Introduction: Anthropometric measurement of the nose has a great importance to differentiate gender, race, and ethnicity. Nasal index is an important parameter in forensic sciences and rhinoplasty surgery. Our aim is to compare the nasal index of both males and females and its role to identify gender differences among medical students. Methods: First and second year medical students were chosen and height, breadth and nasal index were calculated. The height and width of the nose was measured using a vernier caliper. The nasal index of both males and females were calculated and compared and based on this, the nasal shape was also determined. Results: Among 184 total participants, 114 (61.9%) were Nepalese and 70 (38.1%) were Indian. In the Nepalese cohort, mean nasal height for male students was 4.58 ± 0.37 cm which was higher than females (4.39 ± 0.34 cm). The mean nasal index was higher among males in students of both the countries. The mesorrhine was most common type of morphology found among all students. Conclusions: Nasal index of male medical students was significantly higher than females. Mesorrhine nose was the commonest type of nose in our study. This information may be used to estimate gender differences.

Here, we present the case of a giant multinodular goiter with retrosternal extension in an old lady with dyspnea for 3 months. The patient was treated with microscopic-assisted total thyroidectomy without any postoperative complications.

Introduction: External carotid artery originated superior thyroid artery are frequently documented in classical anatomical, surgical and radiological textbooks. Knowledge of anatomical variations, proper identification of superior thyroid arteries is very important to avoid major complications during and after neck surgeries. The aim of the study is to find out the prevalence of right superior thyroid artery originating from right external carotid artery in cadavers of a Medical College in Western Nepal. Methods: A descriptive cross-sectional study was carried out at the department of anatomy in Universal College of Medical Sciences, Bhairahawa, Nepal from October 2020 to January 2021 after ethical clearance from the same institution (IRC UCMS, Ref: UCMS/IRC/078/20). Variations in origin of superior thyroid arteries were observed, recorded and photographed. Convenient sampling method was used. Data was analyzed using Microsoft Excel 2016. Point estimate at 90% Confidence Interval was calculated along with frequency and percentage. Results: Out of 30 right superior thyroid arteries of 30 cadavers, 27 (90%) at 90% Confidence Interval (80.22-96.44) originates from right external carotid artery. Conclusions: In our study we observed that almost nine tenths of right superior thyroid arteries originated from the right external carotid artery which was relatively high in comparison to other studies. Thus, Extensive knowledge of variations in origin of superior thyroid artery is important for surgeons prior to various interventional surgeries.

Introduction: Epistaxis is a common otolaryngological emergency condition. It occurs due to local and systemic cause. Local cause lies within the nose bleeding either anterior or posterior. Commonest site of bleeding anterior epistaxis is kiesselbach’s plexus. In posterior epistaxis, it is difficult to locate bleeding site. Epistaxis is controlled by simply pinching of nose, decongested nasal drop and abgel packing. Some cases become more challenging required nasal packing and arterial ligation. Objectives: To study the epidemiological pattern and management of epistaxis. Methods: This was a retrospective study on pattern of epistaxis man­aged at Gandaki Medical College Teaching Hospital over a period from April 2015 to April 2016. Information regarding demographic profile, presentation and management of epistaxis was obtained from the Hospital records, ENT Outpatient clinic, Emergency Department, ENT ward and operation theatre. Results: A total of 78 cases were managed during study period. There was a significant male preponderance with male to female ratio 1.78:1. Patients’ age varied from eight to 80 years with mean age 40.7 years. The peak age of incidence was 21 - 30 years group. Idiopathic nasal bleeding 27 (34.6%) was commonest followed by nasal trauma 23 (29.5%) cases and hypertension 16 (20.5%) cases. Seventeen (21.8%) cases managed in day care basis with decongested nasal drop, chemi­cal cautery and abgel packing. Remaining cases required nasal packing and bipolar cautery and other specific form of treatment. Five (6.4%) cases required sphenopalatine artery ligation with no recurrence of bleeding. Conclusions: Epistaxis is common ENT emergency. Most common causes are idiopathic followed by nasal trauma and hypertension. Prompt management is instituted according to cases. Most of the cas­es are managed by non-surgical method.

Endoscopic sinus and skull base Surgery has gained significant improvement widely all over the world. A computerized tomography (CT) scan provides a detailed anatomy of the skull base especially the bone framework. This study aims to analyze the fixed anatomical bony landmarks of the anterior skull base through coronal and reconstructed CT in the context of the Nepalese population and guide the surgeon to perform endoscopic sinus and skull base surgery safely. This Prospective study includes 70 Computerized Tomography scans of Paranasal sinuses. The different measurement from nasal floor to skull base was taken in coronal and reformatted sagittal CT scan. Mean, standard deviation, minimum and maximum values were analyzed using descriptive statistics. Student T-test was applied to compare between right and left side. This study includes 75 patients between 18 to 77 years. The measurement from nasal floor to the cribriform plate and ethmoidal roof in right and left side were, mean± SD (47± 4.1, 45.3±4.3, 47.9±5.1, and 49±8.5 mm) respectively. Mean Take off angle at the cribriform plate was 43.9 ±10.9°on right side and 43 ± 9.4° on the left side. The distance from the nasal spine to the skull base (mean ± SD) at nasofrontal recess, bulla ethmoidalis, and the junction of sphenoethmoid levels at right sides were 51.5 ± 4.7, 52.9 ± 4.1, and 61.2 ±4.7 little higher at left side. This study provides a detailed analysis of the anterior skull base in coronal and sagittal CT scans which helps to reduces complications.