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Journal Cover Bengal Journal of Otolaryngology and Head Neck Surgery
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  This is an Open Access Journal Open Access journal
   ISSN (Print) 2395-2393 - ISSN (Online) 2395-2407
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  • Comparative Study of Autologous Ossicular Graft versus Titanium Prosthesis
           (TORP & PORP) in Ossiculoplasty

    • Authors: P Thamizharasan, K Ravi
      Pages: 1 - 7
      Abstract: IntroductionThis prospective cohort study aims to analyze and compare the outcomes of ossiculoplasty in terms of hearing results, intra and post operative course, using autograft incus and titanium middle ear prosthesis.Materials and MethodsPatients with a history of chronic ear discharge and conductive deafness were included in the study. Out of 21 patients with ossicular chain defect included in the study, 10 patients underwent ossiculoplasty with autograft incus and 11 with titanium prosthesis. Pure tone audiogram was done after three months.ResultIn patients with incus ossiculoplasty, average Post operative PTA was 43.5 dB ± 7.934SD and Net gain in hearing was 10.7 decibels ± 15.478SD. In patients with titanium prosthesis ossiculoplasty, average Post operative PTA was 41.4 dB ± 4.789SD and Net gain in hearing was 16 decibels ± 11.981SD.Discussion Three patients underwent only Tympanoplasty post operative PTA was 42 ± 5.292 dB (incus- 39 dB, titanium- 48dB) and hearing gain was 13.33 ± 12.583 (incus-20dB, titanium-0dB). Five patients underwent intact canal wall with Tympanoplasty: Post operative PTA was 35 ± 3 dB (incus-35dB, titanium-30dB) and hearing gain was 23 ± 15.379 (incus-18.33dB, titanium-30dB). Thirteen patients underwent canal wall down procedure with Tympanoplasty: Post operative PTA was 45.67 ± 5.228 dB (incus-50.4dB, titanium-41.8dB) and hearing gain was 9.33 ± 12.309 (incus-2.4dB, titanium-14.285dB). Complications in the short period studied were nil in both groups.Conclusion Incus and titanium have equal postoperative hearing but in terms of hearing gain Titanium prosthesis gave a better hearing gain than incus. 
      PubDate: 2017-04-30
      Issue No: Vol. 25, No. 1 (2017)
       
  • The Incidence of Thyroid Cancer in England and Wales over A Ten-Year
           Period

    • Authors: Louise Marie Evans, Michael Stechman, David Owens
      Pages: 8 - 11
      Abstract: IntroductionThe incidence of thyroid cancer has increased worldwide, whether a real or apparent increase is debated. Literature from the USA suggests greater diagnostic scrutiny, environmental and genetic factors may all play a part. This increase will result in a greater number of referrals for surgical assessment. This study examined the trend in incidence of thyroid cancer in England and Wales.Materials and MethodsA retrospective study, using the HES database over the period 2000-2010. Data were extracted of all newly diagnosed thyroid cancers in England and Wales and the age at diagnosis. Data were examined for the change in incidence of thyroid cancer diagnosis dependent on the age group of the patient using the linear regression model.Results45411 patients were identified. In England the incidence of thyroid cancer rose from 5.7/100,000 of the population in 2000 to 9.9/100,000 in 2010 and in Wales it rose from 3.5/100,000 in 2000 to 7.5/100,000. There was a statistical increase (P≤0.02) (t-stat >2) in the diagnosis of thyroid cancers across all age groups with exception of the 0-14 age group (P>0.5). ConclusionThere has been a statistical increase in the incidence of thyroid cancer. This is likely to impact on hospitals and cancer service resources. An increase in surgical demand and the coinciding ageing population highlights the importance of further investigation into the etiology, use of imaging, patient demographics, histology and overall mortality of this patient group.
      PubDate: 2017-04-30
      Issue No: Vol. 25, No. 1 (2017)
       
  • Use of Nasal Obstruction Symptom Evaluation Scale in Objective Evaluation
           of Symptomological Improvement in Post Septoplasty Patients

    • Authors: Mukulika Saha, Shoham Banerjee, Rabi Hembrom, Indranil Sen
      Pages: 12 - 18
      Abstract: IntroductionThe complaint of nasal obstruction or difficulty in nasal breathing is highly subjective.
      Benefits of Septoplasty, as perceived by the patient, also varies widely with subjective satisfaction ranging from complete alleviation of symptoms to a total failure.Materials and MethodsFifty three patients above 18 years of age, with anatomical deviation of the nasal septum as the sole cause of obstruction and symptoms persisting for more than 3 months, underwent septoplasty. Nasal endoscopy was done for Mladina typing of the nasal septal deviation. Pre and post operative NOSE (Nasal Obstruction & Symptom Evaluation) score were analysed.ResultsMean preoperative NOSE score was 11.98 ±1.23. On the 6th and 12th postoperative week follow up NOSE score was 3.13±1.30 & 1.05±0.87 respectively with p value <0.05. ConclusionMladina typing along with NOSE score will help in letting the patient know about his or her expected outcome following septoplasty.
      PubDate: 2017-04-30
      Issue No: Vol. 25, No. 1 (2017)
       
  • Hypothyroidism – An Underestimated Complication After Hemithyroidectomy:
           A Preliminary Study Report

    • Authors: Neeraj Aggarwal, Sirshak Dutta, Tanaya Panja, Mainak Dutta, Sanjoy Kumar Ghosh, Ramanuj Sinha
      Pages: 19 - 26
      Abstract: IntroductionHypothyroidism is a significant but an under-appreciated complication of hemithyroidectomy. The focus of this study was to assess the incidence of hypothyroidism occurring after hemithyroidectomy, identify the risk factors and to suggest a possible follow-up guideline for diagnosis.Materials and MethodsAn institution based preliminary study was conducted in the Department of Otorhinolaryngology, in a tertiary care hospital, from August 2014 to December 2015 on 25 patients. The patients were regularly followed up in 1st month, 3rd month, 6th month, 9th month and 1 year period with the thyroid function test.ResultsIncidence of hypothyroidism occurring after hemithyroidectomy including transient and permanent cases is 32%. Increased age of presentation, longer duration of thyroid swelling, pre-operative serum TSH level >2.5 mIU/ml, lymphocytic infiltration in histopathology and right sided hemithyroidectomy were found to be the possible risk factors.Conclusion It is indicated from this preliminary report that there should be a serial thyroid function monitoring in every post-operative hemithyroidectomy patient, and special attention should be given to the risk group
      PubDate: 2017-04-30
      Issue No: Vol. 25, No. 1 (2017)
       
  • Tinnitus Among Medical Students Using Personal Sound System

    • Authors: Syam Sasidharan, Sheetal Rai, Gangadhara Somayaji
      Pages: 27 - 33
      Abstract: IntroductionStatistical data on prevalence of tinnitus in India and on the relationship between exposure to recreational sound/music and the presence of tinnitus are scarce. This study was conducted to assess relationship between tinnitus and the use of personal sound system(PSS) in medical students.Materials and MethodsA questionnaire based study was conducted on 100 randomly selected medical students to assess their sound habits with the use of PSS. Information on commonly used intensity, frequency, duration of use, type of earphones and severity of tinnitus was sought. Conventional frequency audiometry (0.25-8kHz) was also performed.ResultThe prevalence of tinnitus was found to be 33%, which was on the higher side of the global prevalence data. All the medical students surveyed in this study used personal sound system. Majority of the students (45%) used PSS less than 1 hour daily. More than 60% of the students complaining of tinnitus preferred louder settings in their PSS.DiscussionThe most common personal sound system used was mobile phones. No statistically significant association was seen with relation to the type of personal sound system, the type of ear phone used, average duration of use and hearing loss. Tinnitus was found to have statistically significant association with volume in our study with majority having tinnitus listening to higher levels of sound.ConclusionUse of personal sound system is common in medical students. Though duration of use of the personal sound system was not associated with the complaint of tinnitus, exposure to louder sounds had statistically significant association with tinnitus. 
      PubDate: 2017-04-30
      Issue No: Vol. 25, No. 1 (2017)
       
  • Effect of Different Positions of the Head on Tympanometry Results: An
           Exploratory Study

    • Authors: Indranil Chatterjee, Rabi Hembram, Arpita Chatterjee Shahi, Ashok Kumar Sinha
      Pages: 34 - 38
      Abstract: IntroductionTympanometry is an objective measure of middle ear function that has been an integral part of the audiological evaluation test battery, for nearly three decades. The parameters of the tympanogram obtained are influenced with many factors such as introduction of positive or negative air pressure, speed of recording tympanogram, etc. This study was aimed to explore the influence of head positioning on tympanometric findings in normal ears.Materials and Methods Thirty ears of fifteen normal hearing subjects (mean age 22.8 years) and five ears of subjects (mean age 23 years) with high negative middle ear pressure were selected for the study. Tympanometry was done in four postures: head erect, head bent forward (chin touching the chest), head in supine and head lateralized towards one side.ResultsTwo different results were obtained. It was interesting to note that the results significantly changed when the tympanogram was recorded after ten minutes in different head positions compared to those taken immediately after changing the head position.DiscussionThe possible explanation for the effect of duration in different head positions on tympanogram is discussed.ConclusionNo significant changes were observed on static compliance, middle ear pressure, ear canal volume and pressure gradient when the tympanogram were recorded immediately bringing head in the particular posture. When head was held in the changed position for ten minutes, significant reduction in the pressure gradient was observed. Further extensive studies may be required to document the relationship between head positioning and tympanometric results.
      PubDate: 2017-04-30
      Issue No: Vol. 25, No. 1 (2017)
       
  • Noise Induced Hearing Loss with Tinnitus: Does TRT Help?

    • Authors: Nidhi Vohra Maggon, Ashwani Sethi, Atul Gupta
      Pages: 39 - 45
      Abstract: IntroductionTo determine if hearing augmentation and tinnitus retraining therapy (TRT) helps in cases of Tinnitus with Noise induced hearing loss (NIHL) and does degree of hearing loss, severity or duration of tinnitus affect recovery Materials and MethodsA prospective study was done on 100 patients of NIHL with tinnitus from Jan 14-Jul 15. Degree of hearing loss was assessed. Tinnitus severity was scored on Tinnitus handicap inventory (THI) scale as Slight, Mild, Moderate, severe or catastrophic and patients were subjected to TRT. Patients scored after 1 year of TRT. A relation between tinnitus severity, duration and degree of hearing loss on recovery from tinnitus was analysed.Result62 of the 100 patients improved following TRT.DiscussionIn 100 patients THI scores improved from a mean of 63.12 (SD-21.12) to 38.16 (SD-18.21). Mean difference between pre and post-intervention THI scores was 24.96 (SD-17.97). Improvement was significant in severe or profound hearing loss (P<.001).Tinnitus severity was slight, mild, moderate, severe or catastrophic on THI. Following TRT, 82.35% with Catastrophic, 70.96% with severe, 52.63% with moderate, 20% with mild tinnitus improved. 1 patient with slight tinnitus did not improve.Based on duration of tinnitus three groups made; 0-6 months, 6-12 months and >12 months. All groups showed improvement. Reduction in Post-TRT THI was significant but did not show any difference among groups.ConclusionTRT helps in tinnitus with NIHL particularly if hearing loss is severe. Severe or catastrophic tinnitus patients experience greater improvement. Duration of tinnitus has no impact.
      PubDate: 2017-04-30
      Issue No: Vol. 25, No. 1 (2017)
       
  • Medical Negligence : An Overview

    • Authors: Bratin Kumar Dey
      Pages: 46 - 54
      Abstract: Medical professionals are treated as next to God. They provide humanitarian services and gives solace to individuals suffering from various diseases and disorders. Due to their great service to humanity, the doctors and medical professionals are treated with reverence and since the ancient times the medical profession has been considered as a noble profession. However with the passage of time, there has been a change in the doctor - patient relationship. During the last few decades a number of incidents have come to light in which the patients have suffered due to the error and inadvertent conduct of doctors. Due to the increasing conflicts and legal disputes between the doctors and patients, most of the legal systems have developed various rules and principles to deal with such inadvertent behavior of doctors. This has led to the development of a new branch of jurisprudence, i.e. medical negligence. Hence, any negligence on part of the medical professional would be treated as either a tort of negligence or a deficiency in service under Consumer Protection Act, 1986. As the profession involves the idea of an occupation requiring purely intellectual skills or of manual skills controlled by the intellectual skill of the operator, it is distinctively different from an occupation, which is substantially production or sale or arrangement for the production or sale of commodities. Medicine is a highly complex domain. It is difficult for consumer laws to review medical negligence cases with flawless technical clarity and accuracy. Thus medical negligence is not purely a matter of consideration for judiciary but also the technical inputs of specialized experts in the field have substantial weightage while deciding the case of medical negligence against doctors. The present paper is devoted to introvert inspection of negligence in medical profession in the light of existing laws with more emphasis on the interpretation of consumer protection law by judiciary.
      PubDate: 2017-04-30
      Issue No: Vol. 25, No. 1 (2017)
       
  • Total Laryngectomy in Laryngeal and Hypopharyngeal Malignancy

    • Authors: Hamsa Shetty, Sridhara S, Gangadhara KS
      Pages: 55 - 58
      Abstract: IntroductionAdvanced laryngeal and hypopharyngeal malignancies are associated with significant morbidity and mortality for the patients with associated financial burden for the society. Recommended treatment for such malignancies includes total laryngectomy or total laryngectomy with partial pharyngectomy  with or without neck dissection, radiotherapy (RT) alone or surgery followed by radio therapy and combined chemotherapy (CT) with radiotherapy (CCRT).Materials and MethodsThis retrospective study was conducted over a period of 5 years, in a tertiary care institute with aim to study the incidence of laryngeal and hypopharyngeal malignancy over a period of 5 years in a tertiary  care institute, to assess the proportion of patients who agreed to undergo the proposed modality of treatment with surgery and post-operative radiotherapy,  to note the post operative complications and also to assess the 5 year survival of the patients who completed the prescribed regimen.ResultThis study highlights the large gap between the high incidence of this disease (a total of 170 cases of laryngeal and hypopharyngeal malignancy diagnosed in our hospital over a five year period ) and the  low turnover of   patients actually undergoing surgery for the same (8 out of 38 patients who were advised surgery underwent the same).DiscussionVast majority of laryngeal and hypopharyngeal malignancies are squamous cell carcinomas. Though 47 proved cases of hypopharyngeal malignancy and 36 proved cases of laryngeal malignancy were assessed, only 8 patients agreed to undergo surgery, indicating a large disparity between disease burden and treatment beneficiaries, despite an excellent 5 yr survival rate.ConclusionThe results of this study  emphasized the need for increased awareness regarding the favourable surgical outcome  when associated with post-operative radiotherapy. A very high five year survival rate can be achieved by combined modality treatment. Late presentation and lack of awareness about the disease are significant hindrances for management of laryngeal and hypopharyngeal malignancy.
      PubDate: 2017-04-30
      Issue No: Vol. 25, No. 1 (2017)
       
  • Kimura's Disease: A Rare Cause of Postauricular Swelling

    • Authors: Suman Kumar Das, Mukesh Kumar Singh, Indranath Kundu, Swapan Kumar Ghosh
      Pages: 59 - 61
      Abstract: Introduction Kimura’s Disease is a chronic inflammatory disorder of lymph node which is very rare in Indian population.Case ReportA 15 year old boy with multiple postauricular swelling for 18 months presenting in OPD and diagnosed having eosinophilia. Then excision biopsy was taken, which indicates Kimura’s Disease. Patient was treated with high dose of corticosteroid.ConclusionKimura’s disease, though rare should be kept in mind for treating a patient with lymphadenopathy with eosinophilia or high IgE level, because it can spare the patient unnecessary invasive procedure.
      PubDate: 2017-04-30
      Issue No: Vol. 25, No. 1 (2017)
       
 
 
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