Browsing by Author "Neupane, Yogesh"
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Publication Does Drilling Induce Hearing Loss after Modified Radical Mastoidectomy? A Retrospective Study(Institute of Medicine, 2020) Neupane, Yogesh; Kharel, Bijaya; Dutta, HeempaliABSTRACT Introduction: Incidence of sensory neural hearing loss following mastoid surgery varies from 1.2 – 4.5%.There are various causes for postoperative sensorineural hearing loss during mastoid surgery. This study aims to identify whether there is any correlation between drilling and postoperative sensory neural hearing loss. Methods: A retrospective study was conducted in the Department of ENT from January 2018 to June 2019. A total number of 68 patients above five years of age who underwent modified radical mastoidectomy for chronic otitis media squamous were included. Revision surgery, preoperative sensorineural hearing loss, injury to the ossicular chain during surgery, patients with lack of follow up or doubtful reports in mentally challenged were excluded from the study. The average bone conduction threshold was calculated from 500, 1000, 2000, 4000 Hz and compared using the Wilcoxon signed-rank test. Results: There were 43 males and 25 females in the study with a median age of 23.5 years (16-55). The mean preoperative bone conduction threshold in the four frequencies of 500 Hz, 1kHz, 2kHz, 4kHz were -2.06dB, -2.06dB, 3.31dB, 4.63 dB respectively and the mean postoperative bone conduction thresholds were 1.03, 1.32, 5.29, 4.04 respectively. There was a decline of mean of 3.09 dB and 3.38dB only at the low-frequencies (500Hz and 1kHz) BC threshold respectively which were statistically significant, whereas at higher frequency there was no decline in average postoperative BC threshold. Conclusion: There is no definite role of drill in inducing hearing loss and if present other causes of hearing loss should be sought in postoperative sensorineural hearing loss. Keywords: Drill, mastoidectomy, noise-induced hearing lossPublication Drug Induced Sleep Endoscopy for Obstructive Sleep Apnea Syndrome: An Initial Experience in a Tertiary Level Centre(Institute of Medicine, 2019) Parajuli, Bashu D; Mandal, Lokendra; Koirala, Megha; Bhattarai, Amit S; Neupane, Yogesh; Shrestha, AnilABSTRACT Drug induced sleep endoscopy (DISE) is a technique of performing endoscopy of the upper airway after inducing sleep by the use of anaesthetic agents in patients suffering from obstructive sleep apnea syndrome (OSAS). The main purpose of DISE is to detect the obstruction or collapse at one or more location in the upper airway, both for the successful diagnosis and management of OSAS. Here we discuss a case of OSAS who underwent DISE under novel anaesthetic agents midazolam and dexmedetomidine. Keywords: Dexmedetomidine, drug induced sleep endoscopy, obstructive sleep apnea syndrome, propofolPublication Prevalence of Bilateral Vocal Fold Palsy in Cases with Perinatal Hypoxia(Institute of Medicine, 2025) Gyawali, Bigyan Raj; Dutta, Heempali; Neupane, Yogesh; Pokhrel, Sishir; Guragain, Rajendra; Shrestha, Laxman; Basnet, Srijana; Balakrishnan, Karthik; Sidel, DouglasABSTRACT Introduction: There is a notable gap concerning the potential impact of perinatal hypoxia on laryngeal innervation and its role as a causative factor for bilateral vocal fold palsy (BVFP) in children. This study aims to assess the prevalence of BVFP in cases with perinatal hypoxia. Methods: This cross-sectional study took place at the Department of Ear, Nose, and Throat (ENT) and the Department of Pediatrics of Institute of Medicine, Kathmandu, Nepal. Institutional Review Board approval was obtained. From November 2019 to March 2023, all children under 2 years of age with documented perinatal hypoxia were included. Exclusion criteria comprised cases without parental consent, identification of another identifiable cause of BVFP, or the child being on oxygen support during examination, preventing laryngoscopy. Additionally, a retrospective cohort analysis included all BVFP patients at the department between January 2013 and November 2019 to validate our findings. Results: The study included 21 cases, and none of those with perinatal hypoxia exhibited BVFP. Furthermore, the retrospective cohort of BVFP cases presenting at our department did not reveal a significant history of perinatal hypoxia. Conclusion: Our study did not yield compelling evidence linking perinatal hypoxia with BVFP however, considering the constraints of our study, insights from existing literature and absence of prior research in this area, the hypothesis of perinatal hypoxia's impact on laryngeal innervation merits further, more comprehensive research in this area. Keywords: Hypoxic injury; perinatal hypoxia; vocal fold palsyPublication Prevalence of Foreign Body Aspiration in Children in a Tertiary Care Hospital(Nepal Medical Association, 2021) Dongol, Kripa; Neupane, Yogesh; Dutta, Heempali Das; Gyawali, Bigyan Raj; Kharel, BijayaAbstract: Introduction: Foreign body aspiration is a common problem in children with signifi cant mortality and morbidity. This study aims to determine the prevalence of foreign body aspiration in children in a tertiary care hospital of Nepal. Methods: A descriptive cross-sectional study was conducted at Tribhuvan University Teaching Hospital from April 2010 to March 2016 after obtaining ethical approval from Institutional Review Committee (Reference number- 08(6-11)E277/78). All children of age up to 15 years with suspected foreign body aspiration were included. The data was collected from the medical record section and entered in Microsoft Excel. The descriptive statistical analysis was performed. Results: A total of 26,294 patients were included in the study. The prevalence of foreign body aspiration in children was found to be 98 (0.37%). On rigid bronchoscopy, 82 patients (83.6%) were confirmed to have a foreign body in the airway. The peak incidence of foreign body aspiration was seen in patients of age group one to two years. The commonest foreign body in the airway was a peanut. Conclusions: The prevalence of foreign body aspiration in children was low, which is similar to other studies. Foreign body aspiration may lead to dreadful complications. Therefore, both the clinicians and the public need to be cautious about it.Publication Prevalence of Post Tonsillectomy Haemorrhage at a Tertiary Care Centre in Nepal(Nepal Medical Association, 2021) Tripathi, Prashant; Bajracharya, Rohita; Acharya, Kunjan; Kharel, Bijaya; Neupane, Yogesh; Dutta, Heempali; Dongol, Kripa; Gurung, UrmilaAbstract: Introduction: Tonsillectomy is one of the common ENT surgical procedures. Post-tonsillectomy haemorrhage remains a frequent complication which can be potentially life-threatening. The objective of the present study was to calculate the prevalence of haemorrhage following a tonsillectomy at a tertiary care centre. Methods: It was a descriptive cross-sectional study performed by medical chart review of the patients who underwent tonsillectomy from January 2018 to December 2019 at the department of ENT- Head and Neck Surgery of Tribhuvan University Teaching Hospital. Ethical approval was obtained from the institutional review committee (Ref:-282(6-11) E2 076/077). Convenient sampling method was used. All patients of any age who had tonsillectomy for recurrent tonsillitis or tonsillar hypertrophy with or without obstructive sleep apnoea and no missing information on chart review were included in the study. Data were entered in MS-Excel 2007 and analyzed in rate and percentage. Results: Ten (5.18%) out of a total of 193 patients who underwent tonsillectomy had a post tonsillectomy haemorrhage. All 10 (100%) were adults patients, operated for recurrent tonsillitis, and used electrocautery. It was common in male patients 7 (70%). All of the haemorrhages was between a third and sixth postoperative day and were mild in severity. Conclusions: The prevalence of post-tonsillectomy haemorrhage was high at our centre during the study period of two years. It was common in adults, males and surgery done for recurrent tonsillitis using electrocauterization.Publication Tracheostomy among Children Admitted in the Pediatric Intensive Care Unit of a Tertiary Care Centre(Nepal Medical Association, 2023) Bathwal, Rahul; Dongol, Kripa; Dutta, Heempali; Neupane, YogeshAbstract Introduction: Tracheostomy is commonly performed for upper airway obstruction, prolonged mechanical ventilation and tracheo-bronchial toileting. Pediatric tracheostomy differs from adult tracheostomy in terms of surgical procedure, post-operative care and recovery. The tracheostomized patients may either be decannulated, discharged with tube-in-situ or the patient may expire. The aim of this study was to find out the prevalence of tracheostomy in patients admitted to the Pediatric intensive care unit of a tertiary care centre. Methods: A descriptive cross-sectional study was performed among children admitted to the Pediatric intensive care unit of a tertiary care centre from 1 May 2017 to 31 August 2022 after obtaining ethical approval from the Institutional Review Committee. A convenience sampling method was used. The point estimate was calculated at 95% Confidence Interval. Results: Among 1472 patients, tracheostomy was done in 65 (4.41%) (3.37-5.47, 95% Confidence Interval). A total of 33 (50.76%) underwent tracheostomy for prolonged ventilation whereas 32 (49.23%) were tracheostomized for airway obstruction. Among them, 41 (63.07%) patients were successfully decannulated, 9 (13.84%) were discharged with tracheostomy tubes in situ whereas 15 (23.07%) patients deceased. The most common complication was tracheostomy tube blockage reported in 5 (7.69%). Conclusions: The prevalence of tracheostomy among the children of the pediatric intensive care unit was found to be lower than in other studies.