Introduction: Epistaxis is a common medical emergency with 5% to 15% of patients admitted for epistaxis will require surgical management as nasal packing has high failure rates. A modern endoscopic technique like Endoscopic Sphenopalatine Artery Ligation has increased in popularity for managing intractable posterior epistaxis. It has less complication and a high success rate. The study conducted to estimate the success rate of Endoscopic Sphenopalatine Artery Ligation of refractory posterior epistaxis among admitted patients in a tertiary care hospital. Methods: This is a descriptive cross-sectional study conducted from June 2019 to June 2020 at the Department of Otorhinolaryngology, Nobel Medical College and Teaching Hospital among the patient with refractory posterior epistaxis with the help of retrospective data. A convenient sampling method was used. These patients underwent endoscopic sphenopalatine artery cauterization for recurrent/intractable posterior epistaxis. Ethical clearance was taken from the Institutional Review Board. Data were analyzed in Statistical Package for the Social Sciences. Results: Out of the total patient with refractory posterior epistaxis who underwent Endoscopic Sphenopalatine Artery Ligation, the overall success rate was 39 (95.12%). Among them, 25 (60.97%) males and 16 (39.02%) females underwent endoscopic sphenopalatine artery ligation. Twenty (48.78%) of them were unilateral whilst 21 (51.21%) were bilateral disease. About 2 (4.8%) cases had re-bleeding within 48 hours which was managed conservatively. Hypertension was found to be the most common comorbid condition followed by diabetes, chronic kidney. Conclusions: From our study, we conclude that the success rate for Endoscopic Sphenopalatine Artery Ligation in a patient with refractory posterior epistaxis was high.

Introduction: Intact tympanic membrane acts as a partition between the external ear and middle ear. Tympanic membrane perforation is one of the commonest causes of conductive hearing loss. Perforation size is the most important determination of hearing loss. The aim of this study was to find out the prevalence of tympanic membrane perforation among patients presenting to the otorhinolaryngology department of a tertiary care hospital. Methods: A descriptive cross-sectional study was carried out in the Department of Otorhinolaryngology and Head Neck Surgery of a tertiary care hospital from March 2021 to August 2021. Ethical approval was taken from Institutional Review Committee (Reference number: 57112021). Convenience sampling was done and data was collected from 414 patients presenting to the department. Collected data were entered, analyzed in Statistical Package for the Social Sciences version 21.0 and documented for study. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Among 414 patients, tympanic membrane perforation was seen in 100 (24.15%) (20.02-28.27 at 95% Confidence Interval). Among 100 patients with a total of 153 perforated eardrums, mild hearing loss was seen in the majority of the cases. Posterior perforation had a mean hearing loss of 40.41±5.96 dB, central had 39.09±3.13 dB, and anterior had 35.15±5.88 dB. Conclusions: Our study showed the prevalence of tympanic membrane perforation to be high when compared to other similar studies. Hearing loss was observed in all cases; the majority with mild hearing loss. The degree of hearing loss was more in larger and posterior perforation.

Pleomorphic adenoma is the commonest benign salivary glands tumor. Major salivary glands are mainly involved, and there is very low reported incidence of such tumor in minor salivary glands of nasal cavity. We report a case of 69-year-old woman who complaint of chronic left nasal obstruction and recurrent scanty bleeding from left nostril for last 2 months. On anterior Rhinoscopy examination, there was a pinkish non-tender mass in left nasal cavity arising from cartilaginous part of nasal septum. Intranasal endoscopic excision was done under general anesthesia and histopathological examination of excised tissue revealed pleomorphic adenoma. Patient was discharged after 3 days. There was no recurrence at sixth month of follow-up.

Introduction: Patients with chronic kidney diseasesuffer from sensorineural hearing loss as a complication.The prevalence, type and degree of hearing loss along with the associated factors like age, electrolyte imbalance, hypertension, diabetes, duration and stage of CKD were studied. Methodology:This was a prospective cross-sectional study conducted in the department of Otorhinolaryngology and Nephrology at Nobel Medical College & Teaching Hospital, Kanchanbari, Biratnagar, Nepal from1st August 2018 to 30th September 2019.After thorough history taking, clinical & biochemical examinations, all patients underwent Tuning fork test and Pure tone audiometry. CKD was staged according to the eGFR. Data were stored in excel spreadsheet and analysis was done using the SPSS software (version 21) Result: Out of 150 patients,the ratio of male to female was 1.2:1. The mean age of the patients was 44.04 ± 10.524 years. 68 (45%) patients had CKD stage V with a median duration of 24 (18 – 36) months. The prevalence of hearing loss was found to be 83 (55.3%), most of them in bilateral ear (58%). The staging of CKD had a significant association with the prevalence of hearing loss and its severity. The duration of the illness had a strong association with hearing loss. Conclusion: This study shows that sensorineural hearing loss prevails in the patients suffering from CKD, which increases with age, duration of CKD, presence of comorbidities like hypertension, diabetes and level of serum urea and creatinine. However, it could not establish diabetes and electrolyte as a potential risk factor for developing hearing loss from CKD.

Introduction: Oral cancer is highly prevalent in the Asian subcontinent and is preventable to some extent by avoiding the use of tobacco and alcohol products. Early diagnosis and treatment guides for better oncological and functional outcomes. We conducted the study evaluating the awareness of patients visiting our outpatient department. It can be utilized for planning, formulating, and executing oral cancer preventive and curative management. Methods: Prospective cross-sectional study of patients from 1st October 2020 to 12th November 2021 visiting our outpatient. The enrolled patients filled out the Performa of structured questionnaire containing a demographic profile, clinical profile, and general knowledge regarding oral cancer. Statistical analysis was performed by using software SPSS version 16.0. The p-value of <0.05 was considered significant. Results: Knowledge of tobacco and alcohol use as a risk for oral cancer was prevalent in 63.9 % and 61.7 % cases. Only 11.4 % knew that neck swelling could be a manifestation of oral cancer while 31.9 % had awareness of oral ulcer as a clinical presentation. Tobacco or alcohol users were having better knowledge that it could cause cancer (p=<0.05). Similarly advancing age and higher education levels had awareness of oral cancer secondary to tobacco and alcohol (p=<0.05). Conclusions: Need for awareness especially regarding early clinical presentation so that early diagnosis could lead to better management. Also, there should be a regular oral screening program for high-risk groups.