Nepalese Journal of ENT Head & Neck Surgery

Journey ahead as editorial team to strengthen our publication

2026-07-27T07:25:26+00:00

Evaluation of Olfactory Fossa Depth: Our Institutional Experience

2026-07-27T07:43:55+00:00

Aims and Objectives: The objective of the study is to find the depth of the olfactory fossa in Nepalese population.
Methods: It is a retrospective study carried at department of Otolaryngology and Head & Neck Surgery at a tertiary hospital. The clinical case records of all the patients who have undergone CT imaging of paranasal sinuses (PNS) from 1 February to 25 September 2024 were taken from the CT archives of radiology department. The depth of the Olfactory fossa was measured on coronal CT images according to Keros classification, based on the vertical height of the lateral lamella of the cribriform plate.
Results: The total number of CT scans studied were 87 out of which 50 were males and 37 were females. The mean length of the olfactory fossa on the right side was 3.74+1.41mm and on the left side was 3.30+1.34 mm. The maximum depth of olfactory fossa was 7.39 mm which was on the right side. Our study shows Keros type I was the commonest (65.5%) followed by Keros type II (35.5%) and there were no Keros type III.
Conclusion: The majority of Olfactory fossa depth in our study fall in Keros type I category(0-4mm). There was a significant difference in the depth of the two sides where the right side was longer than the left side. (p value =0.015)
Keywords: Keros type, Lateral lamella cribriform plate, Olfactory fossa depth

Knowledge, Attitude, and Practice of Self-Medication for Sore Throat Among Medical Students of Nepalgunj Medical College, Banke, Nepal

2026-07-30T03:07:21+00:00

Aims and Objectives: Self-medication for minor problems like sore throat is very common, especially among medical students who can easily get medicines and have basic medical knowledge. Although it may show confidence in their own judgment, using medicines without proper guidance can cause problems such as antibiotic resistance and masking of serious illnesses. To assess the knowledge, attitude, and practice (KAP) of self-medication for sore throat among undergraduate medical students of Nepalgunj Medical College, Banke, Nepal.

Methods: A cross-sectional study was conducted from 1^st May 2018 to 30^th April 2019 among 263 MBBS students using a structured, self-administered questionnaire. The tool consisted of 30 items divided into three sections: knowledge (10), attitude (10), and practice (10). Data were analyzed using descriptive statistics and chi-square tests.

Results: Among 263 respondents, 150 (57.0%) were male and 113 (42.9%) female with a mean age of 21.9 ± 1.8 years. Overall, 74.5% had good knowledge, 47.5% showed a positive attitude toward rational self-medication, and 37.2% had appropriate practices for sore throat. The most commonly used drugs were paracetamol (69.9%), antihistamines (53.8%) NSAIDS and Paracetamol combination (39.3%), Antibiotics (34.9%) and Menthol (31.5%). Major reasons for self-medication were mild symptoms (63.5%), feeling of sufficient knowledge (7.7%). and previous experience of relief (7.7%). There was a positive correlation between all three domains of competency, however only knowledge and attitude have significant correlation. (p<0.03)

Conclusion: Most medical students at Nepalgunj Medical College possessed good knowledge and a positive attitude toward responsible self-medication. However, inappropriate practice of self-medication and especially antibiotic use is a concern.

Keywords: KAP study, Self-medication, Sore throat,

Hearing Outcomes Following Type III Major Columella Tympanoplasty in Cholesteatoma Surgery

2026-07-30T03:15:02+00:00

Aims and Objectives: Chronic otitis media with cholesteatoma is a significant cause of hearing impairment. It is surgically treated by modified radical mastoidectomy. In patients with absent stapes suprastructure, type III major columella tympanoplasty can be performed. The aim of this study was to assess post-operative hearing outcomes after type-III major columella tympanoplasty in patients undergoing modified radical mastoidectomy.

Methods: This prospective, analytical study was conducted in the Department of ENT–Head & Neck Surgery, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Kathmandu, Nepal, over an 18-month period from March 2023 to August 2024 after an ethical approval. Twenty-seven patients aged over 14 years with diagnosis of chronic otitis media with cholesteatoma who underwent modified radical mastoidectomy with type III major columella tympanoplasty were included in the study. Pre-operative and three-month post-operative pure tone audiograms (Air conduction Threshold and Air Bone Gap) were analyzed. The paired-t test was used for normally distributed data, and Wilcoxon’s signed-rank test for data which weren’t normally distributed.

Results: The mean pre-operative air conduction threshold was 48.11 dB, and at three months post-operatively, it was 46.60 dB. The mean hearing gain was 1.51 dB which was not statistically significant (p=0.395). The mean air–bone gap decreased from 31.87 dB pre-operatively to 31.15 dB post-operatively, without statistically significant difference (p = 0.68).

Conclusion: The hearing outcomes at three months post-operative period was not significantly better than that in the pre-operative period, following modified radical mastoidectomy with type III major columella tympanoplasty.

Keywords: Cholesteatoma, Hearing, Modified Radical Mastoidectomy, Otitis media, Tympanoplasty

Developing a Nepali Version of the Dysphagia Handicap Index: Translation and Validation Study

2025-12-09T07:16:54+00:00

Aims and Objectives: Dysphagia affects multiple aspects of daily functioning, highlighting the need for valid patient-reported outcome tools. The Dysphagia Handicap Index (DHI) is used globally as a standard tool, but no validated Nepali version exists. This study aimed to translate, culturally adapt, and validate the DHI for use within the Nepali-speaking population.

Methods: Standard method of translation-back-translation was utilized where English version of DHI was translated and customized by four professors with degree in Nepali language. Later it was administered on 20 native literate Nepali speakers whose first language was Nepali for content validity. The final translated version DHI was administered on 100 individuals. The data was analyzed using SPSS version 20.

Results: The scale demonstrated excellent internal consistency, with a Cronbach’s α of 0.976 and McDonald’s ω of 0.977, indicating high reliability across all items. The inter-item correlation coefficients predominantly ranged from 0.50 to 0.85, reflecting moderate to strong positive correlations among items.

Conclusion: Overall, the scale shows strong psychometric performance, comparable to international DHI versions. Its high reliability and coherent item structure confirm its robustness. These findings support its use in clinical assessment and dysphagia research.

Keywords: Dysphagia, Deglutology, DHI, Handicap, Nepali

Extranodal Natural Killer/T-Cell Lymphoma presenting with Recurrent Nasal Vestibulitis: A Case Report

2025-01-16T16:52:40+00:00

Extranodal NK/T-cell lymphoma, nasal type is a rare lymphoid neoplasm, which is aggressive non-Hodgkin’s type, grouped with a variety of granulomatous diseases in the past. It commonly involves the sinonasal tract leading to destruction of the midline structures of face. Its histological diagnosis can be difficult because of extensive tissue necrosis and has an ominous prognosis.This case report is of a middle-aged woman who presented with recurrent right nasal vestibulitis, mimicking as nasal granulomatosis. Immunohistochemistry confirmed that it was ENKL of nasal cavity. She attained complete remission with L-asparaginase, vincristine, prednisolone regimen with sandwiched radiotherapy. The vague presentation is one of the causes of delayed diagnosis for this type of condition. Radiological imaging along with histopathological examination with immunohistochemistry is essential for early diagnosis.

Keywords: Extra-nodal NK/T-cell lymphoma, Epstein-Barr virus, LVP regimen, recurrent nasal vestibulitis

IgG4-Related Disease Causing Subglottic Stenosis

2026-05-23T06:31:25+00:00

Immunoglobulin G4-related disease is a fibro-inflammatory condition rarely involving the laryngotracheal tract. We present a 55-year-old female with progressive dyspnoea and voice change, with findings of subglottic stenosis, diagnosed as Immunoglobulin G4-related disease. This case highlights the importance of having a high index of suspicion in the diagnosis of the condition.

Keywords: Airway Obstruction, Immunoglobulin G4-Related Disease, Laryngeal Stenosis, Tracheal Stenosis