Browsing by Author "Pradhananga, Rabindra Bhakta"
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Publication Anomalous Intratympanic Facial Nerve Encountered During Stapes Surgery and Its Surgical Implications(Society of Otolaryngologists of Nepal, 2025) Khadgi, Sajish; Dongol, Kripa; Rayamajhi, Pabina; Pradhananga, Rabindra Bhakta; Gurung, UrmilaAbstract: Aims and Objectives: Identifying the facial nerve in any middle ear surgery is of utmost importance. This study aimed to find the frequency of intratympanic facial nerve anomalies encountered during stapes surgery and note any modifications made in the surgical procedure. Methods: The study was conducted in the department of ENT-Head and Neck Surgery in a tertiary referral hospital in Nepal. A retrospective review of medical records of stapes surgery performed between January 2020 and December 2024 was conducted. Results: A total of 121 stapes surgeries were performed in 121 patients (51 males and 70 females). The age ranged from 18 to 65 (mean 34.7 ± 9.2) years. Anomalous facial nerves were found in 10 (8.3%) cases. Partial prolapse of intact fallopian canal and dehiscent facial nerve without prolapse were observed in four (3.3%) cases each. Total prolapse of the facial nerve over the stapes footplate was noted in two (1.6%) cases. Almost all patients underwent standard stapes surgery. However, in the two cases with total prolapse, fenestration was created in the promontory in one, while the procedure had to be abandoned in the other. The facial nerve function was normal post-operatively in all the cases. Conclusion: Anomalous intratympanic facial nerves encountered during stapes surgeries are not uncommon. Being vigilant about the possibilities of anomalous facial nerve and tailoring the surgical technique accordingly is crucial for ensuring a safe and successful outcome. Keywords: Facial nerve, stapes surgery, StapesPublication Burden of chronic otitis media- mucosal type and the impact of its surgical management in the quality of life of patients in a tertiary hospital(Society of Otolaryngologists of Nepal, 2020) Rayamajhi, Pabina; Aggarwal, Poonam; Dutta, Heempali Das; Tripathi, Prashant; Kharel, Bijaya; Pradhananga, Rabindra Bhakta; Neupane, Yogesh; Dongol, KripaAbstract: Objective: The objective of this study was to assess the burden of COM-mucosal disease and analyse the general and disease-specific quality of life (QOL) in patients after myringoplasty. Materials and Methods: The study was conducted in the department of ENT and Head & Neck Surgery (HNS) from 1st December 2019 to 1st June 2020. The data was collected from the initial three months of the mentioned duration. For the assessment of the burden of COM-mucosal disease in the department all the patients visiting with the aforementioned diagnosis was recorded and compared with the total patient visit in the department in the three months duration. Sixty patients were included in the study for the QOL assessment after myringoplasty. Patients who had undergone myringoplasty filled the quality-of-life questionnaires. The means of the pre and postoperative values were compared and the benefit in their quality of life evaluated. Results: The prevalence of COM-mucosal disease among the total new patients visited in the outpatient department of the hospital was 5.4%. Diseasespecific QOL in patients with COM improved after myringoplasty in all the scales of the questionnaire. All the activity/lifestyles scores, medical help scores and symptom scores showed statistically significant improvement after surgery. Conclusion: There is a high burden of the COM-mucosal disease. Myringoplasty did lead to a significant improvement of disease-specific QOL in patients with COM- mucosal type. Keywords: COM- mucosal, Myringoplasty, Quality of life (QOL)