Journal Issue: Volume: 12, No. 1 (2021)
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Volume
Number
Issue Date
2021
Journal Title
Journal ISSN
2091-0843
Journal Volume
Articles
Lets talk: surgeons health & ergonomy
(Society of Otolaryngologists of Nepal, 2021) Neupane, Yogesh
NA
Ent head and neck problems at referral rehabilitation center of Shree Birendra Hospital
(Society of Otolaryngologists of Nepal, 2021) KC, Sarita; Puri, Lokesh; Mahaseth, Rajeev Kumar; Pradhan, Bhawani
Abstract:
Objectives:
The objective of this study was to find out the burden of ENT-HNS problem of differently abled patients at a residential physical rehabilitation center in Nepal. Though people at a residential physical rehabilitation center have many medical problems alike general population, they are known to less emphasize them since the problems related to their primal condition, spinal cord injury (SCI), overshadows others.
Materials and methods:
This retrospective cross-sectional study was conducted at the department of Ear Nose Throat- Head and Neck Surgery, Shree Birendra Hospital. Recorded data were reviewed of clinical examination findings, pure tone audiometry, and speech and language evaluation of 22 residential differently abled patients and were analysed.
Results:
There were total 22 male patients with the mean age of 42 years (ranged 26 -74). Majority had spinal cord injury. Deviated nasal septum was the commonest ENT-HNS finding followed by hearing loss. Five of them (22.72%) had speech and language disorder.
Conclusions:
Patients of physical rehabilitation center have ENT-HNS related problems like DNS, hearing loss, speech and language disorders. However, these problems take less precedence compared to their primary and its associated conditions. Comprehensive check-up and treatment of ENT-HNS problems can contribute to enhance patients’ quality of life.
Keywords: ENT-HNS problems, Physical rehabilitation center, Spinal cord injury
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, Tridip
Abstract:
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 COM
Relation between chronic rhinosinusitis and serum vitamin d3 level
(Society of Otolaryngologists of Nepal, 2021) Yadav, Om Prakash; Pantha, Tridip; Banepali, Niroj; Gautam, Dipendra; Koirala, Bidhan; Shahi, Sudha; Shrestha, Dipendra
Abstract:
Objectives:
To explore the relation between Chronic rhinosinusitis (CRS) and serum Vitamin D3 level.
Materials and methods:
A prospective, observational study consisting of 115 patients with CRS was carried out at Department of ENT & HNS in Bir Hospital from March 2018 to March 2019. Patients were divided into two groups: ‘CRSwNP (Chronic rhinosinusitis with polyp)’ and ‘CRSsNP (Chronic rhinosinusitis without polyp).’ Vitamin D3 levels were measured by Chemiluminescent Immunoassay method and compared between the two groups. Receiver operating characteristic (ROC) curve analysis was also performed to evaluate the role of vitamin D3 in discriminating between the two groups.
Results:
Out of 115 cases, 54 (47%) had CRSwNP and 61 (53%) had CRSsNP. Mean age of the patients was 34.7 years. Sixty six (57%) were female. Mean vitamin D3 level of all patients was 23.86 ng/ml. Only 17 (14.8%) patients had normal vitamin D3 level. CRSwNP patients had significantly lower vitamin D3 levels compared to CRSsNP patients (21.42 ng/ml vs. 26.01ng/ml respectively; p value <0.001). Higher proportion of patients with CRSwNP had Vitamin D3 deficiency compared to CRSsNP cases (35.2% vs. 16.4%). On ROC curve analysis of Vitamin D3 to discriminate CRSsNP from CRSwNP, area under the curve (AUC) was 0.718 and accuracy was 67.83% at a cutoff value of ≥ 23.15 ng/ml.
Conclusion:
The mean vitamin D3 levels in CRSwNP patients was significantly lower than CRSsNP patients. A cut off level of vitamin D3 level ≥23.15ng/ml had a fair ability to discriminate CRSsNP patients from CRSwNP patients.
Keywords: Chronic Rhinosinusitis (CRS), Polyp, Task force criteria, Vitamin D3.
Effect of eustachian tube obstruction in graft uptake rate in myringoplasty
(Society of Otolaryngologists of Nepal, 2021) Budhathoki, Bikram; Bhandari, Akash Mani; Saxena, Ravinder Kumar; Kansakar, Niva
Abstract:
Objectives:
To observe the effect of eustachian tube obstruction in graft uptake/rejection rate in myringoplasty.
Materials and methods:
This study was done in Nepalgunj Medical College Teaching Hospital, Kohalpur, Nepal over the period of one year including patients with COM mucosal inactive with age more than 10 years. Standard underlay myringoplasty technique with temporalis fascia graft was used.
Results:
There were total 60 cases, divided in two groups, 30 cases in each. Group 1 consists of patent eustachian tube and Group 2 consists of patients with eustachian tube dysfunction. Graft uptake was seen in 49 patients (81.7%) and rejected in 11 patients (18.33%). Out of 11 rejected cases 5 were from ET patent (GROUP 1) and 6 from ET obstructed (Group 2). Among 49 graft uptake cases, 25 (51.03%) were from Group 1 and 24 (48.97%) were from Group 2. In Group 1 graft uptake was 83% and was rejected in 17%, whereas in Group2 graft uptake was seen in 80% and rejected in 20% which was not statistically significant (p value 0.739).
Conclusions:
There was no significant difference between two groups regarding the graft uptake.