Background: Diabetes mellitus (DM) is a chronic systemic disease characterized by hyperglycemia due to absolute or relative deficiency of insulin and affects several systems including hearing. It was evidenced that hearing loss is twice as common in people with diabetes in comparison to other non-diabetic individuals. Although there is no epidemiological information are available in Bangladesh, but it can assume that the number would not be less. Methods: This study was a hospital based case-control study conducted at department of ENT & department of Endocrinology for 1.5 year following approval of the protocol. Total 110 people (55 cases and 55 controls) were selected and analysed in this study. All the patients were divided into two groups: Group A (all patients with Diabetes) and Group B (persons without diabetes). For analysis group A were considered as case and group B were as control. Written informed consent was taken from all case and control subjects. A detailed history taking including hearing loss, duration, onset, associated symptoms & diabetes duration, treatment were obtained from the subject. A detailed ENT examination including otoscopic examination and tuning fork test were also conducted for each patient. Moreover, audiometric assessment-PTA, blood investigation-RBS, HbA1C, & renal parameters like blood urea & serum creatinine were tested in each cases. Data analysis was done in the statistical program Statistical Package for Social Science (SPSS) version 16.0. Results: Out of total 55 patients in each group, mean age of Diabetic and non-diabetic were 46.78±8.02 SD and 46.72±8.09 SD (years) with slight female predominance (45.5% vs 54.5% in diabetic group and 49.1% vs 50.9% in non-diabetic group). Bangladesh J Otorhinolaryngol; October 2019; 25(2): 116-124

Background: Bilateral anterior nasal packing is often done after septal surgery for hemostatic reasons and mechanical splinting. It has been suggested that nasal packing following septal surgery is a frequent cause of short term eustachian tube dysfunction such as ear fullness and mild pain. Objectives: To evaluate the effect of anterior nasal packing on middle ear pressure. Methods: For this prospective, longitudinal study, ninety-two (92) patients admitted for routine septal surgeries were selected according to inclusion and exclusion criteria from the in-patient Department of ENT and Head &Neck Surgery, Dhaka Medical College and Hospital, Dhaka during 1st January 2020 to 31st July 2021. Following informed written consent, the patients were interviewed three times: preoperative, after 24 hours of ANS pack and 6 days after pack removal. During each time, middle ear pressure was measured by an impedance audiometer. Any otological symptoms produced when ANS pack was in place for 24 hours and 6 days after pack removal were also observed and recorded. Results: Among 92 patients in this study, mean preoperative middle ear pressure was -5.5 (± 30.14) daPa. After 24 hours of anterior nasal packing, 70 ears (38%) showed abnormal middle ear pressure among 184 ears. Mean middle ear pressure after 24 hours of ANS pack was -76.5 (± 58.8) daPa. Middle ear pressure again measured after 6 days of removal of ANS pack and showed that the middle ear pressure of all the patients were within normal range. Mean middle ear pressure was -12.4(± 36.5) daPa after 6 days of pack removal. Some otological symptoms developed due to change in middle ear pressure following ANS pack like ear fullness, earache and tinnitus. All these symptoms subsided after 6 days of pack removal. Conclusion: Anterior nasal packing decreases middle ear pressure which is reversible and returns to normal 6 days after pack removal. Some otological symptoms developed due to change in middle ear pressure which were transient and all came to normal after 6 days of pack removal. Bangladesh J Otorhinolaryngol 2022; 28(2): 135-140

Background: Tracheostomy is a surgical procedure, often a life saving measure in a variety of clinical conditions. It is one of the commonest procedures carried out on the critically ill patient. The most common causes of non-malignant airway obstruction are head and severe facial trauma, cerebrovascular accident, coma, respiratory burn and presence of foreign bodies in airway etc. Tracheostomy is an increasingly utilised adjunct in the ICU management of patients. Effective tracheostomy management involved the multi-professional team in a coordinated approach. Objectives: To study the indications of tracheostomy in non-malignant disorders. Study design: Cross-sectional study. Study setting and period: Department of Otolaryngorhinology and Head- Neck surgery (Unit- 1,2,3), General Surgery, ICU, Casualty, Neurosurgery, Thoracic surgery, Burn & Plastic Surgery and relevant OPD in Dhaka Medical College Hospitalfrom6th September 2015 to 5th March 2016. Methods: A hospital based cross-sectional study. Fifty patients admitted to hospital, underwent tracheostomy for non-malignant factors. Purposive samplings technique was used. Detail demographic data were collected from the informant and recorded in structured case record form. Clinical examination and relevant investigation were done meticulously. All collected questionnaire checked very carefully to identify the error in the data. Data processing work consist of registration schedules, editing computerization, preparation of dummy table, analyzing and matching of data. Result: A total of 50 patients of non-malignant pathology causing airway patency loss in different ward unit of DMCH were selected. In this study, maximum numbers of patients (36%) were between 51-70 years age groups with mean age was 47.23±11.57 years. It was observed that, frequency of non-malignant aetiology for tracheostomy gradually increases with age. Study show that, 51-70 years was most frequent age group (36%). Out of 50 cases 82% were male. Present study show that socioeconomically majority patients were poor class (52%), highest percentage of patient comprised of day labourer (30%). Head trauma (12%) and cerebrovascular accidents (9%) were the most common etiological factor trauma was the major aetilogical group (50%),followed by, central drive problems or neurological disease (38%) and elective tracheostomy was done. Conclusion: Head and facial trauma, cerebrovascular accident, coma, respiratory burn and presence of foreign bodies etc. are common aetilogical factors. It was found that tracheostomy is safer alternative to intubation when a prolonged artificial airway is required. Bangladesh J Otorhinolaryngol 2022; 28(2): 157-164

Background: Oral cancer is a common neoplasm worldwide which has a increased incidence and mortality rate over the past decades. In spite of skilled surgical and radio therapeutic modalities it is characterized by poor prognosis and a low survival rate. Lymph node metastasis is an important negative prognostic factor in oral cancer. In this study, pattern of cervical lymph node metastasis in oral carcinoma has been described. Such information may contribute to the understanding of oral cancer management plan. Methods: This cross-sectional observational study was conducted in the Otolaryngology and Head-Neck surgery department of Dhaka Medical College Hospital. The study period was from January 2018 to June 2018. A total of 50 patients were selected by purposive sampling technique. Data were collected by study physician himself. Then these collected data were recorded in structured case report forms. Clinical examination and relevant investigations were done. After planned surgical procedure post operative histopathological reports were collected. All collected questionnaire were checked very carefully. Data were processed and analyzed with the help of computer program SPSS and Microsoft excel. Quantitative data were expressed as mean and standard deviation and qualitative data as frequency and percentage. Comparison were done by tabulation and graphical presentation in the form of tables, pie chart, graphs, bar diagrams, histogram & charts etc. Result: Overall demographic features of 50 patients revealed that, the maximum incidence was seen in the age group 31-50 years (54.0%), mean age of the patient was 49.6 ±9.2 year. Male and female ratio was 4.5:1. In this study most of the tumors were well and moderately differentiated, 34.0% and 62.0% respectively. Aetiology and predisposing factors revealed that the most common were cigarette smoking, betal quid and alcohol consumption, present in 52.0%, 28.0% and 22.0% of patients respectively. Post operative histopathology reports showed that 24 patients (48.0%) had neck node metastasis among which 59.4% were with tumor size >1 cm. Tumors with the depth of invasion >3 mm had a very high risk of metastasis (P<0.0001), as compared to tumor less than 3 mm in thickness. Out of the 24 patients with nodal metastasis 17(34.0%) patients had a single node metastasis (N1). Level I and Level II were the commonest site to be involved (14 patients). Nodal metastasis predominantly occurred from primary tumour site of tongue (22.0%) and floor of the mouth (14.0%). It was seen that patients with higher grade had a higher risk of metastasis (grade 1:–29.4%, grade 2:- 54.8%, grade 3:– 100.0%). Conclusion: Oral carcinoma may appear at any sub site, although there are certain areas in which it is found more frequently, such as the oral tongue, cheek and floor of the mouth. Lymph node metastasis is more common in oral carcinoma mostly level I & II, which is one of the most relevant prognostic factors. Elective neck dissection can be considered in all patients with tumors more than 3 mm in thickness. J Dhaka Medical College, Vol. 29, No.1, April, 2020, Page 41-46

Abstract:One