The accessory parotid gland is salivary tissue separated from the main parotid gland and lying on masseter muscle. The accessory parotid gland is not rare, according to cadaver studies, but neoplasm in the accessory parotid gland is rare. Surgical excision is the treatment of choice for the accessory parotid gland tumour. It is important to identify the buccal branch of the facial nerve to avoid injury to the facial nerve. Herein we describe a case of accessory parotid gland tumor in a 30 years old lady. Histopathological diagnosis was Warthins tumour which is very rare in female. DOI: http://dx.doi.org/10.3329/bjo.v20i1.22017 Bangladesh J Otorhinolaryngol; April 2014; 20(1): 43-45
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 were evaluated. Results: Out of 60 patients, superficial parotidectomy was done in52 (86.67%) patients and total conservative parotidectomy was done in 08 (13.33%) patients. In this study 56 cases were benign and 04 cases were malignant. Among this 41 (68.33%) pleomorphic adenoma, 05 (8.33%) warthin’s tumour, 03 (5%) benign lymphoepithelial cyst, 03(5%) haemangioma, 02(3.33) sialocele, 01(1.67) dermoid and 01 (1.67%) had salivary fistula. All 04(6.67%) malignant cases were diagnosed as mucoepidermoid carcinoma. Majority of pleomorphic adenomas (92.68%) involved the superficial lobe of the gland. Most commonly observed post operative complication was facial nerve paresis (05%), but only 1.67% developed permanent palsy. Others complication includes Hypoesthesia of the greater auricular nerve (05%), Frey’s syndrome (3.33%) & wound infection (3.33%). Conclusion: Facial nerve palsy is the frequent complication after parotid surgery in this study. Surgeons have to pay attention to minimize the risk of complication during parotidectomy. However, this operation continues to be a challenge on account of the wide range of tumours encountered and the variations in size and location and the facial nerve preservation. Bangladesh J Otorhinolaryngol; April 2021; 27(1): 59-65
Background: Sinonasal malignancies are challenging not only from diagnostic view point but also from therapeutic aspects. Owing to the rarity of the lesions, delayed clinical presentations and poor prognosis there is lack of large experience. Objectives: Aim of this study is to assess Evaluation of extensions of sinonasal malignancy by correlating clinical and surgical findings with CT scan. Methods: A Cross Sectional study was carried out in the Department of Otolaryngology-Head and Neck Surgery, Sylhet M.A.G Osmani Medical College Hospital, Sylhet, from August 2019 to July 2021. A total 30 subjects were included in this study based on inclusion and exclusion criteria. A data collection form was designed and prepared including general characteristics of subjects and reviewed clinically, radiologically and surgically. All the data were compiled and sorted properly and the numerical data were analyzed statistically by using Statistical Package for Social Sciences (SPSS-26). The result was expressed as frequency and percentage and displayed with figure and table. Z proportion test, Spearman’s rho correlation coefficient test and Diagnostic accuracy test of clinical, CT and surgical finding were performed as applicable. For all comparisons p value of <0.05 was considered as significant. Results: In this study, CT findings was positively related with clinical and surgical findings. But this relation was strongly significant with surgical findings. In this study, clinical evaluation was 28.8% Sensitive and 100% Specific. Positive predictive value (PPV) was 100% and negative predictive value (NPV) was 9.1%. CT evaluation was 78.6% Sensitive and 100% Specific. Positive predictive value (PPV) was 100% and negative predictive value (NPV) was 25%. Surgical evaluation was 92.9% sensitive and 100% Specific. Positive predictive value (PPV) was 100% and negative predictive value (NPV) was 50%. Conclusion: It can be concluded that CT findings was directly correlated with clinical and surgical findings. But this relation was strongly significant with surgical findings. Bangladesh J Otorhinolaryngol 2022; 28(2): 171-179
Background: The nasopharyngeal tonsil, universally known as adenoids is to be found at the crossroads of roof along with posterior wall of nasopharynx. Adenoid is gift next to birth. Adenoid mass may block the eustachian tube, retracted tympanic membrane leads to conductive hearing loss. Impedance audiometry helps to assess the condition. Objective: To observe the changes of impedance audiometry before and after adenoidectomy in a clinically normal ear. Methods: This longitudinal study was done in Cumilla Medical College & Hospital, Cumilla during a period of one year. 50 Cases of enlarged adenoids of 3-12 years admitted in ENT ward were included in this study. All cases underwent adenotonsillectomy. Impedance Audiometry was done before and one month after adenotonsillectomy. Collected data were classified, edited, coded and statistical analysis was done. Results: Total 50 cases, mean age was 6.95(±1.77) years. Majority 33(66%) were male and 17(34%) were female. Middle ear pressure of both ears was increased after adenotonsillectomy. After operation 40(80%) was type A curve and 09(18%) was type B in right ear and 42(84%) was type A curve and 08(16%) was B curve in left ear. Conclusion: Majority tympanometry was type B in both ears before adenotonsillectomy and after operation majority tympanometry curvature was type A in both ears Bangladesh J Otorhinolaryngol 2022; 28(1): 62-67
Objective: The aim of this study was to evaluate the early and late (6 months after surgery) complications in patients undergoing thyroid surgery. Material & methods: A retrospective study was done from January 2015 to December 2019 in the Department of ENT & Head Neck Surgery, Enam Medical College & Hospital. One hundred and sixty three patients with both benign & malignant thyroid disease underwent surgical treatment was selected for this study. Patients were followed up for six months and peroperative & postoperative complications were evaluated. Results: Out of 163 patients 132(80.9%) cases were benign and 31(19.1%) cases were malignant. Total thyroidectomy was done in 71(43.56%) patients and hemithyroidectomy was done in 82(50.3%) patients and 10(6.13%) patients had other thyroid surgery. 29(17.80%) patients develop complications after thyroid surgery. Most common post operative complication was hypoparathyroidism with a incidence of 17(10.43%). 15(9.20%) patients developed temporary hypocalcaemia and 2(1.23%) patients developed permanent hypocalcaemia. Others complications were recurrent laryngeal nerve (RLN) palsy 2(1.23%), superior laryngeal nerve (SLN) palsy 3(1.84%), wound infection 2(1.23%), haematoma 1(0.61%) and hypertrophied scar 4(2.45%). Conclusion: Hypocalcaemia was the most frequent post-thyroidectomy complication, while voice change, seroma, haematoma, wound infection and hypertrophied scar are additional complications. Surgeons have to pay attention to curtail the complications during thyroid surgery. Bangladesh J Otorhinolaryngol 2022; 28(1): 50-55
Objectives: To find out the pattern of complications, frequency, risk factors and the management after total laryngectomy. Methods: It was a cross sectional study done in the Department of Otolaryngology & Head- Neck Surgery, Shaheed Suhrawardy Medical College Hospital, Dhaka from July 2007 to Dec 2009. 15 patients undergoing total laryngectomy for histologically proven Carcinoma larynx were included in this study. Patients were reviewed after surgery and any complication that occurred was recorded. The presentation, diagnosis and management of these complications were discussed after total laryngectomy. Results: There were 15 male patients, 3 non radiated cases and 12 post irradiated cases. Age of patients ranged from 35-75 years. Complications included wound infection (04), pharyngocutaneous fistula (03), flap necrosis (01), pharyngeal stenosis (01), stomal stenosis (01) and stomal recurrence (01). Conclusions: Wound infection and pharyngocutaneous fistula are most common complications after total laryngectomy. Preoperative radiotherapy is an important risk factor for development of pharyngocutaneous fistula in total laryngectomy patients. DOI: http://dx.doi.org/10.3329/bjo.v19i2.16366 Bangladesh J Otorhinolaryngol 2013; 19(2): 82-86
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. Bangladesh J Otorhinolaryngol; April 2021; 27(1): 73-80
Context: Cervical plexus block anaesthetizes the pain sensitive structures in the neck, shoulder and skin of upper chest up to sternal angle which is suitable for operations in the neck and shoulder, particularly on the thyroid gland. It may also be used as a modality of pain therapy in this region. The aim the study was to find out the advantages and disadvantages of thyroid surgery under regional anaesthesia i.e. cervical plexus block. Methods: Nine cases of thyroid disorders were operated in Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka, over a period of 18 months from July 2008 to September 2010, where lobectomy was done in 2 cases, hemithyroidectomy in 4 cases, isthmusectomy in 1 case, subtotal thyroidectomy in 1 case and total thyroidectomy in 1 case. Results: The advantages that we observed were less bleeding, time saving procedure, avoidance of endotracheal intubation, physical ability of the patient to take food and drink immediately at post operative period and early mobility of the patient after the operation. The only disadvantage that we faced was temporary dysphagia in one case. Key words: Cervical plexus block; regional anaesthesia; thyroid surgery. DOI: 10.3329/jdmc.v19i2.7072J Dhaka Med Coll. 2010; 19(2) : 76-79
Background: Ear, Nose, Throat (ENT) & Head Neck diseases are very common in our country. Of course, patterns of ENT diseases vary depending on geographical distribution. Materials & methods: This retrospective study was carried out in ENT OPD in a tertiary hospital, Medical College for Women & Hospital (MCWH), Uttara, Dhaka, Bangladesh from July, 2015 to December, 2015. Total 3314 patients were selected for the study, males being 1582 & females, 1732. Cases were evaluated by local otolaryngologists by taking thorough history and clinical examination with proper and relevant investigations. Personal data included were age (1 month – 80 years) and sex. Information obtained was expressed in numbers and percentages with statistical analysis. Results: Top 10 diseases were selected which includes Chronic Suppurative Otitis Media (CSOM) 18.14%, Chronic tonsillitis 15.67%, Acute otitis media (AOM) 9.90%, Otitis externa (OE) 8.18%, Deviated nasal septum (DNS) 7.79%, Otitis media with effusion (OME) 7.27%, Allergic rhinitis (AR) 6.40%, Wax 4.98%, Pharyngitis 4.29%, Sinusitis 2.90%. The study reveals that the most vulnerable age group was 0-18 years. 47.74% and 52.26% were male and female respectively, the ratio being 0.9:1 that is almost equal. No significant differences were found in ENT diseases between males and females. Regarding infections of specific organs, CSOM was the most common and highest in order in our context followed by Ch. Tonsillitis, AOM, OE, DNS, OME, AR, Wax, Pharyngitis and Sinusitis. Conclusion:This study was made with an attempt to contribute to some extent to the epidemiologic profile of the common ENT & Head Neck diseases. It would probably enable the concerned personnel to enrich their knowledge and skill so that they can deal with the diseases properly. Bangladesh J Otorhinolaryngol 2022; 28(2): 186-192
Simultaneous involvement of lungs, larynx and middle ear by tuberculosis is very rare. We present a rare case of simultaneous involvement of larynx and ear in a patient with pulmonary tuberculosis. A 17 years old male presented with fever and cough for 8 months, bilateral deafness for 5 months and hoarseness of voice for 3 months. The patient gave history of anorexia and progressive weight loss and history of close contact with tuberculosis patient. There were coarse crepitations on auscultation of both lungs. Indirect laryngoscopy revealed diffuse nodular swelling as well as thickening of the vocal cords. Examination of both ears revealed pale-yellow granulation tissue. ESR was 94 mm in 1st hour and chest radiograph showed diffuse patchy opacities extending over both lung fields. The results of two sputum examinations showed numerous acid-fast bacilli Histopathologic examination of punch biopsy from right and left ear lesions and biopsy tissue from laryngeal lesion taken by endoscopic instrument revealed granulomatous inflammation histologically consistent with tuberculosis.The patient responded well and promptly to the antituberculous therapy. The aim of this article is to create an awareness of Ear Nose Throat tuberculosis and to consider tuberculosis in the differential diagnosis of ear and laryngeal diseases and to emphasize the need for prompt recognition and treatment. DOI: http://dx.doi.org/10.3329/jdnmch.v17i1.12195 J. Dhaka National Med. Coll. Hos. 2011; 17 (01): 53-55
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