Total thyroidectomy for bilateral benign multinodular goitre

Total thyroidectomy for benign diseases of the thyroid is a controversial issue because of its serious and permanent complications but on the other hand recuuence rate is high when the thyroid tissue is left behind. This study is done to assess the overall outcome after total thyroidectomy in patients with extensive and bilateral benign multinodular goiter. A prospective experimental study. This study was conducted at Jinnah Medical College Hospital and Zainab Panjwani Memorial Hospital, Karachi over a period of four years from January 2002 to December 2005. A total number of 47 patients were included in this study having extensive and bilateral benign mutinodular goiter. Patients having predominantly unilateral disease, clear or suspicious malignancy and doubtful malignant cases were excluded. Total thyroidectomy was done in all cases by capsular dissection method with either preservation or reimplantation of one parathyroid gland. Ther short and long term complications are as follows: temporary hypocalcaemia [16pts], permanent hypocalcaemia [5pts], temporary recurrent laryngeal nerve palsy [2 pt], permanent recurrent laryngeal nerve palsy [1 pt], post operative bleeding requiring re-exploration [1pts], stitch granuloma [1pt] and tracheomalacia [1pt]. Complication rates are similar and comparable to other studies where sub-total or near total thyroidectomy was performed. So in our opinion total thyroidectomy is a better option in cases with extensive and bilateral benign multinodular goitre

Post-tonsillectomy hemorrhage: incidence and management

This is a retrospective study of 300 cases of tonsillectomy for post-tonsillectomy haemorrhage. Overall incidence figure was found to be 2% i.e. 6 cases out of 300. Reactionary haemorrhage occurred in 2 patients while secondary haemorrhage was present in 4 patients. Reactionary haemorrhage was treated by ligation while the secondary haemorrhage was treated conservatively

Foreign bodies in the ears: the regional experience

Foreign body in the ear is a common complaint in ENT practice. Between February 1993, and March 1994, 200 cases of foreign bodies in the ears were presented at Chandka Medical College Hospital, Larkana. Our experience of managing these foreign bodies along with the review of literature is reported in the article. One hundred eighteen males [59%] and 82 females [41%], 68% of the patients were below the age of 10 years. In-animate foreign body was present in 160 patient [80%], where the majority were of non-vegetative type. Trauma to the tympanic membrane was found in 42 cases [21%], where healing occurred spontaneously in all the cases without any surgical intervention

Hypertension: a common cause of epistaxis in adults

Epistaxis is a very common event and one of the commonest reasons of emergency admission in ENT wards. In the year 1993, 116 cases of epistaxis in adult age group presented in our departments. Hypertension was the most common cause of epistaxis in our series i.e. 68 cases out of 116 [57.8%]. Majority of these hypertensive patients were between the ages of 40 and 60 years [70.6%]. The mean systolic blood pressure in our series was found to be 197.4 mm of Hg, and mean diastolic blood pressure was 128.3 mm of Hg. In 30 patients [44.1%] there was no previous history of epistaxis. All the cases were managed by anterior nasal packing, antihypertensive drugs and other supportive therapy

Carcinoma of larynx

Fifty five cases of carcinoma of larynx subjected to surgical modality of treatment are included in this study. Transglottic tumours were present in 21 patients [38.1%]. Glottic carcinomata were found in 20 patients [36.4%] and supraglottic 14 cases [25.5%]. Majority presented with advanced status. These were followed up regularly for one to five years. 40 patients [72.7%] are living disease free, 9 expired [16.4%] and 6 [10.9%] are living with disease. The actual 3 years survival rate stands out at 81. 8%. T[1] lesions showed best prognosis [100%], T[2] has 83.3% survival rate while T[3] and T[4] showed figures of 75.8% and 53.3% respectively. Glottic carcinomata have the best prognosis [95%]. Oesophageal speech training were offered to 28 patients after radical laryngeal surgery and 19 [68.8%] acquired it successfully