Background: The prevalence of Angiofibroma of juvenile variety is infrequent tumor of nasopharynx7. It grows aggressively and is locally destructive and extends into the cranium as well. Its symptoms usually involve nasal obstruction with or without nasal bleed. Histopathology shows spindle cells scattered between collagen fibers and vascular tissue. MRI and CT angiogram are the two most important investigations used in its diagnosis. Many methods have been used for its excision since ancient times and many researches have been done to control per operative bleeding as it is a vascular tumor. Aim: This study was performed to compare two methods i.e., 1. Carotid artery ligation per operatively and 2. Embolization of the feeding artery pre operatively in order to assess which method is better in controlling per operative bleeding during its excision. Design: Comparative Setting & duration: Department of Otorhinolaryngology, Jinnah Hospital, Lahore from 01st January 2020 to 31st January 2022. Methodology: A group 20 patients were taken having angiofibroma. 10 patients went for pre operative embolization of the feeding vessel of the angiofibroma after localizing the vessel by having MRA. The other 10 patients had their external carotid artery ligated before excising the angiofibroma. The bleeding which occurred during both procedures was quantified by weighing the gauze pieces soaked per operatively , the blood collected in suction bottle and then comparing the values. Results: The 10 patients who had embolization had far more bleeding during excision as compared to the 10 patients who had their external carotid artery ligated per operatively before excision. Conclusion: Results showed that pre operative embolization is not a better procedure to control per op bleeding as compared to external carotid artery ligation during angiofibroma excision. Keywords: Embolization , angiofibroma , per operative ,

Background: The prevalence of Angiofibroma of juvenile variety is infrequent tumor of nasopharynx7. It grows aggressively and is locally destructive and extends into the cranium as well. Its symptoms usually involve nasal obstruction with or without nasal bleed. Aims: To compare two methods i.e 1. Carotid artery ligation per operatively and embolization of feeding artery pre operatively in order to assess which method is better in controlling per operative bleeding during its excision. Design: Comparative study Study setting: The study was conducted in the Department of Otorhinolaryngology of Jinnah Hospital, Lahore. The duration of the study is from 01st January 2020 to 31st January 2022. Methodology: A group 20 patients were taken having angiofibroma. 10 patients went for pre operative embolization of the feeding vessel of the angiofibroma after localizing the vessel by having MRA. The other 10 patients had their external carotid artery ligated before excising the angiofibroma. The bleeding which occurred during both procedures was quantified by weighing the gauze pieces soaked per operatively, the blood collected in suction bottle and then comparing the values. Results: Ten patients who had embolization had far more bleeding during excision as compared to the 10 patients who had their external carotid artery ligated per operatively before excision. Conclusion: Results showed that pre operative embolization is not a better procedure to control per op bleeding as compared to external carotid artery ligation during angiofibroma excision. Keywords: Embolization, angiofibroma, per operative ,

Background: Laryngeal cancers are the second most common cancers in aero digestive tract. In advanced laryngeal cancers total laryngectomy is performed and it gives excellent results post operatively as the 5 year survival rate is 95%. One of the most common complication of total laryngectomy is formation of pharyngocutaneous fistula post operatively. Aim: To compare interrupted vs continuous suturing technique in formation of neopharynx after total laryngectomy in order to find out which technique is better in terms of pharyngocutaneous fistula formation postoperatively. Method: A total of 20 patients requiring total laryngectomy were selected. Patients were segregated into two groups. patients in group A underwent continuous suturing technique and those in group B underwent interrupted suturing technique in formation of neopharynx. Patients were then post operatively monitored for pharyngocutaneous fistula formation for 10 post operative days Result: Mean age in group-a patients was 56.90±12.94 year and 54.60±9.31 year in group-b patients. Pharyngocutaneous fistula developed in 2(20%) patients with interrupted suturing technique and in 7(70%) patients with continuous suturing technique used for formation of neopharynx. Conclusion: Hence it was concluded from our research that formation of neophaynx per operatively using interrupted suturing technique has less incidence of pharyngocutaneous fistula formation postoperatively then continuous suturing technique as it provides more strength to the wall of neopharynx and has less chances of dehiscence. Keywords: Neopharynx , Laryngectomy , Pharyngocutaneous fistula

Aim: To determine the validity of ultrasound in the diagnosis of malignant thyroid nodule keeping histopathology as gold standard. Methodology: This was a cross sectional study conducted in Radiology department of a Tertiary care Hospital, Islamabad for a period of one year. In this study, 55 patients who presented to indoor and outdoor department of hospital with palpable thyroid nodules underwent USG. The results of ultrasound were then compared with histopathological findings. Result: Out of 55 patients, on the basis of ultrasound, 5 male cases with thyroid nodule were malignant and 9 were benign while 8 females were malignant and 33 benign. But on histopathology report, out of 5, only 3(21%) males had malignancy while in females, 7(17%) out of 8 found malignant. 9 patients were true positive for malignancy and 4 patients were false positive, 41 patients were true negative for malignancy and one was false negative. Sensitivity was 90% while specificity was 91.1%. Positive predictive value was 69.2% and negative predictive value was 97.6%. Conclusion: Thyroid ultrasound is a valuable diagnostic tool in predicting malignancy in thyroid nodules with sensitivity of 90% and specificity of 91.1%. Keywords: Thyroid ultrasound, Echogenicity, Calcifications, Thyroid nodule