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> IMRT: Is it superior to formal radiotherapy in the treatment of head neck cancer? <p>Abstract not available</p> <p>Bangladesh J Otorhinolaryngol; October 2019; <strong>25</strong>(2): 64-65</p> MA Matin ##submission.copyrightStatement## 2020-01-28 2020-01-28 25 2 64 65 10.3329/bjo.v25i2.45202 Surgical management of Tympanomastoid Paraganglioma: Experience in BSMMU, Dhaka <p><strong>Objective</strong>: To characterize the clinical presentation, surgical management, and outcomes of a consecutive cases of patients with tympanomastoid paraganglioma (TMP) tumors managed at a single tertiary referral center with 5 years’ experience.</p> <p><strong>Study Design</strong>: Retrospective review.</p> <p><strong>Setting</strong>: Bangabandhu Sheikh Mujib Medical University, a tertiary referral center in Bangaldesh.</p> <p><strong>Methods</strong>: Between November 2014 and May 2019, 10 patients with histologically confirmed TMP tumor underwent surgical treatment. Tumor stage was described using the Sanna modified Fisch and Mattox’s classification system.</p> <p><strong>Results: </strong>Distribution of tumors according to modified Fisch and Mattox classification was as follows: type A2 1 case (10%); B1 2 cases (20%), B2 6 cases (60%) and B3 1 case (10%). Class A2 tumour was safely removed via postauricular-transcanal approach. Two patients with Class B1 tumors were operated on through canal wall up mastoidectomy approach. Six patients including five Class B2 and one Class B3 tumors were managed by canal wall down mastoidectomy approach. One Class B2 underwent a subtotal petrosectomy with blind sac closure of the external auditory canal and middle ear obliteration. Gross total tumor removal was achieved in 9 cases (90%). One patient developed facial weakness (HB grade III) after one week of postoperative period which recovered completely by conservative treatment. No recurrence was noted in follow-up period.</p> <p><strong>Conclusion: </strong>Early diagnosis of tympanomastoid paragangliomas are very rare because of its benign and slow-growing nature. Clinical differentiation between tympanojugular and tympanomastoid paragangliomas are difficult. Surgery is the recommended primary modality of treatment for tympanomastoid paragangliomas with minimum morbidity and recurrence rate.</p> <p>Bangladesh J Otorhinolaryngol; October 2019; <strong>25</strong>(2): 66-75</p> Kanu Lal Saha Md Abul Hasnat Joarder Sampath Chandra Prasad Rao Pran Gopal Datta Harun Ar Rashid Talukder ##submission.copyrightStatement## 2020-01-28 2020-01-28 25 2 66 75 10.3329/bjo.v25i2.45203 Ultrasonographic Evaluation of Solitary Thyroid Nodule with Histopathological Comparison <p><strong>Background: </strong>Thyroid gland is the largest gland of the body which secretes thyroid hormones named T3 &amp; T4. Incidence of solitary thyroid nodule is common in Bangladesh.</p> <p><strong>Objectives: </strong>To validate the ultrasonography evaluation of solitary thyroid nodule comparing with histopathological diagnosis.</p> <p><strong>Methodology: </strong>This cross sectional study enrolled 75 patients of age range between 14 to 72 years during July 2016 to June 2018 and the study was carried out in the department of Radiology &amp; Imaging of Ultrasonography evaluation was finally compared with histopathological diagnosis which was considered as gold standard.</p> <p><strong>Results: </strong>Among 75 patients are included in this study the age ranged between 14 to 72 years. Majority of the patients 37 (49.3%) were found between 31 to 40 years. 65 (86.3%) were female &amp; 10 (13.3%) were male. All patients were presents with thyroid swelling. In USG findings Microcalcifications were present 9 (12%) in benign &amp; 5(6.7%) in malignant cases. Presence of Halo were in all benign cases 14 (18.7%). Comet tail sign were in 5 (6.7%) in benign &amp; 3 (4%) in malignant cases. Histological nodular goiter were 57 (76%), Follicular adenoma 8 (10.7%), Thyroditis 5 (6.7%) and Papillary carcinoma 4 (5.3%), Follicular Carcinoma 1 (1.3%).</p> <p><strong>Conclusion: </strong>This cross sectional study was carried out with an aim to determine the usefulness of ultrasonogram diagnosis of solitary thyroid nodule compared with histopathology findings. As the validity test results are higher, it can be concluded that the ultrasonogram is a useful diagnostic modality in the evaluation of solitary thyroid nodule.</p> <p>Bangladesh J Otorhinolaryngol; October 2019; <strong>25</strong>(2): 76-84</p> Samia Quadir Sabiha Quadir Md Momin Uddin Kazi Shameemus Salam Mohammad Sazzad Hossain Md Rued Hossain ##submission.copyrightStatement## 2020-01-28 2020-01-28 25 2 76 84 10.3329/bjo.v25i2.45204 Hearing Status after Stapedotomy in Otosclerotic Patients <p>Otosclerosis is the most frequent cause of conductive hearing loss in patients with intact tympanic membrane. It can be treated by surgery with various techniques. Because of limited manipulation and comparably similar results, stapedotomy at present is preferred over other surgical techniques by most surgeons. Here we present the operative results of 35 otosclerotic patients who underwent stapedotomy between January 2009 - October 2010 in the department of Otolaryngology- Head &amp; Neck Surgery of Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital and Shahid Suhrawardhy medical college &amp; hospital, Dhaka. The aim of this study was to evaluate the hearing results following stapedotomy in otosclerosis surgery. The average air-bone gap of patients improved significantly to 21.74 dB after operation. Other hearing parameters of patients (including air conduction, bone conduction, speech discrimination score, and tinnitus) also improved. No patient experienced persistent vertigo after the operation and pre operative tinnitus resolved in 12 out of 22 patients. Stapedotomy is a safe and effective modality for improving conductive hearing loss in otosclerotic patients.</p> <p>Bangladesh J Otorhinolaryngol; October 2019; <strong>25</strong>(2): 85-93</p> Ahmed Tariq Mostafizur Rahman Delwar Hossain Sheikh Hasanur Rahman ##submission.copyrightStatement## 2020-01-28 2020-01-28 25 2 85 93 10.3329/bjo.v25i2.45205 Relationship of Preoperative Hearing loss with Peroperative Ossicular Discontinuity in Chronic Otitis Media <p><strong>Background: </strong>Chronic Otitis Media (COM) is a common disease in our country. COM with or without cholesteatoma may lead to ossicular discontinuity. However, the discontinuity of the ossicular chain is usually confirmed during operation. The purpose of the study was to find out the correlation between preoperative hearing loss and the status of ossicular chain at surgery.</p> <p><strong>Methods: </strong>This cross-sectional study was conducted in the department of otolaryngology- Head &amp; neck surgery, Bangabandhu Sheikh Mujib Medical University from January 2013 to June 2014. At least 113 patients of COM were selected as per inclusion and exclusion criteria. Relevant data were collected in a predesigned data collection sheet and analyzed with standard statistical method. Statistically significant inferred for P value &lt;0.05. No groups whose ability to give voluntary informed consent questionable was not included. No potential risks exist in designed this study.</p> <p><strong>Results: </strong>Out of 34 patients with mild degree of hearing loss 31(39.7%) had intact ossicular chain whereas discontinuity was seen in 3(8.6%) cases, 37 patients with moderate degree of hearing loss 16(45.7%) had ossicular discontinuity. Among 23 patients with moderate to severe degree of hearing loss 14(17.9%) had intact ossicular chain whereas ossicular discontinuity was found 9(25.7%), 9 patients of severe degree of hearing loss 7(20%) had ossicular discontinuity. Cases with moderate and severe degree of hearing loss had significant ossicular discontinuity (p&lt;0.05). Air-bone gap &gt; 40 dB was found in 60% cases of ossicular discontinuity, followed by air bone gap 31-40 dB(17.14%), 21-30 dB(14.29%) and 11-20 dB( 8.57%) respectively. So ossicular discontinuity was in higher air-bone gap group and it was statistically significant (p&lt;0.001).</p> <p>Bangladesh J Otorhinolaryngol; October 2019; <strong>25</strong>(2): 94-101</p> Nibash Chandra Ghosh Kanu Lal Saha Nasima Akhtar Md Manjurul Islam Arif Mahmud Jewel Mahmudul Hasan ##submission.copyrightStatement## 2020-01-28 2020-01-28 25 2 94 101 10.3329/bjo.v25i2.45206 Prevalence of Metastatic Neck Nodes <p><strong>Background: </strong>Head and neck cancers include cancers of the lips, mouth, nasal cavity, paranasal sinuses, pharynx and larynx. Most of these cancers are squamous cell carcinomas (SCCs). The presence of metastatic cervical lymphadenopathy is of particular importance as with every single nodal metastasis, survival of the patient is reduced by one half.</p> <p><strong>Objective: </strong>To see the prevalence of metastatic neck node.</p> <p><strong>Methods: </strong>The prospective cross-sectional clinical study was carried out in the Department of ENT and Head Neck Surgery, Combined Military Hospital, Dhaka during March’2018 to March, 2019. All 100 patients were included in this study and were treated at the Department of Otolaryngology of Combined Military Hospital, Dhaka.</p> <p><strong>Results: </strong>Total 26 cases were found parotid among them 8(30.8%) in metastatic neck node and 18(69.2%) in without metastatic neck node. Total 10 cases were found paranasal sinuses among them 1(10.0%) in metastatic neck node and 9(90.0%) in without metastatic neck node. Which were statistically significant (p&lt;0.05) between two groups.</p> <p><strong>Conclusion: </strong>In this study observed that majority of metastatic neck node were found pyriform fossa, supraglottic larynx, base of tongue which were 68.2%, 68%, 77.8% respectively. In oral cavity and parotid site also found 48.1% and 30.8% metastatic neck node.</p> <p>Bangladesh J Otorhinolaryngol; October 2019; <strong>25</strong>(2): 102-107</p> Md Momin Uddin Samia Quadir Sabiha Quadir Kazi Shameemus Salam Debabrota Roy Belayat Hossain Siddiquee ##submission.copyrightStatement## 2020-01-28 2020-01-28 25 2 102 107 10.3329/bjo.v25i2.45207 Transcanal Endoscopic Approach to the Mastoid Segment of Facial Nerve and the Role of the Pyramidal Eminence as a Landmark <p><strong>Objectives: </strong>To study the feasibility of approaches in addressing the mastoid segment of facial nerve through transcanal route exclusively under endoscopic guidance and to verify the usefulness of the pyramidal eminence as a landmark.</p> <p><strong>Study design: </strong>The prospective experimental study</p> <p><strong>Setting: </strong>“Transcanal endoscopic temporal bone dissection lab” situated in the Surgiscope hospital, Chittagong, Bangladesh.</p> <p><strong>Materials: </strong>4 (Four) cadaveric temporal bones.</p> <p><strong>Interventions: </strong>Two pure transcanal endoscopic approaches were applied to excavate the mastoid segment of facial nerve. In anterior-medial approach, the dissection was progressed from medial to the lateral direction through the retrotympanum focusing the anterior-medial side of the mastoid segment of facial nerve. Whereas in anterior-lateral approach, the dissection was progressed from lateral to the medial direction through the posterior canal wall focusing the anterior-lateral side of the mastoid segment of facial nerve. In both approaches, the pyramidal eminence was considered as an anatomical landmark to navigate the dissection for the excavation of the mastoid segment of facial nerve.</p> <p><strong>Main outcome measures: </strong>The efficacy of each approach in respect of the complete excavation of the mastoid segment of facial nerve and the worthiness of the pyramidal eminence as the landmark for navigating the dissection.</p> <p><strong>Results: </strong>In both transcanal endoscopic approaches, the entire mastoid segment of facial nerve could be exposed successfully. But in anterior-medial approach, the chorda tympani nerve was needed to be sacrificed. The search of the mastoid segment of facial nerve with the guidance of the pyramidal eminence was observed as effective and safe.</p> <p><strong>Conclusion: </strong>The entire mastoid segment of facial nerve could be successfully addressed through transcanal route under pure endoscopic guidance. The pyramidal eminence has appeared as an important landmark for such endeavor.</p> <p>Bangladesh J Otorhinolaryngol; October 2019; <strong>25</strong>(2): 108-115</p> Sheikh Shawkat Kamal ##submission.copyrightStatement## 2020-01-28 2020-01-28 25 2 108 115 10.3329/bjo.v25i2.45208 Effect of Diabetes Mellitus on Hearing <p><strong>Background: </strong>Diabetes mellitus (DM) is a chronic systemic disease characterized by hyperglycemia due to absolute or relative deficiency of insulin and affects several systems including hearing. It was evidenced that hearing loss is twice as common in people with diabetes in comparison to other non-diabetic individuals. Although there is no epidemiological information are available in Bangladesh, but it can assume that the number would not be less.</p> <p><strong>Methods</strong>: This study was a hospital based case-control study conducted at department of ENT &amp; department of Endocrinology for 1.5 year following approval of the protocol. Total 110 people (55 cases and 55 controls) were selected and analysed in this study. All the patients were divided into two groups: Group A (all patients with Diabetes) and Group B (persons without diabetes). For analysis group A were considered as case and group B were as control. Written informed consent was taken from all case and control subjects. A detailed history taking including hearing loss, duration, onset, associated symptoms &amp; diabetes duration, treatment were obtained from the subject. A detailed ENT examination including otoscopic examination and tuning fork test were also conducted for each patient. Moreover, audiometric assessment-PTA, blood investigation-RBS, HbA1C, &amp; renal parameters like blood urea &amp; serum creatinine were tested in each cases. Data analysis was done in the statistical program Statistical Package for Social Science (SPSS) version 16.0.</p> <p><strong>Results: </strong>Out of total 55 patients in each group, mean age of Diabetic and non-diabetic were 46.78±8.02 SD and 46.72±8.09 SD (years) with slight female predominance (45.5% vs 54.5% in diabetic group and 49.1% vs 50.9% in non-diabetic group).</p> <p>Bangladesh J Otorhinolaryngol; October 2019; <strong>25</strong>(2): 116-124</p> Uzzal Chandra Ghosh Md Abu Yusuf Fakir Husne Qumer Osmany Dipankar Lodh Md Zahirul Islam Mohammad Nazrul Islam ##submission.copyrightStatement## 2020-01-28 2020-01-28 25 2 116 124 10.3329/bjo.v25i2.45210 Kikuchi’s Disease: A Case Report <p>A 30-year-old female attended in August 2019, presented with painful swelling in right upper neck and fever for 20 days. Biochemical and microbiological tests, and imaging studies were all inconclusive. Histopathology of the affected lymph nodes revealed consistent with Kikuchi’s disease. The Patient was treated properly and complete remission occurred within few weeks. It is a self-limiting idiopathic disease which can mimic several serious conditions such as TB, lymphoma, infectious mononucleosis and others.</p> <p>Bangladesh J Otorhinolaryngol; October 2019; <strong>25</strong>(2): 125-127</p> Saiful Alam Rumana Rahim Afroza Suraya Majumder M Alamgir Chowdhury ##submission.copyrightStatement## 2020-01-28 2020-01-28 25 2 125 127 10.3329/bjo.v25i2.45211