Clinicopathological profile of head and neck cancers in Army Hospital of Nepal: a retrospective study.

Introduction: Head and neck cancer is common in several parts of the world. It is sixth most prevalent neoplasms in the world. Approximately 900 000 cases diagnosed worldwide per year. It has good prognosis when timely diagnosed and treated appropriately. Methods: This was a retrospective study carried out in the Department of ENT-HNS of Shree Birendra Hospital, Chhauni, Kathmandu from May 2022 to April 2023. All histopathologically proven malignant cases of head and neck region were included in the study. Data were entered in Microsoft excel and managed in SPSS version 22. Analysis was done in the form of percentage and proportion and represented as table where necessary. The study has been registerd in clinical trials and has been reported in line with the STROCSS criteria. Results: Total 76 patients were analyzed. Age ranged from 17 to 84 years and the most common age group presenting with head and neck cancer was 61-80 years. The most common malignancy was laryngeal cancer (34%) followed by thyroid malignancies (29%). Squamous cell carcinoma was the commonest histological type (48%). Surgery with postoperative radiotherapy (RT)/radioactive iodine (RAI) was found to be the commonest treatment modality. Conclusions: Head and neck cancers are not uncommon and majority of patients present late with advanced stage cancer. Hence, public awareness, early diagnosis with cost-effective treatment and regular follow-up are needed to improve outcomes of these patients in our society.

A comparative study of endoscopic myringoplasty versus microscopic myringoplasty at tertiary care center.

BACKGROUND AND OBJECTIVES: Myringoplasty is a surgical procedure performed to repair tympanic membrane perforation which can be performed either using a microscope or an endoscope. The aim of this study is to compare the graft uptake, hearing outcome and operative time of endoscopic myringoplasty (EM) versus microscopic myringoplasty (MM) by underlay cartilage island graft technique. SUBJECTS AND METHODS: In this prospective comparative study of sixty patients divided into two equal groups with small to medium sized tympanic membrane perforation were included. Tragal cartilage was used as graft material. Both the groups underwent myringoplasty by underlay cartilage island graft using endoscope (n = 30) and microscope (n = 30). The study was conducted between February 2022 to May 2023 after taking ethical approval from IRC of Nepalese Army Institute of Health Sciences. All patients were followed up on 7th postoperative day (POD), 1 and 3 months after surgery. RESULTS: Graft uptake in was 90 % (27/30) in MM group and 93.33 % (28/30) in EM group. Mean operating time was more in MM group (66.46 ± 6.78min) than EM group (64.53 ± 6.6 min). The improvement in Air Bone Gap (ABG) was better in EM group (12.46 ± 6.58 dB) compared to MM group (10.9 ± 9.01 dB). The differences in graft uptake, operating time and improvement in ABG were not statistically significant. CONCLUSION: The study concludes that it does not matter which approach is used, good results are predictable and choice of the tool used is up to the individual surgeon.

Parotid Lymphangioma of adult: A case report.

Introduction: Lymphangioma is a malformation of the lymphatic system. It is a rare occurrence in adults. The exact etiology of the disease is unclear but it is expected to be either congenital or due to obstruction and retention of lymph in developing lymphatic vessels. Case Description: We report a case of Parotid Lymphangioma in a 35-year-old male who presented to ENT OPD with painless right infraauricular swelling for 1 year which was insidious in onset and progressive in nature. Investigation: FNAC of the right parotid lump, USG of the parotid and neck, CT scan, and MRI of the neck were done which demonstrated the lesion and helped in the diagnosis. Treatment: The lesion was surgically excised under general anesthesia. Outcome and Follow up: After the surgery, the patient was given IV antibiotics for 7 days and then discharged by prescribing Cefixime, Mupirocin, Pantop, Flexon, and eye drops. There was mouth deviation to the left side and incomplete closure of the right eye. However, the follow-up was uneventful with normal mouth and eye closure. Conclusion: Parotid Lymphangioma must be diagnosed and treated as early as possible as it may cause complications. Regular follow-up even after the treatment is recommended.

Sudden sensorineural hearing loss in a post-COVID-19 patient.

A detailed history and diagnostic evaluation for recent or past COVID-19 infection is vital in patients presenting with Sudden Sensorineural Hearing Loss (SSNHL) since SSNHL could be a sequelae of COVID-19 and timely diagnosis and intervention could significantly improve hearing and quality of life.