Nepalese Journal of ENT Head & Neck Surgery

CHALLENGING FOREIGN BODY REMOVAL FROM MIDDLE EAR

Neeraj K.C. — 2024-12-17

Foreign body in external auditory canal is a very common presentation in otolaryngology emergency and outpatient department with most of the patients being children. Although an office-based procedure, severe pain or an uncooperative patient may warrant the need for general anaesthesia for removal. Whatever means is used, the outcome should be free from complications as far as possible, although it may not be possible in all the cases. We are presenting a case of 18 months young boy who had an impacted foreign body in his middle ear with prior history of failed attempt of removal in an outpatient setting. It had to be removed under general anaesthesia by drilling and widening the bony external auditory canal in order to mobilise, hold and remove it.
Keywords: Impacted foreign body, Middle ear, pediatric

ANAESTHETIC MANAGEMENT OF A CHILD WITH UNCORRECTED TETRALOGY OF FALLOT UNDERGOING MYRINGOPLASTY

Binata Acharya — 2024-12-17

Perioperative management of the patients with uncorrected Tetralogy of Fallot (TOF) for noncardiac surgery is a challenge for the anesthesiologists. TOF is the commonest cyanotic congenital heart disease (CHD). We report a case of a child with unrepaired TOF, presented for ear surgery highlighting the anaesthetic concerns and the methods to minimize the complications in the perioperative period.
Keywords: Myringoplasty, non-cardiac surgery, tetralogy of Fallot

THE EFFECT OF TINNITUS ON THE QUALITY OF LIFE OF THE SUFFERERS

T Pantha — 2024-12-17

Background: Tinnitus is a prevalent condition characterized by the perception of sound in the absence of an external source. The impact of tinnitus on individuals can vary significantly, with some experiencing only mild discomfort while others are greatly affected on a day-to-day basis. Some people may find their symptoms relatively manageable, while others may struggle with the physical, emotional, and psychological implications of the condition. This wide range of experiences highlights the need to examine the association between tinnitus and the quality of life of sufferers in greater detail so that appropriate management can be given according to its severity. The study is aimed to investigate the effect of tinnitus on the quality of life of the sufferers.
Method: Cross sectional study of patients suffering from tinnitus.
Result: There were a total of 50 patients, 38 females and 12 males. The mean age of 39.4 (SD 18.56). 34 patients had tinnitus in both ears and 16 patients had tinnitus in one year only. The mean Tinnitus Handicap Inventory (THI) score was 40.79 (SD 7.80). Majority of the patients (42%) had moderate degree of severity in their tinnitus. Patients had higher scores in the functional and emotional domain 59.75% and 59.84% respectively.
Conclusion: The study contributes valuable insights into the various day to day activities where tinnitus has a negative impact causing a poorer quality of life.
Keywords: Key words: Quality of life in tinnitus, Tinnitus, Tinnitus Handicap Index

PREVALENCE OF EAR NOSE AND THROAT DISORDERS IN SCHOOL GOING CHILDRENOUR EXPERIENCE OF SCREENING CAMP IN FOUR GOVERNMENT SCHOOLS IN KATHMANDU

Dipendra Gautam — 2024-12-17

Background: This study was conducted to find out the prevalence of different types of ear nose and throat disorders in school going children of Kathmandu.
Method: The study was done over the period of two months on July and august 2022. Four government schools of Kathmandu were chosen for the study. Those schools were little far away from the core city area and were having relatively less health care services available. Students going to government school mostly were from poor family background especially in Kathmandu. All the students of those schools present on the day of examination underwent ENT screening check up by ENT surgeons and trained medical officers. Brief historywas recorded and findings were noted. Results were expressed in numbers and percentages.
Result: There were 5366 students taken for the study which included 48.5%( n=2610) male and 51.5%(n=2756) female. Mean age of the students was 9.23 years. 31.96% had ENT problems. The most common ear disorder was impacted earwax (17.89%), followed by chronic otitis media (2.14%), otitis media with effusion (1.64%) and acute pharyngitis (1.56 %).
Conclusion: ENT disorders specially ear diseases like impacted earwax, COM and OME were important health problems among school children of Kathmandu, Nepal. Regular school health services, screening program, public awareness, improvement of socioeconomic status can help reduce ENT disease burden and prevent hearing loss.
Keywords: Chronic otitis media, Hearing loss, Impacted earwax, Otitis media with effusion, Screening program

CORRELATION BETWEEN REFLUX SYMPTOM INDEX VERSUS REFLUX FINDING SCORE IN LARYNGOPHARYNGEAL REFLUX DISEASE

Reeba Karki — 2024-12-17

Objective: To evaluate the correlation between Reflux Symptom Index (RSI) Versus Reflux Finding Score (RFS) and to find the prevalence of hypothyroidism in laryngopharyngeal reflux disease
Methods: This is a prospective, analytical study conducted from February 2022 to August 2022 among 75 patients in department of otorhinolaryngology, Shree Birendra hospital, Chaunni. RSI questionnaire with 9 questions were filled by the patients on 5 points scale. A score of more than 13 was considered diagnostic of LPR. RFS consists of scores from 0-4 determined by fiber-optic nasal endoscopy findings. Score more than 7 indicated LPR. Prevalence of hypothyroidism in all patients was calculated by evaluating serum thyroid function test
Results: The reflux symptom index was more than 13 on 41 patients with mean 13.28 ±3.95 and reflux finding score was more than 7 on 23 patients with mean 6.43±3.19 with statistically significant but with low correlation between reflux symptom index and reflux finding score ( p=0.027, r=0.25). The prevalence of hypothyroidism in laryngopharyngeal reflux was similar to general population.
Conclusion: There was low correlation between reflux symptom index and reflux finding score in patient with laryngopharyngeal reflux. The prevalence of hypothyroidism in these patient was similar to the general population.
Keywords: Laryngopharyngeal reflux (LPR), Reflux symptom index (RSI), Reflux finding score (RFS), Hypothyroidism

WHICH IS BETTER- CONVENTIONAL NASAL PACKING VS INTRANASAL SPLINT IN SEPTOPLASTY?

Pushpendra Patel — 2024-12-17

Background: Septoplasty is a frequently performed rhinologic surgery. The surgery is followed by nasal packing or intranasal splinting. This study was done to compare these two procedures in terms of effectiveness, postoperative discomfort and complications.
Materials and methods: A prospective comparative study was done over a period of two years, 48 patients were included and alternatively selected for splint and nasal packing .Patients were compared on basis of postoperative discomfort in terms of nasal pain, headache, epiphora, cheek swelling, epistaxis, foreign body sensation in throat, complications like septal perforation, septal hematoma, synechiae etc. Data were collected and analysed statistically.
Results: Post operatively nasal pain, headache, epiphora, cheek swelling, hypoxic spell, foreign body sensation in the throat, epistaxis, synechia, septal perforation, and septal hematoma were found to be reduced in patients who underwent intranasal splint when compared with nasal packing, deeming it to be a superior choice as compared to nasal packing.
Conclusion: Intranasal splint reduces nasal packing related problems and post-operative complication, without significantly increasing the duration of surgery. Hence from our study, we have gathered enough evidence to state that intra nasal splint would be a better choice to intranasal pack in septoplasty considering the patient’s comfort and lesser postoperative complications.
Keywords: Intranasal splint, Nasal packing, Septoplasty