Background & Objectives: To correlate FNAC of cervical lymphadenopathy with the histopathology.Materials and Methods: Prospective study on 67 patients with cervical lymphadenopathy at the ENT Department, Bir Hospital, from January 2013 to July 2014. Patients were subjected to both FNAC and histopathology.Results: Thirty cases (44.8%) were females and 37 cases (55.2%) were males. Tuberculosis was most common disease in 30(44.80%) patients. Sensitivity, specificity, and diagnostic accuracy of FNAC to diagnose tubercular lymphadenopathies were 83.0%, 100.0%, and 92.54% respectively. Overall correlation of FNAC to histopathology was 86.57%.Conclusion: FNAC is very simple and accurate technique for diagnosis of cervical lymphadenopathy.JCMS Nepal. 2015;11(1): 22-25

Introduction: Upper airway problems are frequently encountered in ENT practice. It is difficult to diagnose upper airway pathology by conventional methods. So use of fibreoptic flexible nasopharyngoscopy (NPL) is very helpful in both diagnosis and treatment of upper airway disorders. The aim of this study is to observe the usefulness of flexible NPL in patients with upper airway problems as an outpatient procedure. Materials and Methods: A cross sectional descriptive study was conducted in the department of ENT at KIST medical college teaching hospital during the period of 2years. A total of 138 patients who had persistent upper airway symptoms and underwent NPL were included in the study Detail history, clinical examination and required investigations were done.  Data were recorded and analysed.Results: Total 138 patients suffering from upper airway disorders underwent NPL. Among them 65(47.1%) were males and 73(52.9%) were females. Age range was from 16 to 82 years. Most common problem observed was laryngopharyngeal reflux disease accounting for 41 percent of cases followed by vocal cord nodule and polyp.Conclusions: Flexible fiberoptic nasopharyngolaryngoscopy (NPL) is safe and noninvasive outpatient department procedure for the assessment of upper airway disorders.

Introduction Gastroesophageal reflux disease (GERD) has been defined as the retrograde flow of gastric contents into the esophagus. Laryngopharyngeal reflux (LPR) is one of the manifestations of GERD which can be diagnosed clinically by Reflux Symptom Index (RSI) and Reflux Finding Score (RFS). The aim of this study was to find the prevalence of laryngopharyngeal reflux in patients with GERD undergoing upper esophagogastroduodenoscopy. MethodsThis was a prospective cross sectional study and all the patients visiting author’s institute with GERD undergoing upper esophagogastroduodenoscopy were included. All the relevant data on history, examination, RSI scores, RFS scores and upper esophagogastroduodenoscopy findings were recorded in the standard proforma and data were analysed. ResultsA total of 205 patients with GERD and undergoing upper esophagogastroduodenoscopy were included whose mean age was 46.1 years. The female to male ratio was 1.3:1. The most common presenting symptoms in our study was hoarseness (97%) followed by coughing (90.7%). The mean RSI score was 11.6. The symptom prevalence of LPR was 23.4%. The prevalence in between age groups and gender was not significantly different. The mean RFS score was 9.5. The prevalence of LPR by RFS assessment was 64.4%, which is significantly more than the prevalence assessed by RSI (23.4%). ConclusionThe prevalence of LPR in patients with GERD by RSI was less than the prevalence by RFS. So both the tools need to be used simultaneously to make the diagnosis and not recommendable to use independently.

Background: The thyroid gland lacks the squamous cell and the primary squamous cell carcinoma (SCC) of the thyroid gland is an uncommon malignancy with less than 1 % of all thyroid malignancy with a very poor prognosis. So far few cases are reported in the literature with very low survival rates.Case report: A 60 years female presented with a rapidly enlarging right lobe of the thyroid with pain, dysphagia and hoarseness of two months duration. She had hard fixed 4cm x 4cm right lobe of thyroid with right vocal cord paralysis. Ultrasound demonstrates 36mm x 36mm right lobe with mixed echogenicity with calcifications. Fine needle aspiration cytology suggested anaplastic carcinoma. Computed tomography showed heterogeneously enhancing soft tissue density in the right lobe of the thyroid gland measuring 51mm x 37mm x 53mm with shifting of the trachea towards the left side with no significant cervical lymph nodes. CT chest, ultrasonography abdomen and pelvis did not reveal any primary lesion or other metastatic disease and stage was made as T4N0M0. Patient underwent total thyroidectomy with center neck clearance with temporary tracheostomy. Histopathology came out to be squamous cell carcinoma and patient was send for chemo-radiotherapy.Conclusion: Primary squamous cell carcinoma of thyroid is a rare and aggressive entity with poor prognosis. Fine needle aspiration cytology is effective confirmatory tool but efforts shall be made to rule out metastatic SCC originating from other sites. Surgery, radiotherapy and chemotherapy alone are ineffective. Aggressive treatment with surgery followed by adjuvant radiotherapy with or without chemotherapy is recommended to achieve better outcome.Nepalese Journal of ENT Head and Neck Surgery, Vol. 6, No. 1, 2015