Ossiculoplasty: study of hearing results in 50 patients

Background: Ossiculoplasty improves conductive hearing loss. Various reconstruction methods and techniques are developed with use of different graft materials over period of time. Results of ossiculoplasty can be predetermined with consideration of prognostic factors. Methods: The present study is retrospective study of 50 patients who underwent ossiculoplasty in the medical college hospital over the period of 3 years i.e. from January 2013 to December 2016. The pre-operative and post-operative audiometric findings were documented and analyzed to study the hearing improvement with the use of auto graft malleus and incus for ossiculoplasty. The results of ossiculoplasty were also compared with other studies done for ossiculoplasty. Predictors of ossiculoplasty results such as ossicular status and middle ear mucosa were also studied. Results: The average post-operative air bone gap was 12.92 dB. The mean post-operative ABG was within 20 dB in both primary and revision cases. Average air-bone closure in patients with normal mucosa was 32.1 dB and that of adhesive mucosa was 18 dB. Significant improvement in post-operative air-bone closure (p <0.01) was observed in patients with auto graft incus than malleus head as ossiculoplast. Conclusions: 84% ossiculopasty patients were having post-operative air bone gap within 20 dB. The ossiculoplasty using auto graft ossicle is physiological, biocompatible, stable and has low complication rate.

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Hearing Status after Stapedotomy in Otosclerotic Patients

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v25i2.45205 ◽

2020 ◽

Vol 25 (2) ◽

pp. 85-93

Author(s):

Ahmed Tariq ◽

Mostafizur Rahman ◽

Delwar Hossain ◽

Sheikh Hasanur Rahman

Keyword(s):

Hearing Loss ◽

Conductive Hearing Loss ◽

Bone Conduction ◽

Surgical Techniques ◽

Neck Surgery ◽

Speech Discrimination ◽

College Hospital ◽

Medical College ◽

Medical University ◽

Conductive Hearing

Otosclerosis is the most frequent cause of conductive hearing loss in patients with intact tympanic membrane. It can be treated by surgery with various techniques. Because of limited manipulation and comparably similar results, stapedotomy at present is preferred over other surgical techniques by most surgeons. Here we present the operative results of 35 otosclerotic patients who underwent stapedotomy between January 2009 - October 2010 in the department of Otolaryngology- Head & Neck Surgery of Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital and Shahid Suhrawardhy medical college & hospital, Dhaka. The aim of this study was to evaluate the hearing results following stapedotomy in otosclerosis surgery. The average air-bone gap of patients improved significantly to 21.74 dB after operation. Other hearing parameters of patients (including air conduction, bone conduction, speech discrimination score, and tinnitus) also improved. No patient experienced persistent vertigo after the operation and pre operative tinnitus resolved in 12 out of 22 patients. Stapedotomy is a safe and effective modality for improving conductive hearing loss in otosclerotic patients. Bangladesh J Otorhinolaryngol; October 2019; 25(2): 85-93

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Hearing Evaluation after Myringoplasty in Underlay Technique

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v22i2.45093 ◽

2020 ◽

Vol 22 (2) ◽

pp. 84-89

Author(s):

Md Khorshed Alam ◽

Mohammad Wakilur Rahman ◽

Md Abdur Razzak ◽

ABM Khorshed Alam ◽

Abu Yusuf Fakir ◽

...

Keyword(s):

Success Rate ◽

Medical College Hospital ◽

Hearing Improvement ◽

College Hospital ◽

Mean Values ◽

Hearing Gain ◽

Medical College ◽

Graft Take ◽

Significant Difference ◽

The Mean

Objective: to determine the success rate of underlay technique of myringoplasty regarding rate of graft take, complications and hearing improvement. Methods: This Cross sectional study was done in the department of ENT & Head-Neck Surgery, Dhaka Medical College Hospital & Shaheed Suhrawardy Medical college Hospital, Dhaka from July 2012 to December 2012. Sixty(60) patients who underwent myringoplasties were included in the study. All myringoplasty were performed by a postaural approach using autologous temporalis fascia and underlay technique. Results: The total success rate (graft uptake) was 88.3% and of the successful cases an overall hearing improvement was achieved in 73.58% of cases. The mean audiological improvement in air conduction threshold was 13.24 dB & mean closure of the air bone gap was 11.64 dB. The mean values of hearing gain of small perforations and subtotal perforations have shown significant difference.The mean values of hearing gain between posterior perforation and subtotal perforation have shown significant difference. Conclusion: Underlay myringoplasty is an effective technique of repairing the tympanic membrane perforation due to high rate of graft take and marked hearing improvement. Bangladesh J Otorhinolaryngol; October 2016; 22(2): 84-89

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Chest Trauma Evaluation and Outcome of Management in a Tertiary Hospital - One Year Experience

Journal of Surgical Sciences ◽

10.3329/jss.v22i2.44075 ◽

2020 ◽

Vol 22 (2) ◽

pp. 110-117

Author(s):

Md Mahmudul Islam ◽

Khondkar AK Azad ◽

Md Aminul Islam ◽

Rivu Raj Chakraborty

Keyword(s):

Road Traffic Accident ◽

Traffic Accident ◽

Chest Trauma ◽

Road Traffic ◽

Tube Thoracostomy ◽

Rib Fracture ◽

Medical College Hospital ◽

College Hospital ◽

Medical College ◽

The Mean

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117

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Comparative study between over underlay with classical underlay techniques of tympanoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201687 ◽

2020 ◽

Vol 6 (5) ◽

pp. 918

Author(s):

Prashanth Kudure Basavaraj ◽

Manjunatha H. Anandappa ◽

Veena Prabhakaran ◽

Nishtha Sharma ◽

Shreyas Karkala

Keyword(s):

Hearing Loss ◽

Informed Consent ◽

Conductive Hearing Loss ◽

Hearing Threshold ◽

Chronic Otitis Media ◽

Success Rates ◽

Hearing Improvement ◽

Group A ◽

Group B ◽

Conductive Hearing

Background: The objective of the study was to compare the over underlay tympanoplasty technique with classical underlay tympanoplasty in terms of hearing impairment, graft acceptance and complications.Methods: 60 patients of chronic otitis media, mucosal, inactive, aged between 16-60 years who presented to ENT OPD with small, medium, large and subtotal perforations having mild to moderate conductive hearing loss were included in the study. After taking informed consent, patients were randomly divided into 2 groups containing 30 patients each. In group A, graft was placed medial to the handle of malleus and medial to the annulus (underlay technique), while in group B, graft was placed lateral to the handle of malleus and medial to the annulus (over underlay technique). Both groups were reviewed after 6 months. Pre-operative and post-operative air bone gap were compared. Surgery was considered successful based on post-operative graft uptake, hearing improvement and maintenance of middle ear space. Results: In group A, re-perforation was seen in 8 cases (26.7%) whereas only 3 cases (10%) in group B had re-perforation. Medialization was noted among 4 patients in group A (13.3%), and was absent in group B. Lateralization was absent in both the groups. Post-operative hearing threshold in group A was 6.2±4.56 dB and in group B was 11.45±7.38 dB.Conclusions: Over underlay tympanoplasty is a safer technique as compared to classical underlay, showing lower rates of re-perforation or medialization and a significant improvement in hearing. Hence over-underlay is an effective method, having higher success rates.

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Stapedotomy post-operative results and complications

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203085 ◽

2020 ◽

Vol 6 (8) ◽

pp. 1442

Author(s):

Hanumant S. Giri ◽

Ram C. Bishnoi ◽

Pooja D. Nayak ◽

Ninad S. Gaikwad

Keyword(s):

Hearing Loss ◽

Hearing Aids ◽

Conductive Hearing Loss ◽

Major Complication ◽

Safe Procedure ◽

Hearing Results ◽

Post Surgery ◽

Localized Disease ◽

Conductive Hearing

Background: Otosclerosis is a hereditary localized disease of the bone derived from the otic capsule. It is characterized by alternating phases of bone formation and resorption and patient presents with conductive hearing loss. Treatment of otosclerosis can be of two kinds: hearing aids and surgery. Stapedectomy and stapedotomy are the two surgical procedures done for treatment of otosclerosis. Present study was conducted on 30 patients with otosclerosis who underwent stapedotomy to assess the hearing results post-surgery by serial Audiometric studies and to study the complications of stapedotomy surgery.Methods: This prospective observational study conducted on 30 patients of otosclerosis who fulfilled the inclusion and exclusion criteria. Results: In this study of thirty cases of otosclerosis which were operated for small fenestra stapedotomy, we conclude that Hearing gain post-surgery was remarkable especially for patients with a pure conductive hearing loss. There was no deterioration in hearing after two years of follow-up. In our study on 30 patients we encountered minor complication in 4 patients (13.33%) and 1 major complication of profound sensorineural hearing loss 3.33%.Conclusions: We conclude that stapedotomy is a relatively safe procedure with significant post-surgery hearing benefit.

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Prevalence of Pre-Existing Corneal Astigmatism in Age Related Cataract Patient

Faridpur Medical College Journal ◽

10.3329/fmcj.v8i1.16887 ◽

2013 ◽

Vol 8 (1) ◽

pp. 02-04

Author(s):

Md Abdur Rashid ◽

KH Anowar Hossain ◽

AKM Rafiqul Islam

Keyword(s):

Prospective Study ◽

Cataract Surgery ◽

Visual Outcome ◽

Corneal Astigmatism ◽

Normal Vision ◽

College Hospital ◽

Medical College ◽

Cataract Patient ◽

Age Related ◽

The Mean

Cataract surgery is no more a blind rehabilitation surgery, it absolutely gives normal vision. In the era of modern cataract surgery patients expectations are also high about visual outcome. This prospective study was carried out to investigate the magnitude and pattern of pre-existing corneal astigmatism in age related cataract patient at Faridpur Medical College Hospital, Faridpur and Agha Yusuf Adhunik Hospital, Kustia, from July 2009 to June 2012. We examined 850 eyes of 730 patients who underwent cataract surgery. The mean age at the time of surgery was 61.9±8.1 (40 to 70) years. Corneal astigmatism was measured by Auto Refracto Keratometer at least two times for each patient. Astigmatism was calculated from diopteric difference of vertical reading from horizontal reading. With the rule (WTR) astigmatism was considered when steep meridian at 90°± 20°. Against the rule (ATR) astigmatism was considered when steep meridian at 180°±20°. Astigmatism is in other direction is defined as oblique. On keratometry, when vertical reading (k1) was found greater than horizontal (k2) was considered WTR astigmatism and the reverse reading for ATR astigmatism. The percentage of corneal astigmatism was 1D or less was 69.6%, more than 1D and less than 1.5D, 27.6% and more than 1.5D and less then 2D 2.8%. Prevalence of ATR astigmatism was more than WTR astigmatism and prevalence of ATR astigmatism increases significantly with age. Approximately two third of pre-operative patient had 1D or less astigmatism and one third had more than 1D corneal astigmatism. DOI: http://dx.doi.org/10.3329/fmcj.v8i1.16887 Faridpur Med. Coll. J. 2013;8(1): 02-04

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Socio-demographic Characteristics of Vesico-vaginal fistula (VVF) patients attended at a tertiary Care Hospital in Bangladesh

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v6i2.50766 ◽

2020 ◽

Vol 6 (2) ◽

pp. 114-117

Author(s):

Shimul Akter ◽

Naznin Rashid Shewly ◽

Kashefa Khatun ◽

Rokshana Parvin Nupur ◽

Kamrun Nahar ◽

...

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Demographic Characteristics ◽

Medical College Hospital ◽

Care Hospital ◽

Vaginal Fistula ◽

College Hospital ◽

Medical College ◽

The Mean ◽

Vesico Vaginal Fistula

Background: Vesico-vaginal fistula can occur in different women with varied socio-economic condition. Objectives: The purpose of the present study was to see the socio-demographic characteristics of vesico-vaginal fistula (VVF) patients attended at a tertiary care hospital in Bangladesh. Methodology: This cross-sectional study was carried out from July 2013 to December 2013 for a period of 6 months in the National Fistula Centre in the Department of Obstetrics & Gynaecology at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh. All patients who underwent surgical repair for iatrogenic VVF in National Fistula Centre of the department of Obstetrics and Gynaecology of Dhaka Medical College Hospital were included in this study. Patients who got themselves admitted to Obstetrics & Gynaecology department of DMCH with the complaints of fistula. The entire selected patients were interviewed for detailed socio-demographic characteristics. Result: A total number of 51 cases of VVF were recruited for this study. The mean age was 46.02 (±SD 6.104) years. Most of the respondents were illiterate (55.0%) and one-third patients had primary level education. The number of highly educated patients was scarce (12.0%). It was evident that average age at marriage of the patients was 15.8(±4.74) years. Some females were forced to accept marriage at the age of 10 years. The mean interval between initiation of menstruation and the marriage was only 4.72 years. Mothers were on an average 17.48 years old at the time of first delivery. Conclusion: In conclusion middle age illiterate women are most commonly suffering from VVF. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 114-117

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Primary Retroperitoneal Ganglioneuroma: A Retrospective Cohort Study of 32 Patients

Frontiers in Surgery ◽

10.3389/fsurg.2021.642451 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jianchun Xiao ◽

Zixuan Zhao ◽

Binglu Li ◽

Taiping Zhang

Keyword(s):

Growth Pattern ◽

Clinical Manifestations ◽

Incomplete Resection ◽

Radiological Imaging ◽

College Hospital ◽

Laboratory Findings ◽

Female Ratio ◽

Medical College ◽

The Mean ◽

The Masses

Purpose: To investigate the clinical characteristics, diagnosis, differential diagnosis, therapy options, and outcomes of retroperitoneal ganglioneuroma.Methods: In this retrospective study, we collected and analyzed the clinical data of 32 patients diagnosed with retroperitoneal ganglioneuroma and admitted to Peking Union Medical College Hospital from October 2012 to August 2019.Results: Among our 32 cases with retroperitoneal ganglioneuroma, the male-to-female ratio was 1:3 and the mean age was 35. Only 25% of the cases presented with abdominal pain while more than 65% had no specific symptoms. The masses could be found through physical examination in only five patients. Most of the tumors are located near the renal area. They were usually single and displayed an embedded growth pattern with diameters <10 cm, clear borders, and soft texture. For radiological imaging, the majority of tumors demonstrated soft tissue density with mild-to-moderate enhancement on CT imaging and showed hypoecho with moderate blood flow signals in ultrasound. No significantly abnormal laboratory examinations were found in most patients. Of all the 32 patients, 2 chose surveillance after biopsy due to difficulties in operation, while others chose surgical resection. The mean follow-up time was 15.8 months among 26 patients. The tumor remained stable in the surveillance cases. Residual tumors were found in four cases receiving operations with no progress and discomfort. No recurrence was seen in all patients.Conclusions: The retroperitoneal ganglioneuroma is a benign tumor without specific clinical manifestations or significant laboratory findings. Typically, it is shown as low density with a clear border and an embedded growth pattern in radiological imaging. The overall prognosis is good. Surgery is an effective approach with possible severe complications. Incomplete resection or surveillance can be considered for some cases where complete resection is difficult to achieve.

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Modification of auditory pathway functions in patients with hearing improvement after middle ear surgery

Otolaryngology ◽

10.1016/s0194-5998(98)70183-4 ◽

1998 ◽

Vol 119 (1) ◽

pp. 125-130 ◽

Cited By ~ 8

Author(s):

Juha-Pekka Vasama ◽

Jyrki P. Mäkelä ◽

Hans A. Ramsay

Keyword(s):

Hearing Loss ◽

Middle Ear ◽

Pure Tone ◽

Conductive Hearing Loss ◽

Adult Patients ◽

Middle Ear Surgery ◽

Ear Surgery ◽

Pure Tone Average ◽

The Mean ◽

Conductive Hearing

We recorded auditory-evoked magnetic responses with a whole-scalp 122-channel neuromagnetometer from seven adult patients with unilateral conductive hearing loss before and after middle ear surgery. The stimuli were 50-msec 1-kHz tone bursts, delivered to the healthy, nonoperated ear at interstimulus intervals of 1, 2, and 4 seconds. The mean preoperative pure-tone average in the affected ear was 57 dB hearing level; the mean postoperative pure-tone average was 17 dB. The 100-msec auditory-evoked response originating in the auditory cortex peaked, on average, 7 msecs earlier after than before surgery over the hemisphere contralateral to the stimulated ear and 2 msecs earlier over the ipsilateral hemisphere. The contralateral response strengths increased by 5% after surgery; ipsilateral strengths increased by 11%. The variation of the response latency and amplitude in the patients who underwent surgery was similar to that of seven control subjects. The postoperative source locations did not differ noticeably from preoperative ones. These findings suggest that temporary unilateral conductive hearing loss in adult patients modifies the function of the auditory neural pathway. (Otolaryngol Head Neck Surg 1998;119:125-30.)

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Laparoscopic Cholecystectomy for Acute Cholecystitis: Indication, Risk, and Outcome

International Journal Of Medical Science And Clinical Invention ◽

10.18535/ijmsci/v8i06.010 ◽

2021 ◽

Vol 8 (06) ◽

pp. 5508-5513

Author(s):

Dr. Shiladitya Shil ◽

Dr. Ashutosh Deb Sarma ◽

Dr. Md. Alomgir Islam ◽

Dr. Md. Abdullah-Hel-Baki Abdul ◽

Dr.Monira Begum

Keyword(s):

Laparoscopic Cholecystectomy ◽

Acute Cholecystitis ◽

Prospective Observational Study ◽

The Other ◽

Surgical Indication ◽

College Hospital ◽

Female Ratio ◽

Medical College ◽

The Mean ◽

Good Treatment Option

Background: A laparoscopic cholecystectomy is a fundamental approach to treating acute cholecystitis, and the timing of performing this given treatment is associated with clinical outcomes. It is unknown whether surgical indication, risk, and consequences of laparoscopic cholecystectomy for acute cholecystitis differ from those for the chronic form, making it questionable whether urgent laparoscopic cholecystectomy is the best approach even in severe acute cases. Objective: This study aimed to evaluate surgical indication, risk, and outcomes of laparoscopic cholecystectomy for acute cholecystitis. Methods: This prospective observational study was carried out at Bangladesh Medical College Hospital (Uttara Campus) from July 2006 to November 2008. A total of 103 acute cholecystitis patients were observed to evaluate the safety, risk, and outcomes (includes hospital stay, joining to routine daily works) of laparoscopic cholecystectomy. Result: Male and female ratio is 1:4, and the mean age in our series is 47 years. Acute calculas cholecystitis ultra-sonogram feature shows the highest percentage (85.4%) compare to the other four parts. The study also confirmations around 69% did not get any complications, and bleeding was the most frequently observed (16%) complication. The overall outcomes in this research were observed around 75% of total operated patients did not experience any difficulty and said they fit entirely. The other 19% who had some complications include Pain, RTI, Seroma, Jaundice, Cholangitis, Wound infection). Conclusion: Regarding bile duct injury and prolonged complications, laparoscopic surgery is not a very good treatment option for acute cholecystitis.

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