Browsing by Author "Gautam, Dipendra"
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Publication Lymhangiohemangioma of face: a case report(Society of Otolaryngologists of Nepal, 2020) Gautam, Dipendra; Pantha, TridipAbstract: Lymphangiohemangiomas are combined deformities of blood and lymphatic vessels. Lymphangiomas are congenital malformations of lymphatic vessels filled with clear protein rich fluid containing few lymph cells. Malformations may be seen in different combinations of vascular and lymphatic elements. Histologically cystic channels may be filled with blood and named lymphangiohemangioma or hemangiolymphangioma according to the dominant tissue structure present. Lymphangiohemangioma clinically tend to behave as lymphangioma. lymphangiohemangioma is a rare developmental anomaly. Although there are many therapeutic options; the definitive treatment is surgical. Here we present case of a five-year-old child with a lymphangiohemangioma located in the face. Keywords: Hemangioma, Lymphangiohemangioma, Lymphangioma, Vascular anomaliesPublication Outcome of augmented cartilage tympanoplasty for the management of tympanic membrane retraction pocket in patients with inactive squamous chronic otitis media(Society of Otolaryngologists of Nepal, 2021) Gautam, Dipendra; Pantha, TridipAbstract: Objectives: To evaluate the outcome of augmented cartilage tympanoplasty for the treatment of tympanic membrane retraction pocket in patients with inactive squamous COM. Materials and methods: This Prospective, interventional study was conducted in the Department of ORL& HNS, NAMS, Bir Hospital, over a period of 3 years, between July 2017 to December 2000. Twenty-five consecutive patients having tympanic retraction pocket of early symptomatic charachon stage II without otorrhoea, keratin debris or cholesteatoma of age above 5 years were taken for the study. Augmented cartilage tympanoplasty was done after excision of the retraction pockets. The outcome of surgery in terms of graft uptake, hearing improvement and recurrence of disease were noted 12 weeks after the surgery. The patients were kept for continued follow up every three monthly thereafter. Follow-up ranged 3-18 months. Results: Out of 25 patients operated, 23 (92%) had successful graft uptake in one and half year observation period. One (4%) had small residual perforation without otorrhoea and one (4%) had mild re-retraction at postero-superior quadrant. The air-bone gap (ABG) improved in 12 (48 %), remained almost similar in 10(40%) and mild deterioration in three (12 %) patients. Conclusion: Augmented cartilage tympanoplasty in the early symptomatic patients of charachon stage II retraction pockets do not have significant hearing loss and recurrence of retraction after the surgery with advantage of prevention of choleasteatoma formation and ossicular erosion. Keywords: Augmented cartilage tympanoplasty, Air bone gap, Tympanic membrane retraction, Inactive squamous COMPublication Prevalence of ear nose and throat disorders in school going childrenour experience of screening camp in four government schools in Kathmandu(Society of Otolaryngologists of Nepal, 2024) Gautam, Dipendra; Shrestha, Sonika Dhari; Giri, Kalpana KAbstract: Background: This study was conducted to find out the prevalence of different types of ear nose and throat disorders in school going children of Kathmandu. Method: The study was done over the period of two months on July and august 2022. Four government schools of Kathmandu were chosen for the study. Those schools were little far away from the core city area and were having relatively less health care services available. Students going to government school mostly were from poor family background especially in Kathmandu. All the students of those schools present on the day of examination underwent ENT screening check up by ENT surgeons and trained medical officers. Brief historywas recorded and findings were noted. Results were expressed in numbers and percentages. Result: There were 5366 students taken for the study which included 48.5%( n=2610) male and 51.5%(n=2756) female. Mean age of the students was 9.23 years. 31.96% had ENT problems. The most common ear disorder was impacted earwax (17.89%), followed by chronic otitis media (2.14%), otitis media with effusion (1.64%) and acute pharyngitis (1.56 %). Conclusion: ENT disorders specially ear diseases like impacted earwax, COM and OME were important health problems among school children of Kathmandu, Nepal. Regular school health services, screening program, public awareness, improvement of socioeconomic status can help reduce ENT disease burden and prevent hearing loss. Keywords: Chronic otitis media, Hearing loss, Impacted earwax, Otitis media with effusion, Screening programPublication Tissue eosinophilia in chronic rhinosinusitis with diffuse bilateral nasal polyps(Society of Otolaryngologists of Nepal, 2021) Pantha, Tridip; Gautam, Dipendra; R, MulmiAbstract: Background: Inflammatory disease of the nose and paranasal sinuses with diffuse polypoid changes are common findings. The eosinophilic infiltration of the polypoid tissue and eosinophil driven inflammation are one of the endotypes of chronic rhinosinusitis (CRS). Objective: The study was aimed to investigate the presence of tissue eosinophilia in patients with diffuse bilateral nasal polyps. Method: It was a descriptive cross-sectional study on 51 patients who underwent Functional Endoscopic Sinus Surgery (FESS) for CRS. Sino-nasal outcome test (SNOT-22) questionnaire and CT scan scores were recorded. Histopathological examination of the polypoid tissue was done and the number of eosinophils per high power field (HPF) was also recorded. Result: Fifty-one patients were included in the current study, of whom 26 were females and 25 were males. The majority of patients (n=37, 72.5%) had tissue eosinophilia counts > 10 per HPF. The mean CT score in patients with tissue eosinophilia > 10 per HPF was 18.35 (SD 4.08), which was significantly higher than the mean CT score in patients with tissue eosinophilia ≤ 10 per HPF (mean CT score = 12.24, SD 2.67). Similarly, the mean Sino-Nasal outcome Test-22 (SNOT-22) score in patients with tissue eosinophilia >10 was 71.25 (SD 5.84), which was significantly higher than the mean SNOT-22 score in patients with tissue eosinophilia ≤10 (mean SNOT-22 score = 57.85, SD 4.49). Conclusion: There was a significant positive correlation between tissue eosinophil count and both SNOT-22 score and CT score. Keywords: Diffuse nasal polyp, Eosinophilic Chronic Rhinosinusitis, SNOT-22, Tissue eosinophilia.