Bangladesh Journal of Otorhinolaryngology 2021-04-28T14:20:30+00:00 Dr. Ahmmad Taous Open Journal Systems Official journal of the Society of Otorhinolaryngologists &amp; Head Neck Surgeons of Bangladesh. <br />BJO is now accepting online submissions. Register with the journal to use the 5 step online submission process.<br />BJO is indexed in BanglaJOL, AsiaJOL, Hinari WHO, <a title="DOAJ" href="" target="_blank">DOAJ</a>, PRORCH. Medicolegal Issues in ENT Practice 2021-04-28T14:19:59+00:00 MA Matin <p>Abstract not available</p> <p>Bangladesh J Otorhinolaryngol; April 2021; <strong>27</strong>(1): 1-3</p> 2021-04-28T12:15:08+00:00 ##submission.copyrightStatement## Surgical Outcome and Quality of Life After Total Laryngectomy in Advanced Laryngeal Cancer- A Study in Combined Military Hospital, Dhaka 2021-04-28T14:20:01+00:00 Muhammad Ali Azad Belayat H Siddiquee AKM Asaduzzaman Faisal Bin Mohsin Mohammad Abul Hasnat <p><strong>Introduction: </strong>Total laryngectomy is the gold standard treatment for advanced laryngeal cancer. Sacrifice of voice is one of the most important shortcomings of the procedure. Possibility of achieving good quality voice is greater with prosthesis compared to other method. Post laryngectomy voice rehabilitation with prosthesis yield excellent outcome in most of the cases. Swallowing, pulmonary and olfactory rehabilitation should be managed by multidisciplinary team for better quality of life (QoL).</p> <p><strong>Objectives: </strong>The purpose of this study was to observe the outcomes of voice, swallowing pulmonary and olfactory rehabilitation and QoL following total laryngectomy.</p> <p><strong>Methods: </strong>This cross sectional retrospective clinical study was conducted at the Head &amp; Neck Oncology Unit, Combined Military Hospital (CMH), Dhaka. Total 57 candidates were selected. Diagnosis was done by thorough clinical examination, Fibre Optic Laryngoscopy. Contrast Enhanced Computed Tomography (CECT) scan of neck was done except few cases where MRI of neck was done for subtle cartilage erosion was suspected. Examination under anaesthesia, direct larangoscopy and biopsy was done for every cases. Candidates were post chemo-radiated/ radiated biopsy proven recurrent cases, clinically nonfunctional larynx with aspiration and radiologically evident of cartilage erosion. In all cases artificial voice prosthesis was used. All the laryngectomees underwent voice, swallowing, pulmonary and olfactory rehabilitation in laryngectomy club of head &amp; neck oncology unit, CMH Dhaka for a period of 3 months as per standard protocol.</p> <p><strong>Results: </strong>Among the 57 patients 42 of them are using voice prosthesis without any complications till to date. Voice rehabilitation started after wound healing &amp; developed meaningful voice in around 6 weeks. Satisfactory speech &amp; voice outcomes were observed near about 3 months. Voice quality was assessed by multivariate statistical analysis. Excellent voice was observed for 38 patients, good voice for 12 patients, fair voice for 05 patients and poor voice for 02 patients. Troubleshooting like mycotic infection developed in 6 patients which was managed by anti-fungal medication with regular appropriate cleaning, Pharyngocutaneous fistula developed in 5 patients, 3 healed later by pressure dressing and anticholinergic &amp; 1 required exploration and flap reconstruction, 01 developed recurrent stomal stenosis which managed surgically by Y-V advancement. Prosthesis expelled out in 3 cases. 02 cases developed dysphagia due to tonicity of pharyngoesophageal (PE) segment &amp; managed by botox injection. Significantly better voice &amp; swallowing were reported by patients undergone laryngectomy alone in comparison with patients receiving adjuvant radiotherapy &amp; patient undergoing salvage laryngectomy.</p> <p><strong>Conclusion: </strong>Awareness should be developed as sacrifice of voice box is no more a permanent comorbidity of total laryngectomy. Excellent voice can be developed by insertion of voice prosthesis as well as swallowing pulmonary and olfactory rehabilitation following laryngectomy for better of QoL.</p> <p>Bangladesh J Otorhinolaryngol; April 2021; <strong>27</strong>(1): 5-11</p> 2021-04-28T12:15:11+00:00 ##submission.copyrightStatement## Incidence of Thyroid Cancer in Thyroid Swelling, Study of 200 Cases 2021-04-28T14:20:05+00:00 MA Matin Mohammad Saiful Islam Md Abdur Razzak Mohosana Khanam Md Abdullah Al Harun Shahjahan Kabir AKM Saifuddin AKMA Sobhan <p><strong>Objective: </strong>The incidence of thyroid cancer has rapidly increased in the United States (US) and other developed countries over the past 30 years but there is no study to find out the true incidence of thyroid cancer in Bangladesh. The aim of this study is to compare FNAC with histopathology reports and to find out the true incidence of thyroid malignancy in thyroidectomy patients presenting with thyroid swelling.</p> <p><strong>Methods: </strong>This is a prospective study of 200 thyroid swelling patients underwent thyroid surgery done at Shaheed Suhrawardy Medical College Hospital, a tertiary Care Hospital in Dhaka from July 2017 to December 2020. FNAC and histopathology reports were studied to find out the incidence of benign and thyroid malignancy among the thyroid swelling.</p> <p><strong>Results: </strong>The age of the patients ranged from 8 to 75 years. The mean age was 37.2 years. There were 156 female and 44 male patients with female male ratio 3.54:1. Diagnostic categorization of 200 thyroid swelling underwent surgery, FNAC based on Bathesda classification showed that 163 (81.5%) cases were cytologically benign, 37 (18.5%) cases were malignant category. Out of 200 cases histopathology showed134 cases(67.0%) are benign and 66(33.0%) are malignant thyroid swelling. Among the benign lesions96.31% are colloid goiter and among the malignant lesions 93.4% are papillary thyroid carcinoma.</p> <p><strong>Conclusion: </strong>Although FNAC is an essential diagnostic test to rule out thyroid malignancy but histopathological examination is the only way to give true incidence of thyroid malignancy among the thyroid swelling and it is observed that there is high incidence of thyroid malignancy(33.0%) among the thyroid swelling patient underwent thyroid surgery.</p> <p>Bangladesh J Otorhinolaryngol; April 2021; <strong>27</strong>(1): 12-16</p> 2021-04-28T12:15:17+00:00 ##submission.copyrightStatement## Comparison between Conventional Microdissection and CO2 Laser in the Treatment of Vocal Cord Polyp 2021-04-28T14:20:09+00:00 - Mohammad Wahiduzzaman Sayed Farhan Ali Razib Afroja Hossain Md Idrish Ali Md Habibur Rahman HM Mustafizur Rahman <p><strong>Background: </strong>Vocal cord polyp usually arises from the epithelium and the lamina propria. Minimally invasive dissection procedures are employed to treat these vocal cord polyp for an effective outcome<strong>. </strong>Two types of microsurgical techniques were developed gradually and practiced namely, the conventional laryngeal microsurgery, which involves the use of cold instruments and the laryngeal laser micro-surgery.</p> <p><strong>Objective: </strong>To compare the conventional cold dissection and CO<sub>2</sub> laser methods in treatment of vocal cord polyp.</p> <p><strong>Methods: </strong>A randomized prospective study was conducted at the Department of Otolayngology- Head &amp; Neck Surgery, at Bangabondhu Sheikh Muzib Medical University (BSMMU) between July 2017 and June 2019. A total of 60 cases were studied on the following parameters: a. Visual analysis on stroboscopy b. Voice analysis –GRBAS (grade, roughness, breathiness, asthenia, strain) indices c. Duration of surgery d. Peroperative bleeding.</p> <p><strong>Results: </strong>During first postoperative assessment, both groups had the normal symmetrical waves, while 50% of cases still had aperiodicity but all patients had the near normal periodicity in the second postoperative assessment. Regarding glottic closure, during preoperative assessment, almost all patients had incomplete glottic closure due to mass lesion as polyps. During first postoperative assessment, glottic closure was found to be better in group B (83% of cases) than group A (76% of cases), while during second postoperative assessment, all patients of both groups had around 95% glottic closure. The mean duration oflaser technique (7.1 ± 1.1 minutes) was less than the conventional technique time (15.6 ± 1.9 minutes), also mean of operative bleeding of laser technique (zero pack) is less than the conventional two(2 packs).</p> <p><strong>Conclusion: </strong>There is no significant difference between both groups in all parameters except operative time and bleeding, as laser technique has less time and clear field.</p> <p>Bangladesh J Otorhinolaryngol; April 2021; <strong>27</strong>(1): 17-24</p> 2021-04-28T12:15:24+00:00 ##submission.copyrightStatement## Relationship between Thickness of Early Oral Tongue Carcinoma (T1, T2) with Cervical Lymph Node Metastasis 2021-04-28T14:20:11+00:00 Md Abdur Razzak Belayat Hossain Siddique Azharul Islam Md Hasanul Haque Md Abdus Sattar Sayed Farhan Ali Razib Effat Zahan Abdullah Arif Mahmud Jewel Md Jaber Al Sayied - Md Quamruzzaman <p><strong>Background</strong>: Carcinoma of oral tongue is the most common oral cancer and because of its structure and function is prone for early local and regional spread of cancer. The final outcome of a primary tongue carcinoma patient depends upon various prognostic factors like thickness of tumor, depth of invasion, size of lesion and neck node 67metastasis. Risk of metastasis and spread to neck nodes increases with increase in tumor thickness</p> <p><strong>Methods</strong>: This prospective observational study was carried out in the Department of Otolayngology- Head &amp; Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka for 18 months. Thirty patients with early oral tongue carcinoma i.e.T1 &amp; T<sub>2</sub> as per UICC and AJC criteria were included in this study by purposive non-randomized sampling technique. Result of the study were expressed as mean, standard deviation (+SD), frequency and percentages. Unpaired Student’s t-test and Pearson’s correlation co-efficient (r) test were performed.</p> <p><strong>Results</strong>: Result of the study showed the mean (+SD) thickness of the tumor was 3.62 (+1.46) mm. Minimum thickness 1.1mm and maximum thickness 7.8mm. Only 21 (70%) subjects neck node were metastasized from tongue and mean (+SD) tumor thickness of the positive neck node metastasis was 5.54 (+1.07) mm and negative neck node metastasis was 2.87 (+0.75) mm. This indicated a significant difference between the groups. Pearson’s correlation co-efficient r (+0.981) which indicated tumor thickness was positively correlated with neck node metastasis.</p> <p><strong>Conclusion: </strong>Tumor thickness of the early oral carcinoma positively correlated with neck node metastasis. Correlation between thickness and metastatic lymph node can help planning the treatment regimen and indicate the disease prognosis.</p> <p>Bangladesh J Otorhinolaryngol; April 2021; <strong>27</strong>(1): 25-35</p> 2021-04-28T13:25:55+00:00 ##submission.copyrightStatement## Correlation of Ultrasonography Guided Fine Needle Aspiration Cytology with Postoperative Histopathology in Diagnosis of Thyroid Nodule 2021-04-28T14:20:14+00:00 Md Jaber Al Sayied A Allam Choudhury Sonia Jahan Bithi Ashim Kumar Biswas Riashat Azim Majumder Md Abdur Razzak Md Hasanul Haque - Md Quamruzzaman <p><strong>Background</strong>: Fine-needle aspiration cytology (FNAC) is recommended as a decisive diagnostic step in the workup of patients with nodular thyroid disease. Unfortunately, FNAC can miss malignancies in smaller and deeper nodule. Ultrasound guided FNAC (US-FNAC) can reduce this error in suspicious thyroid nodule.</p> <p><strong>Objectives: </strong>To find out the correlation of USG guided FNAC with postoperative histopathology in diagnosis of thyroid nodule.</p> <p><strong>Methods: </strong>After obtaining clearance and approval from Institutional Review Board, all 45 patients of thyroid nodule who were admitted in the Department of Otolaryngology – Head &amp; Neck surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from April 2017 to August 2018 and had fulfilled the inclusion and exclusion criteria were selected for the study. Each patient was assessed before surgery by USG guided FNAC and post operatively by histopathology.</p> <p><strong>Results: </strong>In this study mean age of the respondents was 33.33 yearswith SD±10.84. Male female ration was 1:5.4. USG guided FNAC was reported by ‘The Bethesda System for Reporting Thyroid Cytopathology’ (TBS-RTC).Of the 45 specimens 2 samples were nondiagnostic or unsatisfactory (Class I), 26 samples were benign (Class II), 2 samples were showing Atypia of Undetermined Significance or Follicular lesion of Undetermined Significance (Class III), 6 were showing follicular neoplasm or suspicious for a follicular neoplasm (Class IV), 5 samples were suspicious for malignancy (Class V) and 4 samples were positive for malignancy (Class VI). On comparison of ultrasound guided FNAC with histopathology the sensitivity for correct diagnosis was 94%, specificity was 93%, positive predictive value was 88%, negative predictive value was 96% and accuracy was 93%. Pearson’s correlation coefficient was 0.85 which is very strong for positive relationship.</p> <p><strong>Conclusion: </strong>USG guided FNAC is the most accurate method for diagnostic evaluation of thyroid nodules.</p> <p>Bangladesh J Otorhinolaryngol; April 2021; <strong>27</strong>(1): 36-43</p> 2021-04-28T13:26:06+00:00 ##submission.copyrightStatement## Parathyroid Adenoma: an experience in BIRDEM General Hospital 2021-04-28T14:20:16+00:00 Shawhely Mahbub Sudhangshu Shekhar Biswas Badhon Kumar Dey Md Shariful Alam Jahirul Hoq <p><strong>Background: </strong>Parathyroid adenoma is most commonly associated with primary hyperparathyroidism which leads to hypercalcaemia. Hypercalcaemia results in multiple stone formation in Kidney and biliary tract which indicates surgical removal of tumor. Perioperative management of patient is essential to prevent mortality and morbidity. The purpose of this study is to analyze a case series of patient having parathyroid adenoma with difficulties, to localize the adenoma and to take the measures to maintain the normal level of calcium in pre, per and postoperative period.</p> <p><strong>Methods: </strong>This retrospective study was carried out in BIRDEM General Hospital and Ibrahim Medical College from May 2017 to December 2019. 14 patients who were diagnosed as primary hyperparathyroidism due to parathyroid adenoma who had been managed at the BIRDEM General Hospital, Dhaka, Bangladesh from May 2017 to December 2019 were reviewed and included.</p> <p><strong>Result: </strong>Among 14 patients 8 were female and 6 male (M: F=3:4). Age ranges from 26 to 71 years with mean age was 52 years. Serum PTH were above normal (&gt;65 pg/ml) in all cases. Serum calcium level were above normal in 12 cases (85.71 %) and 2 (14.29%) had normal levels. Serum phosphate levels were within normal range. Excision of adenoma done in all cases which were confirmed by frozen section per-operatively. None of our patients develop any complication during and after surgery</p> <p><strong>Conclusion: </strong>Successful management of parathyroid adenoma requires combined skills of surgeons, endocrinologists, anesthesiologists and pathologists. Improvement after operation is quite remarkable and rewarding.</p> <p>Bangladesh J Otorhinolaryngol; April 2021; <strong>27</strong>(1): 44-51</p> 2021-04-28T13:26:13+00:00 ##submission.copyrightStatement## Quality of Life Assessment after Canal Wall Down Mastoidectomy: Our Experiences in Shaheed Ziaur Rahman Medical College Hospital, Bogura 2021-04-28T14:20:18+00:00 Md Khorsed Alam - Md Saiduzzaman Md Asadur Rahman Syed Sanaul Islam Mohammad Anisur Rahman Kanchan Kumar Sarker <p><strong>Objective: </strong>To determine subjective outcomes after cholesteatoma surgery.</p> <p><strong>Design: </strong>Cross sectional observational study</p> <p><strong>Methods: </strong>Study place: Shaheed Ziaur Rahman Medical college Hospital (SZMCH), Bogura, Bangladesh</p> <p><strong>Study population: </strong>Chronic otitis media (COM) with extensive cholesteatoma. <strong>Interventions: </strong>Canal wall down mastoidectomy for cholesteatoma.</p> <p><strong>Main Outcome Measures: </strong>In this study, the Chronic Ear Survey (CES) was provided to all patients preoperatively and one year after surgery. The preoperative and postoperative score differences were analyzed. We also assessed correlations between chronic ear survey scores and air conduction threshold.</p> <p><strong>Results: </strong>Seventy six patients were enrolled in our study &amp; marked improvements were found in total CES score &amp; all subscale scores postoperatively (P value: 0.00). The total CES score and symptom subscale scores were observed greater improvement (P value: 0.00).Significant negative linear correlations were observed among total CES scores, symptom subscale scores and air conduction thresholds (P&lt;.05).</p> <p><strong>Conclusion: </strong>The present study suggests that canal wall down mastoidectomy (CWDM) provides a significant improvement in the post-operative Quality of life (QoL) &amp;b there is a significant association between subjective outcomes &amp;the objective audiometric results.</p> <p>Bangladesh J Otorhinolaryngol; April 2021; <strong>27</strong>(1): 52-58</p> 2021-04-28T13:26:21+00:00 ##submission.copyrightStatement## Complications of Parotid surgery: A study in 60 cases 2021-04-28T14:20:20+00:00 Kazi Atikuzzaman Mushfiqur Rahman Naseem Yasmeen <p><strong>Objective: </strong>To evaluate the common complications following parotid surgery.</p> <p><strong>Material &amp; methods: </strong>A retrospective study was done from January 2011 to December 2019 in the Department of ENT &amp; Head Neck Surgery, Enam Medical College &amp; hospital, Savar. Sixty (60) patients with both benign &amp; 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 &amp; postoperative complications were evaluated.</p> <p><strong>Results: </strong>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%) &amp; wound infection (3.33%).</p> <p><strong>Conclusion: </strong>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.</p> <p>Bangladesh J Otorhinolaryngol; April 2021; <strong>27</strong>(1): 59-65</p> 2021-04-28T14:14:41+00:00 ##submission.copyrightStatement## Surgical Outcome of Parapharyngeal Tumour 2021-04-28T14:20:22+00:00 Kazi Shameemus Salam Samia Quadir Md Momin Uddin Syed Farhan Ali Razib Md Abdus Sattar Md Mosleh Uddin Belayat Hossain Siddiquee <p><strong>Background: </strong>Parapharyngeal tumours are rare accounting for 0.5-1.5% of all head neck tumuors. The anatomy of the Parapharyngeal space (PPS) is responsible for a wide variety of tumours arising from PPS.</p> <p><strong>Objective: </strong>Evaluation of the strategy for parapharyngeal tumor surgery based on preoperative symptoms, clinical signs, imaging investigations and histopathology.</p> <p><strong>Methodology: </strong>This retrospective study was carried out in the Department of Otolaryngology and Head Neck surgery in Bangabandhu Sheikh Mujib Medical University (BSMMU) included 32 patients were underwent surgery for primary parapharyngeal tumors between January 2018 and December 2019. Informed written consent was obtained from the patients prior to their inclusion in the study. In regard to histologic type there were 21 cases salivary gland origin tumors and 11 of neurogenic tumors. The following data were evaluated preoperative symptoms, histological type, surgical approach and complications patients were evaluated following a laboratory investigations.</p> <p><strong>Results: </strong>The most common symptoms of these tumors were a neck swelling. Total of 18 tumors were located in the prestyloid and poststyloid space cases were located 10(31.25%) and 4(12.50%) in the pre and poststyloid. Majority 12(37.50%) was found pleomorphic adenomaof deep lobe of parotid gland followed by 6(18.75%) were schwannoma,4(12.50%) were neurofibroma, 3(9.38%) were ectopic salivary gland tumor,2(6.25%) were mucoepidermoid carcinoma, 2(6.25%) were adenocarcinoma. First bite syndrome and lower lip palsy were common post operative complications. Transcervical approach was the most often performed approach in this study (56.25%).</p> <p><strong>Conclusion: </strong>Parapharyngeal tumours most often derived from parotid gland. Most of them are non-malignant. Pleomorphic adenoma is the more common. Surgical resection being the main stay of treatment. Tumours of this complex anatomy call for careful preoperative planning and great skill for selecting the right approach and for management with minimal morbidity and recurrence.</p> <p>Bangladesh J Otorhinolaryngol; April 2021; <strong>27</strong>(1): 66-72</p> 2021-04-28T14:14:48+00:00 ##submission.copyrightStatement## Effects of Enlarged Adenoids on Middle Ear Pressure and Hearing 2021-04-28T14:20:25+00:00 Md Noor Kutubul Alam SM Nazmul Huque ABM Delowar Hossain Kazi Atikuzzaman Mohammad Jamal Hussain Mostafa Kamal Arefin <p><strong>Background: </strong>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.</p> <p><strong>Objective: </strong>To observe middle ear pressure and level of hearing in children with enlarged adenoids.</p> <p><strong>Methods: </strong>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.</p> <p><strong>Results: </strong>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.</p> <p><strong>Conclusion</strong>: This study revealed significant association between enlarged adenoids and conductive hearing loss of variable degree and negative middle ear pressure.</p> <p>Bangladesh J Otorhinolaryngol; April 2021; <strong>27</strong>(1): 73-80</p> 2021-04-28T14:14:56+00:00 ##submission.copyrightStatement## Correlation between FNAC and Histopathology in the Diagnosis of Thyroid Lesions 2021-04-28T14:20:27+00:00 Md Nazmul Haque Mahmudul Amin Sakik Mohammad Ashequr Rahman Bhuiyan Moshammat Fatima Akhter Saif Rahman Khan Mohammad Zakaria Sarker Md Abul Hossain <p><strong>Objective: </strong>To observe the correlation between fine needle aspiration cytology (FNAC) and Histopathology in the diagnosis of thyroid lesions.</p> <p><strong>Methods:</strong>It was a Retrospective record review study .One hundred four (104) Patients with enlarged thyroid gland of both sexes were selected from admitted patients of National institute of ENT, Tejgaon, Dhaka, Duration was from January 2017 to December 2018. Every patients had preoperative FNAC &amp; postoperative histopathology report of thyroid lesions.</p> <p><strong>Results</strong>: FNACdiagnosis of thyroid lesions were correlated with histopathology diagnosis. Out of 104 patients 26 were male 78 were female. Male-Female ratio were 1:3.out of 104 patients most Patients were 31 to 40 years of ageGroup.out of 104 cases of FNAC 9 cases were false Cyto-diagnosis. Overall accuracy rate was 91.35%.</p> <p><strong>Conclusion</strong>: FNAC is a reliable, safe and relatively accurate method as apreoperative evaluationin thyroid gland swelling before surgery. FNAC has more accuracy in detecting thyroid gland malignancy and therefore it is a reliable diagnostic test for evaluation of thyroid swelling.</p> <p>Bangladesh J Otorhinolaryngol; April 2021; <strong>27</strong>(1): 81-85</p> 2021-04-28T14:15:02+00:00 ##submission.copyrightStatement## Outcome of Interlay Type 1 Tympanoplasty for Large Central Perforation 2021-04-28T14:20:29+00:00 Md Mahmudul Huq SM Mostofa Qaiyoum Md Saifullah Ibne Mannan - Md Kamruzzaman <p><strong>Background: </strong>Perforation of the tympanic membrane may occur from various reasons. Most of these perforations heal spontaneously, whereas the remaining long-standing perforations that lead to recurrent ear discharge need tympanoplasty. Interlay Type 1 Tympanoplasty,a newer technique has shown promising results with higher success ratein terms of hearing gain and graft uptake.</p> <p><strong>Objective: </strong>To analyze the results of interlay Type 1 Tympanoplasty in terms of graft uptake and hearing improvement in cases of inactive mucosal chronic otitis media (COM) with large central perforation.</p> <p><strong>Methods</strong>: This is a prospective study of 24 months (January 2018 to December 2019) duration conducted in department of E.N.T, Khulna medical college, Khulna and data was collected from the 60 patients admitted for tympanoplasty. Results were calculated in terms of graft accepted or rejected and decrease in air bone gap.</p> <p><strong>Result: </strong>The graft uptake rate in the present study was found to be 91.67% and the patients reported an improvement in terms of hearing. Pre operatively mean air bone gap was 26.5dBand post operatively after 12 weeks mean air bone gap improved to 17.58dB.</p> <p><strong>Conclusion: </strong>Interlay Type 1 Tympanoplasty is an effective technique over conventional methods in terms of both graft uptake as well as hearing improvement in large central perforation.</p> <p>Bangladesh J Otorhinolaryngol; April 2021; <strong>27</strong>(1): 86-91</p> 2021-04-28T14:15:09+00:00 ##submission.copyrightStatement## A Diagnostic Dilemma of Lateral Neck Cyst: A Lesson Learnt 2021-04-28T14:20:03+00:00 Dayang Anis Asyikin Ahmad Nazari Mohamad Khir Abdullah Noorizan Yahya Siti Halimahtun Sahab Loo Lit Yee Mohd Razif Bin Mohamad Yunus <p>Large cystic mass is an unusual presentation of papillary thyroid carcinoma, accounting for less than 10% of cases. To make a diagnosis of papillary thyroid carcinoma is challenging since the tumour can mimic a benign lateral neck mass. Therefore, a systematical approach to a patient with neck lump is required so that accurate diagnosis and appropriate treatment can be made. We present a case of a 25-year-old female presenting with an asymptomatic left neck cystic mass diagnosed as a metastatic lymph node of papillary thyroid carcinoma only after surgery.</p> <p>Bangladesh J Otorhinolaryngol; April 2021; <strong>27</strong>(1): 92-95</p> 2021-04-28T14:15:15+00:00 ##submission.copyrightStatement## Congenital Cholesteatoma in Adult: Is it Still Possible? 2021-04-28T14:20:07+00:00 Heng Yao Tan Anuar Idwan Idris Cheng Ai Ong Asma A <p>Congenital cholesteatoma is a mass of squamous epithelium located medial to an intact tympanic membrane without previous history of tympanic membrane perforation, otorrhoea or otological surgery. We described a 24 year old gentleman with a left postauricular discharging fistula for 3 years with recent history of gradual hearing loss, tinnitus and recurrent episodes of positional vertigo. Clinical examination noted left postauricular fistula opening and otoscopy showed a whitish mass medial to a bulging intact tympanic membrane. High-resolution computed tomography of temporal bone was suggestive of cholesteatoma. Left modified radical mastoidectomy was done and he recovered with resolution of symptoms.</p> <p>Bangladesh J Otorhinolaryngol; April 2021; <strong>27</strong>(1): 96-99</p> 2021-04-28T14:15:21+00:00 ##submission.copyrightStatement##