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

Columellar sinus: A rare congenital isolated sinus

Midline congenital malformation of the nose is a very rare presentation and it's midline situation seems curious and is very difficult to explain on the basis of the present day conception of the embryology of the nose. The prevalence of lower lip sinuses has been estimated to be about 0.001 % of the general population. Upper lip sinuses are even more uncommon. We herein report a case of a 13 years old girl having congenital sinus affecting the upper part of the columella

Columellar sinus: A rare congenital isolated sinus

Midline congenital malformation of the nose is a very rare presentation and it's midline situation seems curious and is very difficult to explain on the basis of the present day conception of the embryology of the nose. The prevalence of lower lip sinuses has been estimated to be about 0.001 % of the general population. Upper lip sinuses are even more uncommon. We herein report a case of a 13 years old girl having congenital sinus affecting the upper part of the columella

Schwanoma of tonsil

Background: Schwannoma is mostly benign lesion that originates from the Schwannoma cells that cover the myelinated nerve fibers. Schwannoma arising from the tonsil are very rare. In head and neck region the incidence rate of schwannoma is between 25 to 45%. In most of the cases vestibular nerve followed by a parapharyngeal space is involved. It is also known as neurilemmoma.&#x0D; Objective: To diagnoses and manage the case of a Schwannoma of Tonsil.&#x0D; Findings: A case of tonsillar schwannoma in a 42 years old males was reported. The patient presented with unilateral enlargement of left tonsil with congested pharyngeal mucosa.&#x0D; Conclusion: Proper clinical examination with radiological assessment plays a vital role to diagnosis this accurately.&#x0D; Bangladesh Med Res Counc Bull 2020; 46(2): 142-144</jats:p

White papilloma involving both vocal cords: A Case Report

White papilloma are rare lesions that may occur at any site of mucosa- lined respiratory tract especially in vocal cords. Morphologically it appears villas looking, clinically &amp; microscopically benign in most cases. We report a 70 years old male patient with white papilloma near anterior commissure involving both vocal cords found during indirect laryngoscopy. The lesion was completely resected with a unipolar coagulation device under direct laryngoscopy. Histopathological examination showed papilloma of vocal cords associated with Human papilloma virus(HPV) wart. To our knowledge this is the second reported case concomitant white papilloma with concomitant HPV in the vocal cords.&#x0D; Bangladesh J Otorhinolaryngol; April 2020; 26(1): 73-76</jats:p

Comparison of Reinforcement Cartilage Graft and Temporalis Fascia Graft in Type 1 Tympanoplasty

Background: Chronic otitis media (COM) is the long-standing infection of a part or whole of middle ear cleft characterized by ear discharge and perforation. It is the commonest ear problem in adult and children. Most common presenting symptoms are ear discharge, mild to severe hearing loss, sometimes tinnitus even vertigo. Treatment of COM is mainly operative. Inactive mucosal variety of COM presents with the perforation in tympanic membrane with non-inflamed middle ear mucosa. The treatment of inactive mucosal variety of COM is Type 1tympanoplasty. It can be done by conventional temporalis fascia or cartilage graft. Both have some merits and demerits. Objective: To compare the the outcomes between reinforcement cartilage graft and temporalis fascia graft in type -1 tympanoplasty. Methods: 86 (43 patients in each group) patients with COM (inactive mucosal) who were admitted in the department of Otolaryngology – Head and Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2018 to June 2019, and had fulfilled the inclusion and exclusion criteria were selected for the study. History, examinations, investigations were done. All patients underwent type 1 tympanoplasty. Prior to surgery relevant investigations were done and informed written consent was taken from all patients. In Group-A reinforcement cartilage tympanoplasty cases and in Group-B temporalis fascia tympanoplasty cases were placed. Post-operative graft uptake rate and hearing gain were compared in two groups Results: The surgical outcomes between reinforcement cartilage tympanoplasty in comparison with temporalis fascia tympanoplasty showed no significant difference of graft uptake rate and hearing gain. Conclusion: Cartilage tympanoplasty has been practised for reconstruction of perforated tympanic membrane in COM since long with variable results. Graft uptake rate in cartilage reinforcement is comparatively better than temporalis fascia graft. So, reinforcement cartilage graft can be adopted as an alternative to temporalis fascia graft in type- I tympanoplasty. Bangladesh J Otorhinolaryngol 2021; 27(2): 104-110</jats:p

Primary Tracheal Papilloma: A Case Report

Solitary papilloma in the respiratory tract is a rare benign epithelial tumor which is complete surgical excision of the current standard treatment for this type of tumor. Here a case of solitary tracheal papilloma treated by surgical resection is reported. Due to rarity and non-specific symptoms, tracheal papilloma always subjected to misdiagnosed and suffer from delayed treatment. In this case, a forty two years male has been presented with a recurrent non-productive irritative cough, a progressive shortness of breath, expiratory stridor and occasional hemoptysis. The patient was previously diagnosed as a case of bronchial asthma by a Pulmonologist and wrongly treated as well. CT scan revealed an intraluminal tracheal mass arises from the right side of the tracheal wall opposite c6-c7 vertebrae. The tumour was removed by endoscopic excision. The histopathological result confirms the diagnosis of squamous cell papilloma. No complications occur during surgery and no recurrence was observed in six months after surgery on followup. Bangladesh Med J. 2020 May; 49(2) : 44-47</jats:p

Comparison of Surgical Outcome between Endoscopic and Microscopic Type 1 Tympanoplasty

Background: Chronic otitis media (COM) is the long-standing infection of a part or whole of middle ear cleft characterized by ear discharge &amp; perforation. The most common presenting symptoms are ear discharge, mild to severe hearing loss, sometimes tinnitus even vertigo. Treatment of COM is mainly operative. The treatment of inactive mucosal variety of COM is Type 1 tympanoplasty. It can be done by microscopic or endoscopic technique. Both methods have some merits and demerits.&#x0D; Objectives: Aim of the study was to compare the surgical outcomes between endoscopic and microscopic type 1 tympanoplasty.&#x0D; Methods: This study was carried out in the Department of Otolaryngology–Head &amp; Neck surgery of Bangabandhu Sheikh Mujib Medical University, Dhaka from March 2017 to June 2019 and 60 (30 in each group) patient were included in the study. All patients underwent type 1 tympanoplasty. In Group A endoscopic tympanoplasty cases and in Group B microscopic tympanoplasty cases were placed. Operation duration, post-operative pain, postoperative hearing status, graft uptake was compared in two groups.&#x0D; Results: There were no significant difference of graft uptake and hearing gain (&gt;0.05). But endoscopic operative time and post-operative pain were less than microscopic group (&lt;0.05).&#x0D; Conclusion: Through endoscopic tympanoplasty is a newer approach and it has some limitations. As endoscopic tympanoplasty requires less time, less pain with similar graft uptake and audiological success. It can be adopted as an alternative method of tympanoplasty.&#x0D; Bangladesh J Otorhinolaryngol; October 2020; 26(2): 109-115</jats:p

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 &amp; 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&gt;0.05). No graft material is superior to others in terms of graft uptake. BSMMU J 2022; 15(2): 84-89</jats:p

Role of Foam Sclerotherapy with Injection Ethanolamine Oleate for the Treatment of Venous Malformation in Head-Neck Region

Background: Venous malformations (VMs) are a variety of low flow vascular malformations, which are developmental error of morphogenesis of veins where veins are dysplastic lined by quiescent or normal endothelium. Although surgical extirpation is the standard method for the treatment of vascular malformations, this procedure often leads to significant loss of motor function, nerve damage, or massive bleeding in patients which may endanger the life. Therefore, sclerotherapy has now been accepted as a less invasive alternative and good results have been obtained.&#x0D; Objectives: This study was conducted to evaluate the clinical outcomes after Foam sclerotherapy with injection Ethanolamine Oleate (EO) for the treatment of VMs in head-neck region.&#x0D; Methods: This quasi-experimental study was conducted in the Department of Otolaryngology- Head &amp; Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU). Forty-three patients with venous malformation in head neck region that had the inclusion criteria were enrolled as a study sample. The patients were diagnosed mostly clinically &amp; confirmed by demonstrating non-pulsatile blood flow and venous space using Duplex ultrasound. The sclerosing solution 5% Ethanolamine Oleate (EO) was used in this study. Sclerofoam was produced using the Tessari method in 4:1 air to liquid ratio, the foam had been used within 60- 90 seconds. Results of the study were categorized as excellent, good, fair and poor. Ethical clearance was obtained from the Institutional Review Board (IRB) of BSMMU.&#x0D; Results: Among 43 patients 34(79.1%) patients underwent single session and 9(20.9%) were two sessions. All the lesions were responded to EO. Response to sclerotherapy categorized as excellent were in two third 29 (67.4%) patients and 14 (32.6%) had good response. No sessions resulted in poor responses. No complications occurred following any procedures. All of the sessions were performed as a day case basis without anesthesia.&#x0D; Conclusions: Foam sclerotherapy with injection EO appears to be safe and effective for the treatment of VMs in the head and neck region and should be considered when treating these complex lesions.&#x0D; Bangladesh J Otorhinolaryngol; October 2020; 26(2): 79-85</jats:p