responsible for a wide variety of tumours arising from PPS. Objective: Evaluation of the strategy for parapharyngeal tumor surgery based on preoperative symptoms, clinical signs, imaging investigations and histopathology. Methodology: This retrospective study was carried out in the Department of Otolaryngology and Head Neck surgery in Bangabandhu Sheikh Mujib Medical University (BSMMU) included 32 patients were underwent surgery for primary parapharyngeal tumors between January 2018 and December 2019. Informed written consent was obtained from the patients prior to their inclusion in the study. In regard to histologic type there were 21 cases salivary gland origin tumors and 11 of neuro-genic tumors. The following data were evaluated preoperative symptoms, histological type, surgical approach and complications patients were evaluated following a laboratory investigations. Results: The most common symptoms of these tumors were a neck swelling. Total of 18 tumors were located in the prestyloid and poststyloid space cases were located 10(31.25%) and 4(12.50%) in the pre and poststyloid. Majority 12(37.50%) was found pleomorphic adenomaof deep lobe of parotid gland followed by 6(18.75%) were schwannoma,4(12.50%) were neurofibroma, 3(9.38%) were ectopic salivary gland tumor,2(6.25%) were mucoepidermoid carcinoma, 2(6.25%) were adenocarcinoma. First bite syndrome and lower lip palsy were common post operative complications. Transcervical approach was the most often performed approach in this study (56.25%). 1. Associate professor, Department Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. 2. MD (Radiology and Imaging), Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh. 3. Classified ENT Specialist and Head and Neck surgeon, CMH, Jashore cantonment. 4. Associate professor, Department of Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. 5. Professor, Department of Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. 6. Professor, Department of Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. 7. Chief, Head and Neck Surgery Division & Chairman, Department of Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Address of Correspondence: Dr. Kazi Shameemus Salam, Associate professor, Department of Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. e-mail: drkssalam@gmail.com. Mobile: 01711-846700","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":"27 1","pages":"66-72"},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44104948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khorsed Alam, Saiduzzaman, Asadur Rahman, S. S. Islam, Mohammad Anisur Rahman, K. Sarker
Objective: To determine subjective outcomes after cholesteatoma surgery. Design: Cross sectional observational study Methods: Study place: Shaheed Ziaur Rahman Medical college Hospital (SZMCH), Bogura, Bangladesh Study population: Chronic otitis media (COM) with extensive cholesteatoma. Interventions: Canal wall down mastoidectomy for cholesteatoma. Main Outcome Measures: In this study, the Chronic Ear Survey (CES) was provided to all patients preoperatively and one year after surgery. The preoperative and postoperative score differences were analyzed. We also assessed correlations between chronic ear survey scores and air conduction threshold. Results: Seventy six patients were enrolled in our study & marked improvements were found in total CES score & all subscale scores postoperatively (P value: 0.00). The total CES score and symptom subscale scores were observed greater improvement (P value: 0.00).Significant negative linear correlations were observed among total CES scores, symptom subscale scores and air conduction thresholds (P<.05). Conclusion: The present study suggests that canal wall down mastoidectomy (CWDM) provides a significant improvement in the post-operative Quality of life (QoL) &b there is a significant association between subjective outcomes &the objective audiometric results.
{"title":"Quality of Life Assessment after Canal Wall Down Mastoidectomy: Our Experiences in Shaheed Ziaur Rahman Medical College Hospital, Bogura","authors":"Khorsed Alam, Saiduzzaman, Asadur Rahman, S. S. Islam, Mohammad Anisur Rahman, K. Sarker","doi":"10.3329/BJO.V27I1.53205","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53205","url":null,"abstract":"Objective: To determine subjective outcomes after cholesteatoma surgery. Design: Cross sectional observational study Methods: Study place: Shaheed Ziaur Rahman Medical college Hospital (SZMCH), Bogura, Bangladesh Study population: Chronic otitis media (COM) with extensive cholesteatoma. Interventions: Canal wall down mastoidectomy for cholesteatoma. Main Outcome Measures: In this study, the Chronic Ear Survey (CES) was provided to all patients preoperatively and one year after surgery. The preoperative and postoperative score differences were analyzed. We also assessed correlations between chronic ear survey scores and air conduction threshold. Results: Seventy six patients were enrolled in our study & marked improvements were found in total CES score & all subscale scores postoperatively (P value: 0.00). The total CES score and symptom subscale scores were observed greater improvement (P value: 0.00).Significant negative linear correlations were observed among total CES scores, symptom subscale scores and air conduction thresholds (P<.05). Conclusion: The present study suggests that canal wall down mastoidectomy (CWDM) provides a significant improvement in the post-operative Quality of life (QoL) &b there is a significant association between subjective outcomes &the objective audiometric results.","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":"27 1","pages":"52-58"},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48785436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Mahbub, S. S. Biswas, B. K. Dey, S. Alam, J. Hoq
Background: Parathyroid adenoma is most commonly associated with primary hyperparathyroidism which leads to hypercalcaemia. Hypercalcaemia results in multiple stone formation in Kidney and biliary tract which indicates surgical removal of tumor. Perioperative management of patient is essential to prevent mortality and morbidity. The purpose of this study is to analyze a case series of patient having parathyroid adenoma with difficulties, to localize the adenoma and to take the measures to maintain the normal level of calcium in pre, per and postoperative period. Methods: This retrospective study was carried out in BIRDEM General Hospital and Ibrahim Medical College from May 2017 to December 2019. 14 patients who were diagnosed as primary hyperparathyroidism due to parathyroid adenoma who had been managed at the BIRDEM General Hospital, Dhaka, Bangladesh from May 2017 to December 2019 were reviewed and included. Result: Among 14 patients 8 were female and 6 male (M: F=3:4). Age ranges from 26 to 71 years with mean age was 52 years. Serum PTH were above normal (>65 pg/ml) in all cases. Serum calcium level were above normal in 12 cases (85.71 %) and 2 (14.29%) had normal levels. Serum phosphate levels were within normal range. Excision of adenoma done in all cases which were confirmed by frozen section per-operatively. None of our patients develop any complication during and after surgery Conclusion: Successful management of parathyroid adenoma requires combined skills of surgeons, endocrinologists, anesthesiologists and pathologists. Improvement after operation is quite remarkable and rewarding. Bangladesh J Otorhinolaryngol; April 2021; 27(1): 44-51
{"title":"Parathyroid Adenoma: an experience in BIRDEM General Hospital","authors":"S. Mahbub, S. S. Biswas, B. K. Dey, S. Alam, J. Hoq","doi":"10.3329/BJO.V27I1.53204","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53204","url":null,"abstract":"Background: Parathyroid adenoma is most commonly associated with primary hyperparathyroidism which leads to hypercalcaemia. Hypercalcaemia results in multiple stone formation in Kidney and biliary tract which indicates surgical removal of tumor. Perioperative management of patient is essential to prevent mortality and morbidity. The purpose of this study is to analyze a case series of patient having parathyroid adenoma with difficulties, to localize the adenoma and to take the measures to maintain the normal level of calcium in pre, per and postoperative period. \u0000Methods: This retrospective study was carried out in BIRDEM General Hospital and Ibrahim Medical College from May 2017 to December 2019. 14 patients who were diagnosed as primary hyperparathyroidism due to parathyroid adenoma who had been managed at the BIRDEM General Hospital, Dhaka, Bangladesh from May 2017 to December 2019 were reviewed and included. \u0000Result: Among 14 patients 8 were female and 6 male (M: F=3:4). Age ranges from 26 to 71 years with mean age was 52 years. Serum PTH were above normal (>65 pg/ml) in all cases. Serum calcium level were above normal in 12 cases (85.71 %) and 2 (14.29%) had normal levels. Serum phosphate levels were within normal range. Excision of adenoma done in all cases which were confirmed by frozen section per-operatively. None of our patients develop any complication during and after surgery \u0000Conclusion: Successful management of parathyroid adenoma requires combined skills of surgeons, endocrinologists, anesthesiologists and pathologists. Improvement after operation is quite remarkable and rewarding. \u0000Bangladesh J Otorhinolaryngol; April 2021; 27(1): 44-51","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46246100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Razzak, B. H. Siddique, Azharul Islam, H. Haque, A. Sattar, Sayed Farhan Ali Razib, Effat Zahan Abdullah, A. M. Jewel, Jaber Al Sayied, Quamruzzaman
Background: Carcinoma of oral tongue is the most common oral cancer and because of its structure and function is prone for early local and regional spread of cancer. The final outcome of a primary tongue carcinoma patient depends upon various prognostic factors like thickness of tumor, depth of invasion, size of lesion and neck node 67metastasis. Risk of metastasis and spread to neck nodes increases with increase in tumor thickness Methods: This prospective observational study was carried out in the Department of OtolayngologyHead & Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka for 18 months. Thirty patients with early oral tongue carcinoma i.e.T1 & T 2 as per UICC and AJC criteria were included in this study by purposive non-randomized sampling technique. Result of the study were expressed as mean, standard deviation (+SD), frequency and percentages. Unpaired Student’s t-test and Pearson’s correlation co-efficient (r) test were performed. Results: Result of the study showed the mean (+SD) thickness of the tumor was 3.62 (+1.46) mm. Minimum thickness 1.1mm and maximum thickness 7.8mm. Only 21 (70%) subjects neck node were metastasized from tongue and mean (+SD) tumor thickness of the positive neck node metastasis was 5.54 (+1.07) mm and negative neck node metastasis was 2.87 (+0.75) mm. This indicated a significant difference between the groups. Pearson’s correlation co-efficient r (+0.981) which indicated tumor thickness was positively correlated with neck node metastasis. Conclusion: Tumor thickness of the early oral carcinoma positively correlated with neck node metastasis. Correlation between thickness and metastatic lymph node can help planning the treatment regimen and indicate the disease prognosis.
{"title":"Relationship between Thickness of Early Oral Tongue Carcinoma (T1, T2) with Cervical Lymph Node Metastasis","authors":"A. Razzak, B. H. Siddique, Azharul Islam, H. Haque, A. Sattar, Sayed Farhan Ali Razib, Effat Zahan Abdullah, A. M. Jewel, Jaber Al Sayied, Quamruzzaman","doi":"10.3329/BJO.V27I1.53202","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53202","url":null,"abstract":"Background: Carcinoma of oral tongue is the most common oral cancer and because of its structure and function is prone for early local and regional spread of cancer. The final outcome of a primary tongue carcinoma patient depends upon various prognostic factors like thickness of tumor, depth of invasion, size of lesion and neck node 67metastasis. Risk of metastasis and spread to neck nodes increases with increase in tumor thickness Methods: This prospective observational study was carried out in the Department of OtolayngologyHead & Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka for 18 months. Thirty patients with early oral tongue carcinoma i.e.T1 & T 2 as per UICC and AJC criteria were included in this study by purposive non-randomized sampling technique. Result of the study were expressed as mean, standard deviation (+SD), frequency and percentages. Unpaired Student’s t-test and Pearson’s correlation co-efficient (r) test were performed. Results: Result of the study showed the mean (+SD) thickness of the tumor was 3.62 (+1.46) mm. Minimum thickness 1.1mm and maximum thickness 7.8mm. Only 21 (70%) subjects neck node were metastasized from tongue and mean (+SD) tumor thickness of the positive neck node metastasis was 5.54 (+1.07) mm and negative neck node metastasis was 2.87 (+0.75) mm. This indicated a significant difference between the groups. Pearson’s correlation co-efficient r (+0.981) which indicated tumor thickness was positively correlated with neck node metastasis. Conclusion: Tumor thickness of the early oral carcinoma positively correlated with neck node metastasis. Correlation between thickness and metastatic lymph node can help planning the treatment regimen and indicate the disease prognosis.","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":"1 1","pages":"25-35"},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69459132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jaber Al Sayied, A. Choudhury, Sonia Jahan Bithi, A. Biswas, Riashat Azim Majumder, A. Razzak, H. Haque, Quamruzzaman
Background: Fine-needle aspiration cytology (FNAC) is recommended as a decisive diagnostic step in the workup of patients with nodular thyroid disease. Unfortunately, FNAC can miss malignancies in smaller and deeper nodule. Ultrasound guided FNAC (US-FNAC) can reduce this error in suspicious thyroid nodule. Objectives: To find out the correlation of USG guided FNAC with postoperative histopathology in diagnosis of thyroid nodule. Methods: After obtaining clearance and approval from Institutional Review Board, all 45 patients of thyroid nodule who were admitted in the Department of Otolaryngology – Head & Neck surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from April 2017 to August 2018 and had fulfilled the inclusion and exclusion criteria were selected for the study. Each patient was assessed before surgery by USG guided FNAC and post operatively
{"title":"Correlation of Ultrasonography Guided Fine Needle Aspiration Cytology with Postoperative Histopathology in Diagnosis of Thyroid Nodule","authors":"Jaber Al Sayied, A. Choudhury, Sonia Jahan Bithi, A. Biswas, Riashat Azim Majumder, A. Razzak, H. Haque, Quamruzzaman","doi":"10.3329/BJO.V27I1.53203","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53203","url":null,"abstract":"Background: Fine-needle aspiration cytology (FNAC) is recommended as a decisive diagnostic step in the workup of patients with nodular thyroid disease. Unfortunately, FNAC can miss malignancies in smaller and deeper nodule. Ultrasound guided FNAC (US-FNAC) can reduce this error in suspicious thyroid nodule. Objectives: To find out the correlation of USG guided FNAC with postoperative histopathology in diagnosis of thyroid nodule. Methods: After obtaining clearance and approval from Institutional Review Board, all 45 patients of thyroid nodule who were admitted in the Department of Otolaryngology – Head & Neck surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from April 2017 to August 2018 and had fulfilled the inclusion and exclusion criteria were selected for the study. Each patient was assessed before surgery by USG guided FNAC and post operatively","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":"27 1","pages":"36-43"},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69459191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Wahiduzzaman, Sayed Farhan Ali Razib, A. Hossain, Idrish Ali, H. Rahman, HM Mustafizur Rahman
Background: Vocal cord polyp usually arises from the epithelium and the lamina propria. Minimally invasive dissection procedures are employed to treat these vocal cord polyp for an effective outcome. Two types of microsurgical techniques were developed gradually and practiced namely, the conventional laryngeal microsurgery, which involves the use of cold instruments and the laryngeal laser micro-surgery. Objective: To compare the conventional cold dissection and CO 2 laser methods in treatment of vocal cord polyp. Methods: A randomized prospective study was conducted at the Department of OtolayngologyHead & Neck Surgery, at Bangabondhu Sheikh Muzib Medical University (BSMMU) between July 2017 and June 2019. A total of 60 cases were studied on the following parameters: a. Visual analysis on stroboscopy b. Voice analysis –GRBAS (grade, roughness, breathiness, asthenia, strain) indices c. Duration of surgery d. Peroperative bleeding. Results: During first postoperative assessment, both groups had the normal symmetrical waves, while 50% of cases still had aperiodicity but all patients had the near normal periodicity in the second postoperative assessment. Regarding glottic closure, during preoperative assessment, almost all patients had incomplete glottic closure due to mass lesion as polyps. During first postoperative assessment, glottic closure was found to be better in group B (83% of cases) than group A (76% of cases), while during second postoperative assessment, all patients of both groups had around 95% glottic closure. The mean duration oflaser technique (7.1 ± 1.1 minutes) was less than the conventional technique time (15.6 ± 1.9 minutes), also mean of operative bleeding of laser technique (zero pack) is less than the conventional two(2 packs). Conclusion: There is no significant difference between both groups in all parameters except operative time and bleeding, as laser technique has less time and clear field.
{"title":"Comparison between Conventional Microdissection and CO2 Laser in the Treatment of Vocal Cord Polyp","authors":"M. Wahiduzzaman, Sayed Farhan Ali Razib, A. Hossain, Idrish Ali, H. Rahman, HM Mustafizur Rahman","doi":"10.3329/BJO.V27I1.53201","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53201","url":null,"abstract":"Background: Vocal cord polyp usually arises from the epithelium and the lamina propria. Minimally invasive dissection procedures are employed to treat these vocal cord polyp for an effective outcome. Two types of microsurgical techniques were developed gradually and practiced namely, the conventional laryngeal microsurgery, which involves the use of cold instruments and the laryngeal laser micro-surgery. Objective: To compare the conventional cold dissection and CO 2 laser methods in treatment of vocal cord polyp. Methods: A randomized prospective study was conducted at the Department of OtolayngologyHead & Neck Surgery, at Bangabondhu Sheikh Muzib Medical University (BSMMU) between July 2017 and June 2019. A total of 60 cases were studied on the following parameters: a. Visual analysis on stroboscopy b. Voice analysis –GRBAS (grade, roughness, breathiness, asthenia, strain) indices c. Duration of surgery d. Peroperative bleeding. Results: During first postoperative assessment, both groups had the normal symmetrical waves, while 50% of cases still had aperiodicity but all patients had the near normal periodicity in the second postoperative assessment. Regarding glottic closure, during preoperative assessment, almost all patients had incomplete glottic closure due to mass lesion as polyps. During first postoperative assessment, glottic closure was found to be better in group B (83% of cases) than group A (76% of cases), while during second postoperative assessment, all patients of both groups had around 95% glottic closure. The mean duration oflaser technique (7.1 ± 1.1 minutes) was less than the conventional technique time (15.6 ± 1.9 minutes), also mean of operative bleeding of laser technique (zero pack) is less than the conventional two(2 packs). Conclusion: There is no significant difference between both groups in all parameters except operative time and bleeding, as laser technique has less time and clear field.","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":"27 1","pages":"17-24"},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47047124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To evaluate the common complications following parotid surgery. Material & methods: A retrospective study was done from January 2011 to December 2019 in the Department of ENT & Head Neck Surgery, Enam Medical College & hospital, Savar. Sixty (60) patients with both benign & malignant parotid disease underwent surgical treatment was selected for this study. All cases were diagnosed preoperatively by Fine Needle Aspiration Cytology (FNAC). Patients with preoperative facial nerve palsy were excluded from this study. Patients were followed up for six months and per operative & postoperative complications
{"title":"Complications of Parotid surgery: A study in 60 cases","authors":"K. Atikuzzaman, Mushfiqur Rahman, Naseem Yasmeen","doi":"10.3329/BJO.V27I1.53208","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53208","url":null,"abstract":"Objective: To evaluate the common complications following parotid surgery. Material & methods: A retrospective study was done from January 2011 to December 2019 in the Department of ENT & Head Neck Surgery, Enam Medical College & hospital, Savar. Sixty (60) patients with both benign & malignant parotid disease underwent surgical treatment was selected for this study. All cases were diagnosed preoperatively by Fine Needle Aspiration Cytology (FNAC). Patients with preoperative facial nerve palsy were excluded from this study. Patients were followed up for six months and per operative & postoperative complications","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":"27 1","pages":"59-65"},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46089578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Noorain Alam, Sm Nazmul Huque, Abm Delowar Hossain, K. Atikuzzaman, M. Hussain, M. K. Arefin
Background: Adenoids are common childhood upper respiratory tract problem which frequently obstruct the nasopharyngeal opening with tubal occlusion causes reduction in middle ear pressure with conductive hearing loss. Objective: To observe middle ear pressure and level of hearing in children with enlarged adenoids. Methods: This cross sectional observational study conducted among 72 children of enlarged adenoids admitted or attended in Dhaka Medical College Hospital and Bangabandhu Sheikh Mujib Medical University Dhaka. Results: 72 children of enlarged adenoids of age ranges between 5-12 years with male female ratio was 1.25:1. Mouth breathing (65.27%), hearing impairment (59.72%), nasal obstruction (55.55%) and snoring (56.94%) were the presenting symptoms of the patients. Majority of the patients of this study came from middle class (52.77%). Most of the patients with enlarged adenoids were grossly enlarged (51.38%). 43.05% grossly enlarged adenoids had significant hearing loss . In this series 65 ears (45.13%) had type A Tympanogram. 58 ears (40.27%) has Type B Tympanogram and 21 ears (14.58%) has Type C Tympanogram. Conclusion: This study revealed significant association between enlarged adenoids and conductive hearing loss of variable degree and negative middle ear pressure.
{"title":"Effects of Enlarged Adenoids on Middle Ear Pressure and Hearing","authors":"Noorain Alam, Sm Nazmul Huque, Abm Delowar Hossain, K. Atikuzzaman, M. Hussain, M. K. Arefin","doi":"10.3329/BJO.V27I1.53210","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53210","url":null,"abstract":"Background: Adenoids are common childhood upper respiratory tract problem which frequently obstruct the nasopharyngeal opening with tubal occlusion causes reduction in middle ear pressure with conductive hearing loss. Objective: To observe middle ear pressure and level of hearing in children with enlarged adenoids. Methods: This cross sectional observational study conducted among 72 children of enlarged adenoids admitted or attended in Dhaka Medical College Hospital and Bangabandhu Sheikh Mujib Medical University Dhaka. Results: 72 children of enlarged adenoids of age ranges between 5-12 years with male female ratio was 1.25:1. Mouth breathing (65.27%), hearing impairment (59.72%), nasal obstruction (55.55%) and snoring (56.94%) were the presenting symptoms of the patients. Majority of the patients of this study came from middle class (52.77%). Most of the patients with enlarged adenoids were grossly enlarged (51.38%). 43.05% grossly enlarged adenoids had significant hearing loss . In this series 65 ears (45.13%) had type A Tympanogram. 58 ears (40.27%) has Type B Tympanogram and 21 ears (14.58%) has Type C Tympanogram. Conclusion: This study revealed significant association between enlarged adenoids and conductive hearing loss of variable degree and negative middle ear pressure.","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":"27 1","pages":"73-80"},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46944902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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