Introduction: Thyroid swellings/goiter are still prevalent in north east part of India. Apart from its sub-Himalayan location the areas along the river Brahmaputra suffer from flooding every year and there is also frequent changing of river course, thought to be another reason for iodine depletion in soil of this region(3).       Aim: To determine the incidence of thyroid swellings and distribution among different sections of society and geographical areas, and to evaluate the role of FNAC in the diagnosis and management and find out its accuracy by comparing with histopathology.     Materials and methods: In the present study, total 212 patients with thyroid swellings attending department of ENT of a state medical college during the period from January 2013 to December 2015 and undergone FNAC at department of Pathology were taken into consideration.     Results: Out of 212 cases major fraction (52.83%) were hailed from areas along the Brahmaputra river followed by patients (33.96%) from tea gardens and adjacent areas. Patients belonging to tribal communities constituted 45.28%, whereas patients from tea workers section of society formed the second majority (34.9%). Female male ratio of cases was 5:1. Majority of patients were from 21-40 years age group with mean age of 37.2 years.  Cytology results of 212 cases showed colloid goiter 73.58%, adenomatous goiter 8.49%, thyroiditis 9.9%, hurthle cell neoplasm 1.41%, follicular neoplasm 4.24%, papillary carcinoma 1.41%, papillary carcinoma of follicular variant 0.47% and medullary carcinoma in 0.47% cases. Histopathology was possible in 65 cases and compared with FNAC results with accuracy rate of 89.23%.     Conclusion: Frequent flooding and changes of river course may be one of the reasons for high prevalence of thyroid swellings and goiter along the Brahmaputra valley apart from its sub-Himalayan location. Consumption polluted drinking water and goitergenous food stuffs may be another reason of high incidence. FNAC is an easy, rapid, reliable, less invasive, low cost technique for diagnosis of thyroid swellings.

<p class="abstract">Otolaryngologists are more prone for exposure to aerosols during routine ENT examination and endoscopic procedures. ENT endoscopy procedures are considered as most aerosol-generating procedures and preferably routine procedures are avoided and deferred, if at all not necessary or urgent at this time of COVID-19 pandemic. The small particle size and extended travel of airborne aerosols mandate the use of specific personal protective equipment (PPE) and barriers by the health care workers to protect against transmission of COVID-19. Studies have recommended ENT endoscopy in awake patients with adequate topical preparation for local anaesthesia. Use of sprays should be avoided, instead, carefully placed pledgets should be used to provide adequate decongestion and anesthesia. Well ventilated endoscopy room with negative pressure (preferably), wearing a N95 mask with face shield or full PPE, thorough cleaning of entire endoscope after removal by standard disinfectants, decontamination of endoscopy room after each procedure and proper disposal of contaminated waste products are some common guidelines advised by health authorities globally till date.</p>