DEPARTMENT OF SURGICAL ONCOLOGY
ENT, HEAD AND NECK UNIT
ENT, Head and Neck unit is mainly dedicated for the detection and treatment of the premalignant and
malignant conditions of Head and Neck region, considering the high indulgence in addiction habit of
chewing tobacco, consumption of alcohol, smoking cigarettes has been major factor for Head and Neck
malignancies being the most common malignancy in our country. Due to lack of awareness and insufficient
screening programs nationwide most of the patient present in late stage of the malignancy thus posing
challenge for the treatment of the disease; surgery as well as adjuvant therapy.
Head and Neck region is complex anatomical site and plays important role in the physiology of digestion,
deglutition, respiration, and speech voice production. This demands more challenging work to treat,
so that the postoperative period physiological outcome becomes normal or near to normal. The Head
and Neck region represents the major portion for the cosmetic factor it leads to more challenge for the
postoperative cosmetic outcome.
For the treatment of the Head and Neck cancer a multidisciplinary approach is needed. Surgical, Radiation
and Medical oncology work together to provide the best possible treatment to the patient. Patient with
advance stage of disease are predominating in our hospital which makes treatment more challenging.
We follow the standard treatment protocols incorporating with radiation and chemotherapy as needed in
adjuvant or neoadjuvant setting.
ENT, Head and Neck surgery unit is continuously upgrading our technique in terms of radical resection
and reconstruction of the area involved using local flap and regional flap. Commonly performed
surgeries are Total Thyroidectomy, Composite resection of Buccal Mucosa, Hemi/Segmental/Marginal
Mandibulectomy Parotidectomy, Hemi/Total Glossectomy, Laryngectomy, Maxillectomy. Various Flaps are
used for reconstruction like; Pectoralis Major Flap, Perctoralis Major Myocutaneous Flap, Nasolabial Flap,
Sub Mental Island Flap, Detopectoroal Flap, Forehead Flap.
Department of Ent, Head and Neck surgery unit runs OPD services 3 days a week; Sunday, Tuesday and
Thursday and Major Operation rest 3 days of week: Monday, Wednesday and Friday. Minor surgeries and
Biopsies are performed daily. Total 25 beds are allocated to this unit. Total 1029 cases were operated on
2018 among them 372 were major cases, 305 were intermediate and 352 were minor cases.
Table 1 : Surgeries Performed in Year 2018
Wide Local Excision of Buccal Muco-
sa and Reconstruct on
Examinat on Under Anesthesia
Punch Biopsy (at Operat on Theater
Debridement and Re-suturing
Microscopic Laryngeal Surgery
Incision and Drainage
Laser Fulgurat on
ANNUAL REPORT - 2018
Table 2 : Month Wise Distribut on of Operat ve Cases 2018
Training to Post M.S. Graduates, M.S. students of Different medical colleges of Tribhuwan University
(TU), Kathmandu University (KU) and Nat onal Academy of Medical Sciences (NAMS).
Various awareness programs conduct on along with the collaborat on with Cancer prevent on, Control
and Research Department.
Conduct on of Joint Clinic Discussion among mult department at OPD days.
Dr. Dej Kumar Gautam, Unit Chief and Senior Consultant
Dr. Anil Bikram Karki, Consultant
Dr. Dilip Karmacharya, Jr. Consultant
Dr. Amar Shrestha, Registrar
Dr. Sadikshya Adhikari, Registrar
Dr. Liu Liu, Chinese Medical Team-Team Leader from the People’s Republic of China
Dr. Ban Yan Xin, Chinese Medical Team- Member from the People’s Republic of China
Dr. Surakshya Rayamajhi, Medical Officer
Dr. Rubin Shrestha, Medical Officer