Anaesthetic complications in CO2 laser in ENT surgery

The word laser is an acronym for light amplificationby stimulated emission of radiation and lasertechnology is one consequence of Novel Prize winningin quantum mechanics, which is most important in20th century physical sciences. The rapidadvancement of this technology in ENT surgery hasbeen accompanied by complications, making itimperative that anaesthesiologists as well as ENTsurgeons understand the potential threat to theirpatients and themselves and be preparing to respondproperly. CO2 Laser surgery in ENT is one of thosesurgical procedures in which the surgical risk isminimal while the anaesthetic risk is great. This isbecause of the general problems presented bylaryngeal, pharyngeal and tracheal surgeries combinedwith unique specific problems of the lase

CO2 laser tonsillectomy: a comparison with conventional technique

Objective: To define the advantages and disadvantages of CO2 laser tonsillectomy compared with conventional method. Study design: Retrospective review. Setting: Department of Otolaryngology & Head and Neck Surgery, Apollo Hospitals Dhaka. Materials and Methods: This study included fifty two patients with tonsillectomies from October 2007 to May 2008. The patients were diagnosed with history and clinical examination. Preoperative investigations have been done for general anaesthesia. Patients were intubated with laser reinforced endotracheal tube and fire precautions were taken. Laser tonsillectomy has been avoided below 10 years in our centre. 52 patients aged 10-35 years underwent tonsillectomy in a period of 10 months. Out of them 12 patients underwent laser tonsillectomies. The data of each patient included intra-operative blood loss, operation time, postoperative pain and postoperative healing. Results: All Patients were admitted for 24 hours. Intra operative blood loss was dramatically less with the use of CO2 laser than that of conventional method (5ml vs. 18ml). Profuse bleeding did not prolong this time especially in laser technique. The incidence of postoperative reactionary hemorrhage were not significantly different between two techniques. 2 patients suffered with secondary haemorrhage in conventional technique and in laser technique one patient had secondary haemorrhage. There was statistically significant difference in duration of operating time (15 vs. 40 min). Both methods of surgery had non-identical effect on post operative pain. Postoperative pain was less in laser technique than that of conventional technique in 7 days postoperative follow up. Leukocytic membrane formation and separation and final healing were earlier in laser technique than in conventional technique. Conclusion: CO2 laser is a safe and acceptable method for tonsillectomy. CO2 laser tonsillectomy reduces operation time and intraoperative blood loss. Postoperative pain is less than conventional technique and healing is also earlier in laser technique

Evaluation of graft uptake in underlay myringoplasty using dry and wet temporalis fascia graft

Chronic otitis media (COM) is a vital cause of deafness worldwide. Myringoplasty is one of the best treatment options for COM (inactive mucosal variety). Temporalis Fascia is the most favored grafting material among various autografts, which can be used as dry or wet depending upon the Surgeon's choice. The main focus of this study is to compare the graft uptake rate by using dry and wet temporalis fascia by underlay technique. This cross-sectional comparative study was directed from January 2018 to June 2019 at the Department of Otolaryngology-Head & Neck Surgery of BSMMU, Dhaka. All consecutive cases of COM (inactive mucosal) who underwent surgery were randomly assigned either into the dry (Group-A) or wet temporalis fascia group (Group-B). At 12 weeks follow-up, the density of graft failure (4.4% vs. 8.8%) and retraction pocket (0% vs. 2.2%) were higher in the wet procedure. However anterior blunting (2.2% vs. 2.2%) were the same in both procedures, and medialization (2.2% vs. 0%) were more in the dry procedure. Air Bone Gap (ABG) improved significantly in both groups following operation but reduced in Group-A more significantly than Group-B. On the other hand, there was no remarkable difference in successful graft uptake between the groups (Dry group-91.12% vs. wet group-84.44%, p>0.05). No graft material is superior to others in terms of graft uptake. BSMMU J 2022; 15(2): 84-8

Original Article Clinicopathological study of sinonasal masses

Objective: To observe the incidence, clinical presentation and to perform comparative study of different sinonasal masses. Study design: Prospective study. Setting: Department of otolaryngology and Head-Neck Surgery & ENT OPD of Chittagong Medical College Hospital. Patients & methods: 50 patients are included in this study (39 male & 11 female) between the ages of 3 years and 80 years who were treated between August 2006 to January 2007. Study based on history, clinical, radiological, laboratory and histopathological examination. Results: Mean age for male was 35.12 years and for female was 22.63 years. Male to female ratio was 3.5:1. Highest frequency was noted in second decade. Most of patient (78%) were from poor class. Frequency of inflammatory nasal masses were more in second decade, benign tumour in fourth and fifth decade, malignant tumour in second decade (OAN & NHL) and fifth and second decades (others). Rhinosporidiosis were most frequent inflammatory nasal masses. Nasal obstruction was the commonest and orbitus symptoms were less frequent symptoms. But orbital symptoms were more prevalent in malignant lesion. Conclusion: sinonasal masses are found in all age group. Rhinosporidiosis are appearing to be the commonest nasal masses. The prevalence of nasal polyp is also high. Among the malignant sinonasal masses the percentage of squamous cell carcinoma is high