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ORIGINAL ARTICLE
Mohan Mogarnad, Vandana Mohta

A Study on Clinical Profile of Deviated Nasal Septum and to determine the Efficacy of the Surgery

[Year:2017] [Month:May-August] [Volumn:10 ] [Number:2] [Pages:57] [Pages No:70-73][No of Hits : 1186]


ABSTRACT

Aim: To study the clinical profile of deviated nasal septum and to assess the subjective efficacy of the surgical outcome using Likert scale.

Materials and methods: This study is a prospective, observational, single-center study from October 2013 to May 2015. The study was conducted in Sri Siddhartha Medical College, Tumkur, Karnataka, India. A detailed clinical history was taken and clinical examination of the patient was carried out. Sixty symptomatic patients were taken up. Patient scored their symptom-related severity using a Likert scale preoperatively. All patients underwent conventional septoplasty. Postoperatively, their symptoms were scored on 30th, 45th, and 90th day.

Results: Preoperative and Postoperative values were analyzed. Statistically significant improvement was observed in the entire population: Nasal obstruction (p<0.001), headache (p<0.001), nasal discharge (p<0.001), facial pain (p<0.001), and hyposmia (p<0.001). Patient satisfaction was high and they used fewer nasal medications.

Conclusion: After surgical correction of the septum and analysis of the subjective scale, i.e., Likert scale showed improvement in all symptoms. The principal benefits of septal surgery relate to improvement in nasal symptoms.

Keywords: Clinical profile, Deviated nasal septum, Likert scale, Septoplasty.

How to cite this article: Mogarnad M, Mohta V. A Study on Clinical Profile of Deviated Nasal Septum and to determine the Efficacy of the Surgery. Clin Rhinol An Int J 2017;10(2):70-73.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Navjot Kaur, Harsimran Tiwana, Shikhar Sawhney, Ashok K Gupta

Malignancy mimicking Juvenile Nasopharyngeal Angiofibroma

[Year:2017] [Month:May-August] [Volumn:10 ] [Number:2] [Pages:57] [Pages No:99-102][No of Hits : 1149]


ABSTRACT

Nasopharyngeal masses in young males can be benign or malignant. As the treatment regimen for these masses differs considerably, it is crucial to differentiate benign from malignant masses for successful and adequate treatment of patients and also for minimizing morbidity from unnecessary interventions. We are presenting two case reports of patients with nasopharyngeal carcinoma (NPC) mimicking juvenile nasopharyngeal angiofibroma (JNA). Both the cases were presumed as JNA and underwent excessive surgical intervention only to reveal NPC on final histopathology report. We wish to highlight the importance of complete clinical examination and preoperative imaging in differentiating an ideal management of nasopharyngeal masses.

Keywords: Carcinoma, Endoscopic approach to juvenile nasopharyngeal angiofibroma, Nasopharynx.

How to cite this article: Kaur N, Tiwana H, Sawhney S, Gupta AK. Malignancy mimicking Juvenile Nasopharyngeal Angiofibroma. Clin Rhinol An Int J 2017;10(2):99-102.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Devang P Gupta, SK Dinesh, Ashil D Manavadaria

Transnasal Endoscopic Repair of Cerebrospinal Fluid Rhinorrhea

[Year:2017] [Month:May-August] [Volumn:10 ] [Number:2] [Pages:57] [Pages No:45-48][No of Hits : 1047]


ABSTRACT

Introduction: Cerebrospinal fluid (CSF) leak can arise as a complication of trauma, hydrocephalus, endoscopic sinus surgery, or it may occur spontaneously without any identifiable cause. Surgical repair is recommended in patients who do not respond to the conservative management. In recent years, transnasal endoscopic approach has become the preferred method for repairing CSF leaks, and better outcomes have been reported as compared with the intracranial approaches that were previously used. The objective of this study was to analyze the outcome of transnasal endoscopic repair of CSF rhinorrhea.

Materials and methods: T his p rospective s tudy w as c onducted in the Department of ENT, B.J. Medical College, Ahmedabad, India, from April 2013 to July 2016. Twenty-five patients with CSF rhinorrhea were included in the study. They were diagnosed based on the clinical evaluation, computed tomography, and magnetic resonance imaging. These patients did not respond to conservative management and were operated transnasally using rigid endoscope. Patients were followed up for a mean duration of 9 months, and the outcome was analyzed.

Results: The patients included in the study ranged in the age group of 12 to 55 years. Among the patients, 15 were females and 10 were males. The cause of CSF rhinorrhea was traumatic in 18, idiopathic or spontaneous in 7. In 12 patients, the site of leak was cribriform plate, 6 from ethmoid, 5 from sphenoid sinus, and in 2 frontal sinuses were affected. Primary surgery was successful in 23 of cases. In two cases, reexploration had to be performed. Overall success rate was 100%.

Conclusion: Transnasal endoscopic repair of CSF rhinorrhea is highly successful, safe, and less traumatic.

Keywords: Cerebrospinal fluid, Endoscopic repair, Transnasal.

How to cite this article: Gupta DP, Dinesh SK, Manavadaria AD. Transnasal Endoscopic Repair of Cerebrospinal Fluid Rhinorrhea. Clin Rhinol An Int J 2017;10(2):45-48.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Trilok C Guleria, Shobha Mohindroo, Narender K Mohindroo, Ramesh K Azad, Arun Kumar

Histopathological Profile of Nasal Cavity, Paranasal Sinuses, and Nasopharyngeal Masses in Hill State of Himachal Pradesh, India

[Year:2017] [Month:May-August] [Volumn:10 ] [Number:2] [Pages:57] [Pages No:93-98][No of Hits : 1033]


ABSTRACT

Introduction: Nasal masses are common finding in the ear, nose, and throat outpatient department. Most patients present with complaints of nasal obstruction. A sinonasal mass can have various differential diagnoses. They may be congenital, inflammatory, neoplastic (benign or malignant), or traumatic in nature. A careful histopathological examination is necessary to decide the nature of any particular lesion.

Materials and methods: The retrospective study was carried out between January 2011 and December 2013. A total of 185 cases diagnosed with masses of the nasal cavity, paranasal sinuses, and nasopharynx were included. Data from histopathological records were retrieved to confirm the diagnosis.

Observations: Among 185 cases, 75% were non-neoplastic and 25% were neoplastic. Among neoplastic masses, 57% were benign and 43% were malignant. The age of presentation ranged from first to eighth decade of life (mean age 37.74 years). The lesions had a stronger predilection for males (1.68:1). Among non-neoplastic lesions, nasal polyp was the commonest lesion followed by ethmoidal mucocele (1.44%) and lupus vulgaris (0.72%). Among benign lesions, inverted papilloma (30.77%) and nasopharyngeal angiofibroma (30.77%) were the commonest followed by capillary hemangioma (15.38%), osteoma (7.68%), nasopharyngeal lymphoepithelioma (3.85%), chondroma (3.85%), pleomorphic adenoma (3.85%), and schwannoma (3.85%). Squamous cell carcinoma (40%) was the commonest malignant neoplastic lesion observed followed by adenoid cystic carcinoma (20%), malignant melanoma (15%), nasopharyngeal carcinoma (10%), esthesioneuroblastoma (10%), and non-Hodgkin lymphoma (5%).

Conclusion: Among the noninflammatory lesion, nasal polyp is the commonest lesion. Nasal polyps are more common in hilly area may be due to exposure to pine pollens. There is no difference in the histopathological profile of benign and malignant lesions.

Keywords: Lymphoepithelioma, Melanoma, Nasopharygeal, Ranged.

How to cite this article: Guleria TC, Mohindroo S, Mohindroo NK, Azad RK, Kumar A. Histopathological Profile of Nasal Cavity, Paranasal Sinuses, and Nasopharyngeal Masses in Hill State of Himachal Pradesh, India. Clin Rhinol An Int J 2017;10(2):93-98.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Swati Tandon, Praveen K Rathore, Anoop Raj, Anjali Prakash, Vikram Wadhwa

Correlation of Computed Tomographic Findings and Intraoperative Findings in Patients with Chronic Sinusitis

[Year:2017] [Month:May-August] [Volumn:10 ] [Number:2] [Pages:57] [Pages No:78-85][No of Hits : 957]


ABSTRACT

Objective: Chronic sinusitis affects more than 30 million people each year worldwide. Computed tomography (CT) has become a standard diagnostic tool in the evaluation of paranasal sinuses (PNS), but medical literature lacks studies correlating preoperative CT and intraoperative findings of functional endoscopic sinus surgery (FESS). The aim of our study was to evaluate ostiomeatal unit on multidetector CT (MDCT) and correlate findings of MDCT with intraoperative findings during FESS in patients with chronic sinusitis and hence check for its usefulness during surgery.

Study design: Prospective clinical study.

Materials and methods: Forty-nine patients with chronic sinusitis who visited the Lok Nayak Hospital, Delhi, India, between October 2010 and February 2012 were included in the study. All such patients underwent preoperative CT scan of PNS before surgery, i.e., FESS with or without septoplasty under general anesthesia.

Results: Maxillary sinus was found to be the most common sinus involved in chronic sinusitis. Preoperative CT findings correlated well with intraoperative findings for all sinuses except left maxillary sinus.

Conclusion: Multiplanar CT of nose and PNS helps to delineate the anatomy of nose and PNS, and drainage pathways of sinuses preoperatively. Therefore, the operating surgeon should be well versed with it. Progress of endoscopic sinus surgery can be partially attributed to revolution in imaging modalities.

Keywords: Functional endoscopic sinus surgery, Multidetector computed tomography, Ostiomeatal complex, Paranasal sinuses, Rhinosinusitis.

How to cite this article: Tandon S, Rathore PK, Raj A, Prakash A, Wadhwa V. Correlation of Computed Tomographic Findings and Intraoperative Findings in Patients with Chronic Sinusitis. Clin Rhinol An Int J 2017;10(2):78-85.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Jyothi A Chavadaki, Ajay K Manvikar, BH Shrikrishna

Endoscopic Dacryocystorhinostomy: Our Experience

[Year:2017] [Month:May-August] [Volumn:10 ] [Number:2] [Pages:57] [Pages No:49-52][No of Hits : 931]


ABSTRACT

Purpose: To determine the outcome and safety of endoscopic dacryocystorhinostomy (ENDO-DCR) with the use of silicon stents in nasolacrimal duct obstruction (NLDO).

Materials and methods: This study was done in the Department of Otorhinolaryngology and Head and Neck Surgery, Navodaya Medical College, Raichur, from January 2013 to June 2015, with a total of 82 cases (10 cases with bilateral disease) who underwent a standardized procedure, with an endonasal approach to the lacrimal sac, surgical removal of nasal mucosa, lacrimal bone, and a fragment of the frontal process of the maxilla. The medial wall of the lacrimal sac was removed completely and canalicular silicone intubation tube was placed for 6 weeks postoperatively.
Main outcome measures were resolution of epiphora, absence of discharge, and patency of the ostium confirmed by irrigation and endoscopic evaluation of neo-ostium at 6 weeks.

Results: The ENDO-DCR procedure with adjunctive canalicular silicone intubation tube was successful in 78 (95%) cases. No significant complications were encountered during or after the operative period.

Conclusion: Endoscopic dacryocystorhinostomy with canalicular silicon intubation for shorter duration (6 weeks) is a safe and successful procedure for the treatment of NLDO in adults as well as in children, with a success rate of 95%.

Keywords: Endoscopic dacryocystorhinostomy, Lacrimal sac, Nasolacrimal duct obstruction, Neo-ostium, Silicone intubation tube.

How to cite this article: Chavadaki JA, Manvikar AK, Shrikrishna BH. Endoscopic Dacryocystorhinostomy: Our Experience. Clin Rhinol An Int J 2017;10(2):49-52.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Reji Mathew, Chandrakala Srinivasa, Vinayababu Sathyanarayana, Sindhura Suryanarayana, Pooja Harsha

Role of Pterygopalatine Fossa Block in achieving Relatively Bloodless Field during Endoscopic Sinus Surgery

[Year:2017] [Month:May-August] [Volumn:10 ] [Number:2] [Pages:57] [Pages No:62-65][No of Hits : 849]


ABSTRACT

Aim: To study the efficacy of pterygopalatine fossa (PPF) block with 2% xylocaine and 1:80,000 adrenaline on bleeding during endoscopic sinus surgery (ESS).

Materials and methods: Single-blinded prospective comparative study was conducted on patients who underwent bilateral functional endoscopic sinus surgery after obtaining written informed consent. The effect of PPF infiltration was tested by injecting 2% xylocaine with adrenaline on test side, and saline on the control side. The test and the control side were determined by block randomization technique. The surgeon was blinded as to which side the test and control drug was to be given. The surgical field was assessed and graded every 15 minutes on both sides according to Boezaart and Vander Merwe scoring system, and the results were compared and analyzed using Mann-Whitney U test.

Results: Thirty-two patients were included in the study, of whom 59.4% were males. Ethmoidal polyposis was the most common diagnosis (50%). The median computed tomography grade and the endoscopic grade of disease in test side and control side were comparable. The mean blood loss grade on test side was 9.0 ± 3.5 and in control side was 10.9 ± 3.5, and the difference was statistically significant. Significant positive correlation was observed between preoperative endoscopic grade of the disease and blood loss during surgery. A statistically significant correlation was also observed between the vital parameters and blood loss.

Conclusion: Pterygopalatine fossa infiltration with 2% xylocaine and 1:80,000 adrenaline reduces bleeding during ESS.

Clinical significance: This study is pivotal in devising an additional method for providing a clear bloodless operative field which to date is one of the major challenges faced by the otorhinolaryngologist.

Keywords: Control of bleeding, Endoscopic sinus surgery, Prospective case-control study, Pterygopalatine fossa.

How to cite this article: Mathew R, Srinivasa C, Sathyanarayana V, Suryanarayana S, Harsha P. Role of Pterygopalatine Fossa Block in achieving Relatively Bloodless Field during Endoscopic Sinus Surgery. Clin Rhinol An Int J 2017;10(2):62-65.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Anuj K Goel

Adenoidectomy: Conventional or Endoscopic Assisted?

[Year:2017] [Month:May-August] [Volumn:10 ] [Number:2] [Pages:57] [Pages No:74-77][No of Hits : 823]


ABSTRACT

Objectives: Adenoid hypertrophy is known as the most common cause of nasal obstruction in children; thus, adenoidectomy is one of the most commonly performed surgical procedures in the pediatric population. We performed both conventional and endoscopic-assisted adenoidectomies in 54 patients. Our objectives were to compare the efficacy of both methods in terms of subjective and objective relief of symptoms, safety, recurrence, and postoperative morbidity.

Materials and methods: Fifty-four patients were studied and were diagnosed depending upon clinical examination and radiological investigation. The patients were operated by either conventional or endoscopic-assisted adenoidectomy (EAA). Intraoperative and postoperative complications were looked for. After discharge from the hospital, the patients were called for follow-up on 1st week, 3rd week, 2nd and 4th month, and patients were asked for relief of symptoms and examined for nasal disease and for recurrence.

Results: Adenoid hypertrophy was seen commonly in children and the most common presenting complaints were nasal obstruction, mouth breathing, and snoring. The patients were diagnosed to have chronic adenoiditis, chronic adenotonsillitis, with or without chronic suppurative otitis media. More number of patients became symptom free with EAA as compared with conventional adenoidectomy.

Conclusion: Conventional adenoidectomy and EAA both have comparable success rates. Endoscopic-assisted adenoidectomy allows complete removal of adenoid tissue, thereby reducing the chances of developing recurrent adenoid obstructive symptoms and reducing the bacterial reservoir in the nasopharynx.

Keywords: Adenoid, Nasal obstruction, Nasopharynx.

How to cite this article: Goel AK. Adenoidectomy: Conventional or Endoscopic Assisted? Clin Rhinol An Int J 2017;10(2):74-77.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Kuldeep Thakur, Aditya Kashyap, Satisg Negi, Prem L Chauhan

Anatomical and Functional Evaluation of Conventional vs Inferior Endoscopic Dacryocystorhinostomy in Study Cases of Idiopathic Chronic Dacryocystitis

[Year:2017] [Month:May-August] [Volumn:10 ] [Number:2] [Pages:57] [Pages No:86-90][No of Hits : 813]


ABSTRACT

Objective: To compare the results of conventional nasal endoscopic dacryocystorhinostomy (DCR) and inferior nasal endoscopic DCR in Study cases of idiopathic chronic dacryocystitis. Materials and methods: Forty patients diagnosed with idiopathic chronic dacryocystitis were divided into two groups alternately. After relevant investigations, they were subjected for endoscopic DCR by two techniques. Twenty patients underwent conventional endoscopic DCR and 20 underwent inferior endoscopic DCR under transoral pterygopalatine block and topical lignocaine (4%) with adrenaline 1:2,000. After 3 months of follow-up in the outpatient department, nasal endoscopy along with fluorescein dye disappearance test (FDDT) at 10 minutes was done.

Results: Ninety-five percent (19/20) of patients undergoing conventional endoscopic DCR and 90% (18/20) of patients undergoing inferior endoscopic DCR were found to have patent anatomical fistula. On FDDT, nasal endoscopy after 10 minutes revealed 84% (16/19) in group I and 94.4% (17/18) in group II with fluorescein in nasal cavity.

Conclusion: Present study concludes the importance of bony, tendinous, and muscular support of lacrimal sac in physiological lacrimal pump functioning and advantage of relatively new technique of inferior endoscopic DCR. Inferior endoscopic DCR is associated with less operative time as well as less local complications.

Keywords: Chronic dacryocystitis, Dacryocystorhinostomy, Nasolacrimal duct obstruction.

How to cite this article: Thakur K, Kashyap A, Negi S, Chauhan PL. Anatomical and Functional Evaluation of Conventional vs Inferior Endoscopic Dacryocystorhinostomy in Study Cases of Idiopathic Chronic Dacryocystitis. Clin Rhinol An Int J 2017;10(2):86-90.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
SV Manjunatha Rao

Radiofrequency Turbinoplasty in Imidazoline-induced Rhinitis Medicamentosa

[Year:2017] [Month:May-August] [Volumn:10 ] [Number:2] [Pages:57] [Pages No:53-57][No of Hits : 793]


ABSTRACT

Aim: To evaluate the efficacy and results of radiofrequency turbinoplasty in patients with rhinitis medicamentosa due to imidazolines like oxymetazoline and xylometazoline.

Study design: This is a prospective, single-blinded, randomized controlled study.

Materials and methods: Study was conducted on 20 patients in a tertiary level center from January 2010 to February 2016. Patients with symptoms and signs of nasal obstruction due to rhinitis medicamentosa were selected. Patients were aged from 16 to 43 years (mean age is 24 years). Twelve were males and eight were females. The duration of use of nasal decongestant drops varied from 3 months to 5 years. The turbinoplasty was performed using the radiofrequency method. Nasal obstruction symptom evaluation (NOSE) questionnaires are used for subjective assessment and nasal endoscopy view score (NES) was used for objective assessment pre- and postoperatively. Follow-up was done at the end of 15 days and 3 months after surgery. The results were statistically analyzed by paired t-test.

Results: The mean NOSE score before procedure was 92. At the 15th postoperative day, mean NOSE score reduced to 1.3 and it further reduced at the 3rd month to 0.5 (p < 0.001), with 99.5% reduction in subjective symptoms. The mean NES before procedure was 3.95. On the 15th day, it was 0.35 and at the end of 3rd month, it was 0 with 91.1% reduction in objective evaluation (p < 0.001). Results were same on left and right side of nose. No major postoperative complication was observed in patients.

Conclusion: Radiofrequency turbinoplasty technique can be recommended as an effective method in imidazoline-induced rhinitis medicamentosa. It is simple, comfortable, fast relief giving, no repeated steroids, and cost-effective, single-session treatment. Good compliance and cooperation from patients can be obtained with no major complications of the treatment. It allows patients to be managed in the office environment.

Keywords: Imidazoline, Radiofrequency, Rhinitis medicamentosa.

How to cite this article: Rao SVM. Radiofrequency Turbinoplasty in Imidazoline-induced Rhinitis Medicamentosa. Clin Rhinol An Int J 2017;10(2):53-57.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Kavita Sachdeva, Saurav Naskar

A Study of Neoplastic and Non-neoplastic Sinonasal Masses at a Tertiary Center

[Year:2017] [Month:May-August] [Volumn:10 ] [Number:2] [Pages:57] [Pages No:66-69][No of Hits : 715]


ABSTRACT

Aim: The aim of this study was to evaluate all the cases of sinonasal masses based on histopathology into neoplastic and non-neoplastic lesions and to study their clinical and radiological presentations.

Materials and methods: The present study was carried out in 42 patients coming to the outpatient and inpatient Department of ENT of Netaji Subhash Chandra Bose Medical College & Hospital with the complaint of nasal obstruction during the period of March 2015 to August 2016. Patients were subjected to thorough clinical examinations and radiological investigations, which included digital X-ray paranasal sinus (PNS) and contrast-enhanced computed tomography PNS, and diagnosis was confirmed by nasal biopsy for histopathology reports.

Results and observations: A total of 42 patients were studied, of which 71.43% were non-neoplastic and 28.57% were neoplastic. Nasal polyps were the commonest non-neoplastic lesions (61.91%). Most common benign neoplastic lesion was angiofibroma (11.9%), while the commonest malignant neoplastic mass was found to be squamous cell carcinoma (7.14%). There was one case of adenoid cystic carcinoma.

Conclusion: Patients with sinonasal masses may present with trivial complaints, but proper evaluation of all the cases will enable us to make specific diagnosis and treat them accordingly.

Keywords: Nasal polyp, Neoplastic lesion, Non-neoplastic lesion, Sinonasal mass.

How to cite this article: Sachdeva K, Naskar S. A Study of Neoplastic and Non-neoplastic Sinonasal Masses at a Tertiary Center. Clin Rhinol An Int J 2017;10(2):66-69.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Pragya Singh, Mahesh K Mittal, Neeraj N Mathur, Mukul Sinha

Concha Bullosa Osteoma: An Unusual Cause of Headache

[Year:2017] [Month:January-April] [Volumn:10 ] [Number:1] [Pages:44] [Pages No:25-27][No of Hits : 693]


ABSTRACT

Aim and background: Osteomas are common benign tumors of the paranasal sinuses, but are usually asymptomatic and found as a coincidental finding during routine radiological investigations. The aim is to demonstrate typical radiological findings of osteomas and demonstrate rare occurrence of osteoma in middle turbinate.

Case report: Patient presenting with recurrent headaches, left-sided facial pain, and intermittent nasal obstruction was evaluated using Philips Brilliance 40-multislice computed tomography scanner, which showed bilateral maxillary and ethmoid sinusitis with bilateral fluid-filled concha bullosa with left-sided concha bullosa showing a well-defined lesion of bone attenuation suggestive of osteoma.

Conclusion: Osteomas can rarely occur in nasal turbinates and may be symptomatic requiring endoscopic/surgical removal. Clinical significance: Radiological investigations are diagnostic for osteomas and play an important role in preoperative planning. Osteomas arising from the turbinates are more easily accessible by endoscopy than sinus osteomas; hence, removal carries less risk. Therefore, it is important to diagnose nasal osteoma when it is small in size, follow it up, and resect it when its size is appropriate for endoscopic surgery.

Keywords: Concha bullosa, Endoscopic surgery, Neuralgia, Osteoma, Sinusitis.

How to cite this article: Singh P, Mittal MK, Mathur NN, Sinha M. Concha Bullosa Osteoma: An Unusual Cause of Headache. Clin Rhinol An Int J 2017;10(1):25-27.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
MK Rajasekar, Vivek Mariappan, Narendrakumar Veerasigamani

Our Experience with Maxillectomies: A Retrospective Decade Study

[Year:2017] [Month:May-August] [Volumn:10 ] [Number:2] [Pages:57] [Pages No:58-61][No of Hits : 654]


ABSTRACT

Objective: The aim of the study is to evaluate the age, sex, site of lesion, histopathological diagnosis, and recurrence rate of the maxillectomy patients.

Materials and methods: A retrospective study was done in 42 patients, who underwent maxillectomy for malignant growth of the nose and paranasal sinuses from 2006 to 2015 at our center.

Results: The most common age group is 55 to 65 years (73.8), with male predominance (66.7%). Among symptoms prevalent is nasal obstruction (47%). Maxillary sinus is the most common site of origin (61.9%). Squamous cell carcinoma is the most common histopathological diagnosis (52.4%) and recurrence rate is 16%.

Conclusion: Exact clearance, reconstruction, postoperative care, and perfect teamwork play a vital role. Thus, successful outcome of maxillectomy is multifactorial.

Keywords: Maxillectomy, Paranasal tumors, Reconstruction, Squamous cell carcinoma.

How to cite this article: Rajasekar MK, Mariappan V, Veerasigamani N. Our Experience with Maxillectomies: A Retrospective Decade Study. Clin Rhinol An Int J 2017;10(2):58-61.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Nishi Gupta, Sima Das, Neeraj Chawla

Canaliculitis Masquerading as Dacryocystitis: Rhinologist’s Dilemma

[Year:2017] [Month:May-August] [Volumn:10 ] [Number:2] [Pages:57] [Pages No:91-92][No of Hits : 648]


ABSTRACT

Aim: To highlight canaliculitis masquerading as chronic dacryocystitis that may mislead a rhinologist.

Background: Canaliculitis is an inflammation of the lacrimal canaliculi caused by infection or as a complication of punctal plug insertion.It is often misdiagnosed, leading to a delay in diagnosis.

Case report: We report a case of a 20-year-old female patient who presented with complaints of watering from left eye since 1 year and was referred to the Department of Ear, Nose, and Throat for endoscopic dacryocystorhinostomy (DCR). She had a history of silicone punctal plug insertion in the same eye for “dry eye” following an attack of herpes zoster 12 years earlier. She was asymptomatic for 10 years following punctal plug insertion, but started complaining of epiphora since the last 2 years. Punctal plug was removed 1 year back by an ophthalmologist but the epiphora persisted. Regurgitation of purulent discharge on pressure over lacrimal sac area made it look like dacryocystitis. Syringing through lower punctum was blocked while through the upper punctum it was patent. Thus, possibility of nasolacrimal duct block was ruled out. An occuloplasty opinion was sought and a diagnosis of lower canaliculitis with possibility of retained plug was made.

Conclusion: Canaliculitis should be considered as a differential diagnosis in cases presenting with epiphora as canaliculitis is a close masquerade of dacryocystitis.

Clinical significance: As more a nd m ore rhinologists are getting direct referrals of cases needing endoscopic DCRs, it is important for them to be well aware of other associated pathologies of proximal lacrimal system. This will help them to reach a correct diagnosis before going ahead with endoscopic DCR.

Keywords: Canaliculitis, Dacryocystitis, Epiphora, Masquerading.

How to cite this article: Gupta N, Das S, Chawla N. Canaliculitis masquerading as Dacryocystitis: Rhinologist’s Dilemma. Clin Rhinol An Int J 2017;10(2):91-92.

Source of support: Nil

Conflict of interest: None


 
RESEARCH ARTICLE
Parth B Kapadia, Anand V Chaudhari, Jaymin A Contractor, Rahul B Patel, Jay N Suratwala, Jalpa A Patel

A Study of Correlation between Subjective Sensation of Nose Block and Objective Assessment of Nasal Patency by Cold Spatula Test in a Patient with Nose Block

[Year:2017] [Month:January-April] [Volumn:10 ] [Number:1] [Pages:44] [Pages No:1-5][No of Hits : 605]


ABSTRACT

The complaint of a nose block is often a complex clinical problem by itself. There is no consensus about the value of objective measurements of nasal patency. However, the perception of nasal airflow ultimately is a subjective sensation and, therefore, difficult to quantify. In this study, we have objectively evaluated 75 patients coming to our institute with the complaint of nose block. The mean area of air blast of both the nasal cavities of each patient was calculated by cold spatula test using modified “Glatzel mirror (GM),” and the subjective sensation of nose block was compared on each visit. We observed that both medical and surgical interventions objectively did improve the area of air blast in both unilateral and bilateral nose block patients. This also correlated with the increase in subjective sensation of relief from nose block in the patients. Thus, we could conclude that in patients with nose block, both medical and surgical interventions improved the area of air blast (p < 0.001), which correlated with the subjective sensation of relief in nose block. Thus, in standard conditions, cold spatula test using modified GM can be used to objectively evaluate the nasal patency.

Keywords: Cold spatula test, Glatzel mirror, Nasal patency, Nose block.

How to cite this article: Kapadia PB, Chaudhari AV, Contractor JA, Patel RB, Suratwala JN, Patel JA. A Study of Correlation between Subjective Sensation of Nose Block and Objective Assessment of Nasal Patency by Cold Spatula Test in a Patient with Nose Block. Clin Rhinol An Int J 2017;10(1):1-5.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Jitendra S Yadav, Vineet Kumar, Siva Selvaraj, Chander Bhan, Manish Pandey

Endoscopic Removal of Clival Chordoma

[Year:2017] [Month:January-April] [Volumn:10 ] [Number:1] [Pages:44] [Pages No:28-31][No of Hits : 552]


ABSTRACT

Clivus chordomas are locally aggressive benign, with primary bone tumor arising from remnant of notochord anywhere from the coccyx to the base of the skull, in either a midline or paramedian position. The tumors show rare presentation and relatively common recurrence rate. Intracranial chordomas usually arise from the region around the clivus and account for about a third of all chordomas. Clival chordomas rarely metastasize and become symptomatic after local invasion to cranial nerves and skull base structure. Diagnosis is based on computed tomography scan/magnetic resonance imaging findings and histopathological examination of soft tissue mass. Complete surgical resection is the primary line of management with or without radiotherapy. We are presenting a case of clival chordoma of a 35-year-old female who presented with diminished vision and headache since 6 months. After evaluation, the patient was treated with endoscopic endonasal transsphenoidal resection of the tumor. After surgery, the patient showed relief from headache and slight improvement in vision loss.

Keywords: Clival chordoma, Endonasal, Endoscopic, Transsphenoid approach.

How to cite this article: Yadav JS, Kumar V, Selvaraj S, Bhan C, Pandey M. Endoscopic Removal of Clival Chordoma. Clin Rhinol An Int J 2017;10(1):28-31.

Source of support: Nil

Conflict of interest: None


 
Editorial
ASHOK K GUPTA

Editorial

[Year:2017] [Month:May-August] [Volumn:10 ] [Number:2] [Pages:57] [Pages No:iv][No of Hits : 501]


ABSTRACT

Advances in instrumentation, plays a key role in evolution of any surgical discipline. During this process, there are certain key junctures where the state of the art in technology truly augments the surgeon’s ability to manage higher levels of pathology.


 
REVIEW ARTICLE
Rajalaxmi Panigrahi, Sudhir K Acharya

Recent Trends in Management of Allergic Rhinitis

[Year:2016] [Month:September-December] [Volumn:9 ] [Number:3] [Pages:45] [Pages No:130-136][No of Hits : 2047]


ABSTRACT

Allergic rhinitis is an inflammatory, immunoglobulin E (IgE)- mediated disease, characterized by nasal congestion, rhinorrhea, and sneezing with or without nasal itching. It can significantly interfere with patient’s quality of life. The goals of treatment are to provide the patient with symptomatic relief and improve the quality of life with minimal adverse effects. Prevention has been a large focus in the treatment of allergic rhinitis, but few interventions have proven effective. Although dust mite allergies are more common.

Keywords: Allergens, Allergic menifestation, Rhinorrhea, Rhinitis.

How to cite this article: Panigrahi R, Acharya SK. Recent Trends in Management of Allergic Rhinitis. Clin Rhinol An Int J 2016;9(3):130-136.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
MK Rajasekar, Malarvizhi R Sankar

A Rare Case of Pediatric Self-inflicted Meningoencephalocele

[Year:2016] [Month:September-December] [Volumn:9 ] [Number:3] [Pages:45] [Pages No:143-145][No of Hits : 1657]


ABSTRACT

Cerebrospinal fluid (CSF) rhinorrhea is common in traumatic penetrating nasal injuries. In the pediatric age group, we often encounter self-inflicted foreign body injuries of blunt type, which rarely leads to any complications. We came across a case of CSF rhinorrhea due to self-inflicted penetrating nasal injury, after 7 years of initial injury. In this case, the sharp end of a screw nail had injured the fovea ethmoidalis and caused a meningoencephalocele on removal, which had been asymptomatic until 4 years ago, when the patient came with CSF rhinorrhea. Miraculously, there were no complications in the period before presentation and after surgical correction.

Keywords: Cerebrospinal fluid rhinorrhea, Endonasal approach, Pediatric trauma, Screw nail trauma

How to cite this article: Rajasekar MK, Sankar MR. A Rare Case of Pediatric Self-inflicted Meningoencephalocele. Clin Rhinol An Int J 2016;9(3):143-145.

Source of support: Nil

Conflict of interest: None


 
Original Article
Niru Moran, Debajit Das

Epistaxis—Incidence, Etiology, and Management: A Hospital-based Study

[Year:2016] [Month:January-April] [Volumn:9 ] [Number:1] [Pages:58] [Pages No:18-20][No of Hits : 1604]


ABSTRACT

Epistaxis is defined as bleeding from the nose. Though it is not serious, it causes anxiety both to the sufferer and to the attending physician. The objective of this study was to review the incidence, common etiological factors, and management modalities of epistaxis. It is a prospective study of 288 patients seen with epistaxis over 1.5 years at Assam Medical College and Hospital from January 2014 to July 2015. The age of patients ranged between 4 and 80 years. An incidence of 7.5% (38,400) was recorded and slight male preponderance with a male:female ratio of 25:9. Trauma and local nasal factor were the main etiological factors identified, but over 5.90% had no discernable cause. About 65% presented with active bleeding and 50% required admission. Patients were managed according to their cause. About 10.41% required blood transfusion. Epistaxis is a common rhinological emergency that requires prompt intervention to reduce morbidity and prevent mortality.

Keywords: Blood transfusion, Epistaxis, Rhinological.

How to cite this article: M oran N , D as D . E pistaxis- Incidence, Etiology, and Management: A Hospital-based Study. Clin Rhinol An Int J 2016;9(1):18-20.

Source of support: Nil

Conflict of interest: None


 
Review Article
Anuja Bhargava, Sachin Khanduri, Mohd Shakeel, Saurabh Srivastava, Prasoon Varshney

Maxillary Sinus Hypoplasia—A Not-so-uncommon Clinical Entity: A Case Report and Review of the Literature

[Year:2016] [Month:January-April] [Volumn:9 ] [Number:1] [Pages:58] [Pages No:43-45][No of Hits : 1501]


ABSTRACT

Bilateral sinus maxillary sinus hypoplasia is a rare anomaly. Radiological diagnosis of maxillary sinus hypoplasia is important for diagnosis to prevent recurrent rhinosinusitis and complications during endoscopic sinus surgery. A high index of suspicion is required by outpatient department examination for proper clinical evaluation and further management of these patients.

Keywords: Anamoly, Maxillary sinus, Hypoplasia.

How to cite this article: Bhargava A, Khanduri S, Shakeel M, Srivastava S, Varshney P. Maxillary Sinus Hypoplasia-A Not-so-uncommon Clinical Entity: A Review. Clin Rhinol An Int J 2016;9(1):43-45.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Sanjeev Mohanty

Effect of Endoscopic Sinus Surgery on Olfaction: A Prospective Analysis

[Year:2016] [Month:September-December] [Volumn:9 ] [Number:3] [Pages:45] [Pages No:115-119][No of Hits : 1012]


ABSTRACT

Objective: To examine the impact of endoscopic sinus surgery (ESS) on olfactory impairment in patients with chronic rhinosinusitis (CRS) and nasal polyposis over intermediateto long-term follow-up.

Study design: Prospective, cohort study. Conducted in a t