To determine the frequency of malignancy in solitary nodule of thyroid in ENT, head and neck surgery department at civil hospital Karachi

Objective: To determine the frequency of malignancy in solitary nodule of thyroid

Study Design: Observational / Descriptive study

Place and Duration of Study: This study was conducted in the Department of Otolaryngology and Head and Neck Surgery at Civil Hospital Karachi from January 2007 to July 2008

Materials and Methods: This study comprises of 70 cases, in one and half years. We have included all cases of solitary nodule of either sex more than 10 years and excluded those patients who were exposed to radiation or underwent any sort of neck surgery previously. All Patients with solitary thyroid nodule were investigated with routine hematological and biochemical tests, thyroid profile, thyroid Scan, ultra sound neck and FNAC in outpatient department. At admission all risks/benefits of surgical procedures were explained to patients

Post-operative histopathological report of specimen was compared with preoperative fine needle aspiration cytology

Results: In our 70 cases study 59 patients were diagnosed with benign and 11 with malignant disease. Papillary carcinoma was found the most common tumor in 63.63%

Conclusion: Papillary carcinoma is the most common tumor in solitary thyroid nodule in our study followed by

To assess the accuracy of fine needle aspiration cytology [FNAC] for diagnosis of malignancy in solitary thyroid nodule at civil hospital Karachi

Objective: To assess the accuracy of fine needle aspiration cytology [FNAC] for the diagnosis of malignancy in solitary thyroid nodule

Study Design:Observational / Descriptive study

Place and Duration of Study: This study was conducted in the department of otolaryngology and Head and Neck Surgery at Civil Hospital Karachi from January 2007 to July 2008

Materials and Methods: This study comprises of 70 cases in one and half years. We have included all cases of solitary nodule of either sex more than 10 years and excluded those patients who were exposed to radiation or underwent any sort of neck surgery previously. All Patients with solitary thyroid nodule were investigated with routine hematological and biochemical tests, thyroid profile, thyroid Scan, ultra sound neck and FNAC in outpatient department. At admission all risks/benefits of surgical procedures were explained to patients. Postoperative histopathological report of specimen was compared with preoperative fine needle aspiration cytology

Results: In our 70 cases study 59 patients were diagnosed with benign and 11 with malignant disease. Sensitivity, specificity, accuracy was also recorded which were 72.72%, 99.20% and 94.20% respectively. Papillary carcinoma was found most common tumor in 63.63%

Conclusion: FNAC is valuable investigation for the preoperative assessment of solitary thyroid nodule and also has high diagnostic accuracy in its evaluation

Sinonasal polyposis and fungus: a growing relationship

To determine the frequency of underlying fungus in nose and paranasal sinuses in patients present with nasal polyposis. A total of 324 patients presented with nasal polyps were included in this study. Data collected from all the patients admitted in ENT department with diagnosis of nasal polyposis. All the relevant information about their presenting symptoms was recorded in a proforma. Post operatively the removed material was sent for histopathology and fungal culture. Later the findings of biopsy and culture reports were also recorded and analysed. Out of 324 patients 159 were males and 165 were females. Underlying fungus was present in 226[69.75%] and out of them, 102[45.13%] were males and 124[54.86%] were females with a P value of 0.039. The mean age was 25.95 +/- 9.32 [15-45] years for the patient with fungus. Aspergillus was the commonest organism found. Underlying fungus was found in a significantly high number of patients presented with nasal polyps and Aspergillus was the commonest organism found

Xeroderma pigmentosa - squamous cell carcinoma lip

A 10 Years old female patient of xeroderma pigmentosa [XP] presented with an oval shaped swelling on left upper lip for 2 months. Excisional biopsy was done and histopathology revealed moderately differentiated Squamous cell carcinoma. We report this case as Xeroderma pigmentosa with squamous cell carcinoma is rarely seen in ENT practice

Presentation and management of allergic fungal sinusitis

To assess the presentation of allergic fungal sinusitis and describe the line of management in our setup. Descriptive study. Study was conducted in Otorhinolaryngology Department, Dow Medical College and Civil Hospital, Karachi, from January 2004 to January 2005. Culture and sensitivity / fungal stain proven 20 cases of allergic fungal sinusitis were selected for the study, irrespective of age and gender. Data including age, gender, socioeconomic status, signs, symptoms, laboratory findings [especially Immunoglobulin E and eosinophil count] and imaging studies [Computed Tomography and /or Magnetic Resonance Imaging] were noted for the study. Pre and postoperative medical treatment, surgery performed, follow-up; residual/recurrence disease and revised surgery performed were also recorded. In this series, allergic fungal sinusitis was a disease of younger age group with an average age of 20.75 years with male dominance [70%]. Poor socioeconomic status [80%], allergic rhinitis [100%] and nasal polyposis [100%] were important associated factors. Nasal obstruction [100%], nasal discharge [90%], postnasal drip [90%] and unilateral nasal and paranasal sinuses involvement [60%] were the commonest presenting features. Aspergillus [60%] was the most common etiological agent. In all cases [100%], increased eosinophil count and IgE levels were present. Orbital [20%] and intracranial [10%] involvement were also seen. Surgical management was preferred in all cases. Functional endoscopic sinus surgery in 90% cases and lateral rhinotomy in 10% cases were performed. Recurrence / residual disease was seen in 20% cases. In this series, allergic fungal sinusitis was seen in immunocompetent, young males, belonging to poor socioeconomic status, suffering from allergic rhinitis and nasal polyposis, presenting with nasal obstruction, nasal discharge and postnasal drip. Functional endoscopic sinus surgery was the most important problem solving procedure while lateral rhinotomy was reserved for extensive disease

Ossicular damage in chronic suppurative otitis media- study of 100 cases

To identify the extent of ossicular chain damage in chronic suppurative otitis media [CSOM]. Prospective study. This study was conducted at department of Otolaryngology-Head and Neck Surgery, Dow Medical College and Civil Hospital, Karachi. March 2003 to March 2004. 100 cases presenting with CSOM under going mastoid exploration. The age of presenting of CSOM undergoing mastoid exploration ranged from 5 yrs to 55 yrs. The most commonly affected group was between 11 yrs to 20 yrs [50%]. Females were affected more than male [60%]. All patients presented with chronic discharging ears having conductive deafness, 60% presenting with moderate degree of hearing impairment [31 to 50 dB] while 30% had less than 30 dB loss and only 10% had greater than 50 dB loss. Granulation tissue was found in 47 cases, cholesteatoma in only 30 cases, inflamed mucosa in 24 cases, polyps in 7 cases and tympanosclerosis in 3 cases. Handle of malleus was necrosed in 30 cases, while in 20 cases all the three ossicles were necrosed except the foot plate of stapes. Long process of incus and handle of malleus were missing in 10 cases and the long process of incus alone was necrosed in 5 cases while malleus and incus were missing in 5 cases. In 30 cases all the ossicles were intact and mobile. Multi ossicular chain damage is more frequent than single ossicle damage in cases of chronic discharging ears. It is also observed that cholesteatoma is less frequent than the granulation tissue and inflamed mucosa in our setup