Bangladesh Journal of Otorhinolaryngology 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. Society of Otolaryngologists and Head Neck Surgeons of Bangladesh en-US Bangladesh Journal of Otorhinolaryngology 1728-8835 <p>Manuscripts submitted for publication in the Bangladesh Journal of Otorhinolaryngology must not have been previously submitted or published. Accepted papers become the permanent property of the Bangladesh Journal of Otorhinolaryngology. By submitting a manuscript, the authors(s) agree that copyrights for their articles are automatically transferred to Bangladesh Journal of Otorhinolaryngology, if and when the articles are accepted for publication.</p> <p>The use, in this journal, of registered trade names, trade marks, etc. without special acknowledgement does not imply that such names, as defined by the relevant protection laws, be regarded as unprotected, and, thus, free for general use.</p> <p>Authors who publish with this journal agree to the following terms:</p> <p> </p> <p>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</p> <p>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</p> <p>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).</p> Narrow band imaging (NBI) in ENT <p>Abstract not available</p><p>Bangladesh J Otorhinolaryngol; October 2015; <strong>21</strong>(2): 60-61</p> Khabiruddin Ahmed ##submission.copyrightStatement## 2016-05-07 2016-05-07 21 2 60 61 10.3329/bjo.v21i2.27640 Correlation of Enlarged Adenoids with conductive hearing impairment in children under twelve <p><strong>Objective: </strong>To find out the relation of conductive hearing loss in children with enlarged adenoids.</p><p><strong>Methods: </strong>Study was conducted in out patients department and Indoor wards of the Department of Otolaryngology on Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka during the periods of October 2005 to March 2006. 60 patients with enlarged amides were included in this study. The assessment of the patients were established on the basic of history clinical, 2 and audiological examination was done. Data were collected and analyzed using statistical package for Social Science.</p><p><strong>Results: </strong>In this study 60 patients (from 3 years to 12 years age) diagnosed as having ‘enlarged adenoids’ in the Otolaryngology and Head-Neck Surgery out patient and in patient Departments of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from May 2005 to March 2006 are included in this series. Most of the patients presented with multiple symptoms, the commonest was the hearing impairment (58.33%). Other common symptoms were mouth breathing (50.00%), Nasal obstruction (50.00%), snoring (46.67%). Majority of them were male (62.85%) and 53.33% were in the 5-10 years age group. Middle class family occupy the lion share (58.33%). 60.00% patients live in a overcrowded condition. 50.00% patients were found with gross enlargement of adenoids. Hearing impairment was found in 58.33% ears of-patients of adenoids. Reduced middle ear pressure and compliance were found in 64.00% ears. Among the patients of enlarged adenoids otitis media with effusion was found in 58.33% (35) of patients. Among the patients of OME majority was male (62.85%). There was 77.14% (27) bilateral and 22.85% (8) unilateral cases. On otoscopy of OME patients, all patients had retraction of tympanic membrane, cone of lights were distorted in 50.00%, fluidlevels in 68.57% and bubbles were in 28.57% of ears. 71.43% OME patients had hearing loss in the range of 26-40 dB. Middle ear pressure and compliance were found reduced in 88.57% (62) ears of OME patients. There were 58.33% incidence of OME among enlarged adenoids cases. All the patients of OME with enlarged adenoids had a hearing loss between 26-55dB. Out of the 22 OME cases with gross adenoids, 16 had a middle ear pressure between -201 to-300 mm of H20 and 19 had a middle ear pressure between -101 to -200 mm of H20. On myringotomy fluid came out from all 62 (100%) ears. From majority (38) ears serous type of fluid came out.</p><p><strong>Conclusion: </strong>This is an endeavor to find out a correlation of enlarged adenoids with conductive hearing impairment in children. Otitis media with effusion is suspected in all children suffering from enlarged adenoids. All together 60 patients with enlarged adenoids were included in the study. Result of this study may not be the actual picture of overall situation due to many limitations is this study. Still it can be concluded that enlarged adenoids has a definite role in causing OME and conductive hearing impairment. So early diagnosis and treatment of enlarged adenoids can be encouraged to decrease the actual incidence, morbidity and complications of otitis media with effusion and thus conductive hearing impairment in childhood.</p><p>Bangladesh J Otorhinolaryngol; October 2015; <strong>21</strong>(2): 62-68</p> SM Sarwar Masroor Rahman Mohammad Idrish Ali Md Morshed Alam Md Anwar Hossain Narayan Prosad Sanyal ##submission.copyrightStatement## 2016-05-07 2016-05-07 21 2 62 68 10.3329/bjo.v21i2.27641 Comparative study on complications of emergency and elective tracheostomy <p><strong>Background: </strong>Both elective and emergency tracheostomy as life saving procedure is frequently performed. Tracheostomy can be associated with numerous (per operative and post operative) complications.</p><p><strong>Methods: </strong>this was a cross sectional study 120 patients were studied age ranged from 9 years to 79 years in four different tertiary hospitals in Dhaka from July 2011 to June 2013.</p><p><strong>Results: </strong>Among 120 tracheostomized patients, 75 (62.5%) were patients of emergency tracheostomy group and 45 (37.5%) were patients of elective tracheostomy group. Laryngeal carcinoma and other head-neck malignancy were the common (67.34%) indications for emergency tracheostomy. Maxillofacial and laryngeal surgery (50.1%) was the common indications for elective tracheostomy. Haemmorage was the most common complication. The second most common complication were subcutaneous surgical emphysema and wound infection , Then tube displacement, pericondritis and stomal stenosis/ granulation tissue formation were the complications . In all stages (peroperative, immediate postoperative, early postoperative and late postoperative), the frequency of complications was more in emergency tracheostomy and it was statistically significant (p&lt;0.05).</p><p><strong>Conclusion: </strong>Complications are more in emergency than elective tracheostomy. To reduce complications should be aim of all types of tracheostomy</p><p>Bangladesh J Otorhinolaryngol; October 2015; <strong>21</strong>(2): 69-75</p> Md Harun Or Rashid Ahmmad Taous ##submission.copyrightStatement## 2016-05-07 2016-05-07 21 2 69 75 10.3329/bjo.v21i2.27642 Endoscopic management of congenital choanal atresia: Second look is mandatory <p>Congenital choanal atresia (CA) is a rare abnormality characterized by unilateral or bilateral obstruction of the posterior end of the nasal cavity. With an incidence of 1:1000 to 1:8000 births, it is more in female than in males and unilateral more common than bilateral. Surgical procedures aim to provide adequate functional choanal patency and a low rate of rest enosis, with shorter surgery and hospitalization times, to minimize morbidity and mortality, this study done to evaluate the effectiveness and safety of endoscopic nasal surgical techniques for the treatment of congenital choanal atresia in patients with unilateral and bilateral atresia and to emphasis in the important of second look procedure at the time of removal of stent to assess the wideness of neochoana, and to remove any granulation tissue ,or polyps, it involved 13 patients, 10 with unilateral CA and 3 bilateral CA, all involved in surgery and second look.</p><p>Bangladesh J Otorhinolaryngol; October 2015; <strong>21</strong>(2): 76-79</p> Ali Maeed S Al Shehri ##submission.copyrightStatement## 2016-05-07 2016-05-07 21 2 76 79 10.3329/bjo.v21i2.27643 Study on Hearing Status of Elderly Patients attending a Specialized ENT Hospital (SAHIC) <p><strong>Background: </strong>Age related hearing loss is a natural process in elderly population all over the world.</p><p><strong>Objectives</strong>: To determine the hearing level of elderly patients in relation to age, sex, socioeconomic condition and to determine the pattern and extent of hearing loss in old age.</p><p><strong>Method: </strong>This cross sectional study was carried out at out patient department of Specialized ENT Hospital of SAHIC, Mohakhali, Dhaka, from October 2012 to March 2013. 200 patients were included with age &gt; 50 years and who have no past history of drug therapy. Data were collected by detailed history, clinical examination and audiometric findings and result were expressed in table form.</p><p><strong>Result: </strong>57% patients were found with normal hearing and 43% had variable degree of hearing impairment. Highest number of hearing impairment was found in 9th decade. Most of hearing loss were found to be bilateral and sensorineural in type.</p><p><strong>Conclusion</strong>: A good number of elderly people in our country is suffering from some degree of hearing loss, which are mostly sensorineural in type. The prevalence and severity of hearing loss increases with increasing age.</p><p>Bangladesh J Otorhinolaryngol; October 2015; <strong>21</strong>(2): 80-84</p> Mohammad Wakilur Rahman Ali Imam Ahasan Timir Kumar Debnath Abul Naser Md Jamil Raju Barua M Nurul Amin ##submission.copyrightStatement## 2016-05-07 2016-05-07 21 2 80 84 10.3329/bjo.v21i2.27644 Clinicopathological Study on Hypopharyngeal Carcinoma in Dhaka Medical College Hospital <p>A Cross-Sectional Study was carried out from July 2006 to June 2007 at Department of Otolaryngology and Head-Neck Surgery of Dhaka Medical College Hospital, Dhaka. Data was collected from 150 patients with histologically diagnosed Hypopharyngeal carcinoma. Results of this study showed that hypopharyngeal carcinoma affects more in fifth (36.7%) and sixth (27.4%) decades of life. It was found that male were highly predominant to develop hypopharyngeal carcinoma and male female ratio was 9:1. People with lower educational level were found to be affected more by hypopharyngeal carcinoma. In this study 86 percent patients had history of smoking. Mean duration of smoking was 38.0±23.6 years. This study found that the key symptoms of hypopharyngeal carcinoma was dysphagia, pain and neck mass. In this study 83.5 percent patients presented with palpable lymph node and most (76.6%) of them were in level II. Pyriform fossa was found to be the commonest site (83.3%). In this study all malignancy in hypopharynx was histopathologically squamous cell carcinoma</p><p>Bangladesh J Otorhinolaryngol; October 2015; <strong>21</strong>(2): 85-89</p> Md Nazmul Islam Dipankar Lodh Mohammad Mamun Siddiqui AF Mohiuddin Khan Kazi Meherunnesa ##submission.copyrightStatement## 2016-05-07 2016-05-07 21 2 85 89 10.3329/bjo.v21i2.27645 CT Evaluation of Anatomical Variations in Osteomeatal Complex in Patients with Deviated Nasal Septum <p>Background:The presence of septal deviation has been positively associated with sinus disease, especially osteomeatal complex disease and anterior and posterior ethmoid disease.Computerized tomographic imaging (CT) of the paranasal sinuses has become a widely accepted tool for assessing the paranasal sinuses (PNS) and providing a detailed anatomy of the lateral nasal wall.</p><p>Objective:The objective of the study was to identify the anatomical variations of lateral nasal wall and paranasal sinuses in patients with Deviated nasal septum.</p><p>Methods:Computerized tomographic (CT) examination was carried out using the bone algorithm in the coronal plane in 40 patients who met the inclusion criteriain the Postgraduate Department of Otorhinolaryngology and Head and Neck Surgery, SMHS Hospital an associated Hospital of Government Medical College, Srinagar from March 2011 to May 2012.</p><p>Results:In our study, CT Nose and PNS revealed Deviated nasal septum in 40 (100%) patients, Hypertrophied Inferior turbinate in 11 (27.50%) patients, Concha bullosa in 5 (12.50%) patients, Paradoxical Middle turbinate in 8 (20%) patients, Everted Hypertrophied Uncinate in 2 (5%) patients, Aggernasi cells in 4 (10%) patients, Haller cells in 3 (7.50%) patients and Onodi cells in 2 (5%) patients.</p><p>Conclusion:The most common anatomical variation associated with deviated nasal septum was Hypertrophied Inferior turbinate and the least encountered variation was Everted Hypertrophied Uncinate and Onodi cells. The CT scan provides supplementary clinical data to the history and endoscopic examination and assists in directing surgical treatment to the affected areas.</p><p>Bangladesh J Otorhinolaryngol; October 2015; <strong>21</strong>(2): 90-93</p> Mirza Aneesa Sajad Majid Qazi Aijazul Haq ##submission.copyrightStatement## 2016-05-07 2016-05-07 21 2 90 93 10.3329/bjo.v21i2.27646 A clinicopathological study of Rhinosporidiosis <p>Introduction: Rhinosporidiosis is one of the common tropical diseases in ENT practice in this subcontinent having the affinity for the mucosa of upper respiratory tract –chiefly the nose &amp; nasopharynx. Though this chronic granulomatous disease is quite common in this subcontinent but its distribution is not even.</p><p>Objectives: The aim of this study is to find out the age distribution, clinical sign-symptoms&amp; attachment of rhinosporidiosis, that’s mean to establish the clinical profile of the patient.</p><p>Method: A cross sectional study was done at the department of ENT &amp; HNS, Sir Salimullah Medical College Mitford Hospital from January to December 2012. The study included 49 patients treated in this department and histologically proved.</p><p>Rersults: Among 49 patients there was male predominance(37), female were-12. Majority of the patient presented with the feature of nasal obstruction(27), nasal mass(23) and it’s majority site of attachment was nasal septum(30). In anatomical site distribution majority cases(39) it was distributed in nose &amp; nasopharynx.</p><p>Conclusion: This study suggests total excision, wide base cauterization and regular follow up to prevent recurrence.</p><p>Bangladesh J Otorhinolaryngol; October 2015; <strong>21</strong>(2): 94-96</p> Sharfuddin Mahmud Rojibul Haque Abdullah Al Mamun Rafiul Alam DGM Akaiduzzaman Utpal Kumar Datta Zahedul Alam ##submission.copyrightStatement## 2016-05-07 2016-05-07 21 2 94 96 10.3329/bjo.v21i2.27647 Status of Ossicles in Cholesteatoma <p>The study was conducted to detect and analyze the different types of ossicular chain defect in chronic suppurative otitis media with cholesteatoma on mastoid exploration and to identify the ossicle most commonly eroded by the disease process. A total 60 cases of CSOM with cholesteatoma of different age groups, who underwent surgery were included in this study and their intra operative ossicular chain findings were noted. 100% cases were presented with long standing aural discharge. It was observed that cholesteatoma was more common in male (60%) than female (40%) and 53.33% patients were in young age group (21-35 years). 90% cases showed ossicular erosion while only 10% cases showed intact ossicles. The incus was found to be absent in 15% cases and eroded in 75% cases. And the malleus was observed as the most resistant ossicle to be eroded.</p><p>Bangladesh J Otorhinolaryngol; October 2015; <strong>21</strong>(2): 97-101</p> Mohammad Delwar Hossain Md Nasir Uddin Ahamed Mohammad Misbah Al Kabir Sumon Bhuiyan ARM Shoyeb ##submission.copyrightStatement## 2016-05-07 2016-05-07 21 2 97 101 10.3329/bjo.v21i2.27648 Experience of management of nasal foreign bodies in Out patient department of a Tertiary Hospital <p><strong>Objectives: </strong>To evaluate 113 cases of nasal foreign body removal with regard to type of foreign body, location, complications, techniques for removal, age , genderand to present the results of theevaluation.</p><p><strong>Methods: </strong>Between April 2009 to May 2011, a total of 113 nasal foreign bodies were attended inOutpatient Department ofENT, Head and Neck Surgery in Sir Salimullah Medical College, MitfordHospital,Dhaka. A retrospective reviewwas undertaken to evaluate the parameters related to the nasal foreign body and their removal and the data wereanalyzed.</p><p><strong>Results:</strong>113 cases of nasal foreign bodies were attended in Outpatient department of ENT, Head and Neck Surgery in Sir Salimullah Medical College, Mitford Hospital, Dhaka. Of these 113 cases, 101cases were removed in outpatient department and 12 cases were admitted and were removed under general anaesthesia. We found higher incidence in patients between ages 2 and 5 years. The distribution of nasal foreign body was 44.25% in male and 55.75% in female.</p><p><strong>Conclusion:</strong>Nasal foreign bodies are encountered daily in our routine clinical practice in the pediatric age group. General anaesthesia is required in uncooperative agitated patients or impacted foreign body to avoid complications.Button batteries and penetrating foreign body must be treated immediately.</p><p>Bangladesh J Otorhinolaryngol; October 2015; <strong>21</strong>(2): 102-109</p> Md Abdur Rahman Mesbah Uddin Ahmed Md Abdullah Al Harun Mohammad Harun OR Rashid MA Kalam Prodhan ##submission.copyrightStatement## 2016-05-07 2016-05-07 21 2 102 109 10.3329/bjo.v21i2.27649 Septoplasty in children: Results of 250 cases <p><strong>Backround: </strong>Septoplasty in children is still a matter of debate, because it is thought that a surgical procedure on a developing structure might produce some adverse effects on normal nasal and facial growth.On the other hand septal deviation in children may alter the early physiological process of breathing, causing obligatory mouth breathing and consequently changing craniofacial development and even intellect.</p><p><strong>Objectives: </strong>The goal of this retrospective study is to indicate the importance of septoplasty in children,to evaluate the effects of paediatric nasal septal surgery on normal nasal and facial growth, improvement of symptoms and any complications of surgery.</p><p><strong>Methods: </strong>This is a retrospective study of 250 children in the age group of 7-14 years done at Maleka nursing Home , Bogra, Human care hospital, Rajshahi and Khidma hospital Dhaka,from January 1999 to December 2014.All patients were selected from history, clinical examination and selected investigations. All patients had X-ray soft tissue nasopharynx done to see adenoid enlargement.Some patients had done PTA and tympanometry to confirm OME. All patients had septoplasty done with left hemitranfixional incision with elevation of left mucoperichondrial flap and elevation of both mucoperiosteal flaps. In addition adenoidectomy was done for adenoid enlargement and myringotomy with grommet insertion for OME. Patients were followed up on day 8, day 15, 1 mothh, 6 month and one year after operation.</p><p><strong>Results: </strong>Out of 250 children there were 163 male(65.2%)and 87 female(34.8%).Age ranged from 7 to 14 years,lowest number of patients were between 7 and 8 years old-64(25.6%),between 9 and 11 years-73(29.2) and 113(45.2%) between 12 and 14 years.210 patients had septal deviation to left side(84%) Patient felt improvement in nose breathing in 85% of cases.The most often complication was nasal blockage due to insufficient removal of deviated septum in 9.2 % of cases.We had synechia in 8 cases and septal haematoma in 2 cases.There were no asthetic deformities.</p><p><strong>Conclusion: </strong>Effective septal correction by septoplasty in children not only relieves nasal blockage but also controls the associated symptoms.Septolasty in early childhood does not produce any untoward events in terms of the growth and development of the nose and face.</p><p>Bangladesh J Otorhinolaryngol; October 2015; <strong>21</strong>(2): 110-114</p> MA Matin Md Nurul Islam Md Rawshan Ali Abul Kalam Azad ##submission.copyrightStatement## 2016-05-07 2016-05-07 21 2 110 114 10.3329/bjo.v21i2.27650 Cervical Vagal Swannoma: A Case Report <p>Cervical vagal schwannomas are rare, slow growing tumours usually occur in patients between thirty and fifty years of age with no sex related predisposition. They are usually asymptomatic benign lesion and complete surgical resection with preservation of neural pathway, whenever possible is the treatment of choice.</p><p>Bangladesh J Otorhinolaryngol; October 2015; <strong>21</strong>(2): 115-118</p> Shouvanik Satpathy Goutam Mondal Anup Kumar Bhowmick Aniruddha Dam ##submission.copyrightStatement## 2016-05-07 2016-05-07 21 2 115 118 10.3329/bjo.v21i2.27651 Seborrheic keratosis of the nasal tip-an unusual case report <p>Seborrheic keratosis is a benign tumour of skin, a common hyperkeratotic lesion of the epidermis,that usually occurs in the trunk and less frequently in the extremities, face and the scalp. A 65-year old farmer presented with a long standing, slowly growing, firm, redbrown, polypoidal mass about 2×2.5 cm in size, located at the skin mucosa interfare of the tip of nose. The lesion was excised under general anesthesia and histopathologic examination showed seborrheic keratosis. Diagnosis is made on the basis of clinical &amp; histopathological examination. Here, we discuss the clinical presentation, differential diagnosis, pathological diagnosis and management of such a case. There was no recurrence during a year follow-up.</p><p>Bangladesh J Otorhinolaryngol; October 2015; <strong>21</strong>(2): 119-121</p> Abdullah Al Mamun Dewan Mahmud Hasan ##submission.copyrightStatement## 2016-05-07 2016-05-07 21 2 119 121 10.3329/bjo.v21i2.27652 Primary Laryngeal Tuberculosis Masquerading Laryngeal Malignancy <p>Nowadays, tuberculosis (TB) infection shows re-emergence again in many other part of the world due to HIV/AIDS- related disease, low socioeconomic as well as insurgence of multidrug resistance tuberculosis. TB is a disease which is primarily affects a lung. However it also can affect other organs as a secondary disease in a body via hematogenous or lymphatic spread. As in ENT field, TB also can manifest as a solely ear, nose or throat (ENT) diseasea such as in primary laryngeal tuberculosis (TB). In the past, laryngeal TB typically presented as a secondary disease with ulcerated laryngeal lesions in advanced pulmonary tuberculosis patient. In our case, we report a case of primary laryngeal tuberculosis masquerading as laryngeal malignancy in adult patient without pulmonary tuberculosis. In conclusion, in a patient who presented with various laryngeal symptoms, physician should be aware of the reemergence of laryngeal tuberculosis and the various manisfestation of the disease.</p><p>Bangladesh J Otorhinolaryngol; October 2015; <strong>21</strong>(2): 122-128</p> Nik Mohd Syukra Nik Abdul Ghani Hazama Binti Mohamad Nik Khairani Nik Mohd Amran Mohamad ##submission.copyrightStatement## 2016-05-07 2016-05-07 21 2 122 128 10.3329/bjo.v21i2.27653 Embryonal Rhabdomyosarcoma: A Case Report <p>Rhabdomyosarcoma is the most common soft tissue sarcoma of childhood and adolescence. There are four histological types and among them the embryonic types are the most common. It can occur in any anatomic location, although when occurring in the head and neck region, it has an affinity to invade the cranial cavity. Patient was a 5 years old boy who was admitted with the complaints of pain and discharge from the ear, swelling on left side of the upper neck, and mastoid region and a fleshy mass protruding from the ear canal. The mass was confirmed to be Embryonal Rhabdomyosarcoma on histopathology. CT scan of the Head-Neck region, showed extension of the mass into infra-temporal fossa and in the mastoid antrum. After complete excision, the patient was referred to oncology deptt for consultation. The chemotherapy schedule comprised of Vincristine and Dactinomycine for 9-12 cycles. Otolaryngologists need to be aware of this rare condition as it may mimic the symptoms of CSOM or nasal polyp. And also long term followup is needed since recurrence can present several years after initial treatment.</p><p>Bangladesh J Otorhinolaryngol; October 2015; <strong>21</strong>(2): 127-131</p> Muntasir Mahbub Nabila Mannan Md Mazharul Shaheen Manash Ranjan Chakraborti AKM Shaifuddin Shahjahan Kabir KM Mamun Murshed Mahmudul Hassan Khabiruddin Ahmed ##submission.copyrightStatement## 2016-05-07 2016-05-07 21 2 127 131 10.3329/bjo.v21i2.27654