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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 : 856]


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 : 799]


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 : 747]


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 : 656]


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 : 653]


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 : 645]


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 : 619]


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 : 576]


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


 
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 : 552]


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
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 : 545]


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 : 527]


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


 
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 : 1606]


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 : 1568]


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 : 1300]


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 : 1162]


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
Priyanko Chakraborty, Rajiv K Jain, Purnima Joshi, Rakhi Kumari, Sidharth Pradhan

Anatomic Variations of the Nose in Chronic Rhinosinusitis: Correlation between Nasal Endoscopic and Computerized Tomography Scan Findings and a Review of Literature

[Year:2016] [Month:January-April] [Volumn:9 ] [Number:1] [Pages:58] [Pages No:13-17][No of Hits : 923]


ABSTRACT

Background: Chronic rhinosinusitis (CRS) refers to a group of disorders characterized by inflammation of the mucosa of the paranasal sinuses. Nasal endoscopy and computed tomography (CT) scans are successfully used as diagnostic modalities of nose and paranasal sinus diseases. There have been many studies regarding the anatomic variations leading to pathogenesis of paranasal sinus diseases. Considerable progress has been made in the medical and surgical control of these conditions; however, a large number of questions relating to the diagnosis, evaluation, and treatment of the diseases remain unanswered.

Materials and methods: The study included 82 clinically diagnosed cases of CRS who underwent CT scan and were advised to undergo diagnostic endoscopy. The anatomical findings of the nose were compared to see correlation between nasal endoscopy and CT scan.

Results: The mean age (±standard error of the mean) of presentation was 34.11 (±1.42) years, while most patients were from the age group of 18 to 30 years. Males were predominating the study group with 62.2%, while 37.8% were females. The most common anatomic variation was deviated nasal septum with 92.68% CT reported patients. This was followed by inferior turbinate hypertrophy, septal spur, concha bullosa, and agger nasi cells.

Conclusion: Computed tomography scan is considered the gold standard for sinonasal imaging. Diagnostic endoscopy and CT scan are a must prior to any functional endoscopic sinus surgery. They help in assessing the extent of sinus disease and to know the variations and vital relations of the paranasal sinuses. Computed tomography scan assists the surgeon as a “road map” during endoscopic sinus surgery.

Keywords: Anatomic variation, Chronic rhinosinusitis, CT scan, Nasal endoscopy.

How to cite this article: Chakraborty P, Jain RK, Joshi P, Kumari R, Pradhan S. Anatomic Variations of the Nose in Chronic Rhinosinusitis: Correlation between Nasal Endoscopic and Computerized Tomography Scan Findings and a Review of Literature. Clin Rhinol An Int J 2016;9(1):13-17.

Source of support: Nil

Conflict of interest: None


 
Research Article
Kiran Rao

Computed Tomography of Paranasal Sinus Pathologies with Functional Endoscopic Sinus Surgery/Nasal Endoscopy Correlation

[Year:2016] [Month:January-April] [Volumn:9 ] [Number:1] [Pages:58] [Pages No:1-5][No of Hits : 859]


ABSTRACT

A prospective study was conducted on 50 patients at the SGRD Institute of Medical Sciences and Research, Amritsar, suffering from paranasal sinus disease correlating the findings of computed tomography (CT) using Siemens SOMATOM Emotion 6 slice CT machine with diagnostic nasal endoscopy or functional endoscopic sinus surgery (FESS).
Infection of the paranasal sinuses is very common. Surgical clearance of these chronically infected sinuses while maintaining their ventilation and drainage is the treatment of choice. To achieve this goal, there should be some diagnostic modality that guides us toward the exact diagnosis and safe intervention. Computed tomography proves to be the most reliable method of preoperative assessment of patients undergoing FESS as it delineates the extent of the disease and defines any anatomical variants and relationship of the sinuses with the surrounding important structures, thus providing a road map for sinus surgery.
In our study, most patients were in the 3rd and 4th decades of their life with equal disease incidence in males and females. The most common sinus involved was anterior ethmoid sinus, while sphenoid sinus was the least commonly involved. The most common pattern of inflammation was sinonasal polyposis followed by osteomeatal unit pattern. On correlating CT diagnosis with the final diagnosis, chronic sinusitis had 86% sensitivity and 96.5% specificity. Polyps had sensitivity of 96.15% and specificity of 95.83%. Again for fungal sinusitis, CT had a lower sensitivity of 71.4% and specificity of 93.02%. For diagnosing benign and malignant lesions, CT had 100% sensitivity a nd s pecificity, w hich c ould b e d ue t o t he s mall number of masses evaluated. This study proved that CT is the modality of choice for evaluating and planning the management of symptomatic patients of paranasal sinus pathologies.

Keywords: Computed tomography scan, Functional endoscopic sinus surgery, Paranasal sinus pathology.

How to cite this article: Rao K. Computed Tomography of Paranasal Sinus Pathologies with Functional Endoscopic Sinus Surgery/Nasal Endoscopy Correlation. Clin Rhinol An Int J 2016;9(1):1-5.

Source of support: Nil

Conflict of interest: None


 
Original Article
Niveditha J Sagar, Chidananda R Devasamudra

Intermediate Osteotomy and other Unique Techniques used in Reduction Rhinoplasty

[Year:2016] [Month:January-April] [Volumn:9 ] [Number:1] [Pages:58] [Pages No:6-12][No of Hits : 833]


ABSTRACT

Background: A 25-year-old male patient came with a history of nasal obstruction on the left side. He was also concerned about his nasal framework deformities, such as gross deviation of the nose to left, hump over the nose, asymmetrical nostril, and overall bulky nose.

Materials and methods: Detailed history was taken and examination done to rule out contraindication to septorhinoplasty. Expectations, requirements, and postoperative results of the patient were understood. Open approach reduction rhinoplasty was carried out. Unique techniques, such as intermediate and transverse osteotomies were done to achieve the required results.

Results: Bulky deviated nose was reduced to an esthetically good-looking nose by humpectomy, four types of osteotomies, extended spreader grafts, columellar strut, and Tipplasty.

Conclusion: Surgical steps must be undertaken in order to achieve good esthetic results. Surgeries, such as humpectomy must be done before osteotomies, intermediate osteotomies must be done before lateral osteotomies, and Tipplasty must be done after osteotomies.

Keywords: Intermediate osteotomy, Medial lateral, Reduction rhinoplasty.

How to cite this article: Sagar NJ, Devasamudra CR. Intermediate Osteotomy and other Unique Techniques used in Reduction Rhinoplasty. Clin Rhinol An Int J 2016;9(1):6-12.

Source of support: Nil

Conflict of interest: None


 
Original Article
Shilpam Sharma, Abhinav Srivastava, Chander Mohan Sharma

Middle Ear Dysfunction: Connection to Allergic Rhinitis

[Year:2016] [Month:May-August] [Volumn:9 ] [Number:2] [Pages:49] [Pages No:65-67][No of Hits : 753]


ABSTRACT

Introduction: The correlation between middle ear pathology due to Eustachian tube dysfunction and nasal allergy has been a topic of debate since long. Studies of the pathogenesis of otitis media have identified interactions among infection, allergic reactions and Eustachian tube dysfunction. AIMS- The aim of this study was to evaluate the relationship between Eustachian tube dysfunction and nasal allergy and to evaluate the efficacy of oral steroids and intranasal steroidal spray on Eustachian tube dysfunction.

Materials and methods: The patients were diagnosed according to the diagnostic criteria of allergic rhinitis. A total of 50 patients having moderate/severe symptoms who had not taken any treatment for allergic rhinitis in the past 6 weeks with deranged middle ear function were included in the study. Group I patients were given Prednisolone, 30 mg once daily for 10 days in tapering dose along with intranasal steroid spray for 6 weeks. Group II patients were given only intranasal steroid spray for 6 weeks. Impedance audiometry was repeated at the end of 6 weeks and results were statistically analyzed.

Result: This study demonstrated the outcome of systemic steroids and intranasal steroidal spray in the treatment of middle ear dysfunction. In our study impedance audiometry was done at the start of study and showed type B tympanogram in 36% ears in group I and 21% in group II and type C tympanogram in 60% in group I and 50% in group II. Impedance audiometry was repeated at 10 days of treatment and showed reversal to type A curve in 26% of ears in group I and 14% of ears in group II. Impedance audiometry at the end of treatment demonstrated reversal to type A tympanogram in 64% of ears in group I and 48 % of ears in group II.

Keywords: Allergic rhinitis, Intranasal steroidal spray, Middle ear dysfunction, Oral steroids.

How to cite this article: Sharma S, Srivastava A, Sharma CM. Middle Ear Dysfunction: Connection to Allergic Rhinitis. Clin Rhinol An Int J 2016;9(2):65-67.

Source of support: Nil

Conflict of interest: None


 
Original Article
Shrinath D Kamath Patla, Pretty Rathnakar, Vadisha S Bhat, Jayaramesh

A Radiological Study of Anatomical Variations of Uncinate Process

[Year:2016] [Month:May-August] [Volumn:9 ] [Number:2] [Pages:49] [Pages No:59-61][No of Hits : 722]


ABSTRACT

Aim: (a) To study the variations in the superior attachment of uncinate process. (b) Incidence of pneumatization of uncinate process was also studied.

Materials and methods: A total 200 sides of 100 CT scans of paranasal sinuses coronal section were studied for variations in the superior insertion of uncinate process using Landsberg and Friedman classification. Incidence of pneumatization of uncinate process was also studied.

Results: In our study out of 200 sides, type 6 attachment was commonest (41%) followed by types 1 and 2. Pneumatization of the uncinate was seen in very small percentage of cases.

Conclusion: Lateral insertion of uncinate (lamina papyracea + aggar nassi) is the commonest variant followed by the insertion into the skulbase. Pneumatization of uncinate is rare.

Clinical significance: Though the inferior attachment of the uncinate is almost constant the superior attachment has several variations, the knowledge of which is very important for the endoscopic surgeon to avoid intraoperative complications.

Keywords: Aggar nasi, Cribriform plate, Lamina papyracea, Middle turbinate, Pneumatization, Uncinate process.

How to cite this article: Patla SDK, Rathnakar P, Bhat VS, Jayaramesh. A Radiological Study of Anatomical Variations of Uncinate Process. Clin Rhinol An Int J 2016;9(2):59-61.

Source of support: Nil

Conflict of interest: None


 
Case Report
Hitesh Verma, Arjun Dass, Surinder K Singhal, Nitin Gupta, TM Arun, Amrinder Kaur

Changing Trends in E ndoscopic Endonasal Medial Maxillectomy

[Year:2016] [Month:January-April] [Volumn:9 ] [Number:1] [Pages:58] [Pages No:56-58][No of Hits : 709]


ABSTRACT

Medial maxillectomy is a surgical resection of the medial walls of the maxillary bone, medial part of the orbital floor, and ethmoid sinuses. Lateral rhinotomy or sublabial degloving is the traditional approach used for an open medial maxillectomy. Endoscopic medial maxillectomy is used as an alternative approach with similar cure rate with less morbidity. We report here a case of inverted papilloma of the medial wall of the right maxillary sinus where the disease clearance was done with preservative of nasolacrimal duct, inferior turbinate, and lateral nasal wall mucosa by the endoscopic medial maxillectomy approach.

Keywords: Endoscopic, Inferior turbinate, Medial maxillectomy, Nasolacrimal duct.

How to cite this article: Verma H, Dass A, Singhal SK, Gupta N, Arun TM, Kaur A. Changing Trends in Endoscopic Endonasal Medial Maxillectomy. Clin Rhinol An Int J 2016;9(1):56-58.

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 : 647]


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 tertiary care center over a period of 2 years (August 2014-July 2016).

Materials and methods: A total of 42 patients presenting for ESS were examined preoperatively and at 1st, 3rd, 6th, and 12th week postoperatively. Demographic, comorbidity, and olfactory scores were collected at each point of time. Sniffin Sticks test was used to assess the olfaction of the patients.

Results: Olfactory scores in anosmic patients significantly improved after ESS at 3-month follow-up. Only few hyposmic patients improved after surgery and others did not show any change. Among normosmic patients, 80% showed no change after surgery, whereas 20% became hyposmic postoperatively. None of the normosmics became anosmic after surgery.

Conclusion: Patients with severe olfactory dysfunction significantly improved after ESS, whereas patients with mild olfactory dysfunction did not. A realistic assessment of effects of ESS on olfaction could be derived. This will help in counseling the patients undergoing ESS in future. Olfactory impairment is an important patient safety and quality-of-life issue for patients with CRS and one that requires continued research.

Keywords: Anosmia, Endoscopic sinus surgery, Hyposmia, Sniffin sticks test.

How to cite this article: Mohanty S. Effect of Endoscopic Sinus Surgery on Olfaction: A Prospective Analysis. Clin Rhinol An Int J 2016;9(3):115-119.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Mohammad W El-Anwar, Ahmed I Ali

Concha Bullosa in Paradoxical Middle Turbinate: A New Variation

[Year:2016] [Month:September-December] [Volumn:9 ] [Number:3] [Pages:45] [Pages No:141-142][No of Hits : 590]


ABSTRACT

Introduction: Concha bullosa is the most common anatomic variation of osteomeatal complex region that is generally seen in the middle turbinate (MT).

Materials and methods: A 25-year-old male presented with headache and nasal obstruction. Computed tomography (CT) scan documented right paradoxical MT. The right MT also showed aerated concha bullosa with narrow right osteomeatal area. Routine preoperative laboratory tests were within normal limits.

Results: This case of concha bullosa in paradoxically bent MT was reported, described, and could be safely managed endoscopically. Patient was symptom free up to date without any complication, recurrence, or other pathology.

Conclusion: Computed tomography may easily identify such uncommon anatomic variations of the osteomeatal region. This directs the surgeon attention to these variations as a cause of headache and osteomeatal area obstruction.

Keywords: Concha bullosa, Middle turbinate, Osteomeatal area.

How to cite this article: El-Anwar MW, Ali AI. Concha Bullosa in Paradoxical Middle Turbinate: A New Variation. Clin Rhinol An Int J 2016;9(3):141-142.

Source of support: Nil

Conflict of interest: None


 
Original Article
V Narendrakumar, V Subramanian

Anatomical Variations in Osteomeatal Complex among Patients undergoing Functional Endoscopic Sinus Surgery

[Year:2016] [Month:January-April] [Volumn:9 ] [Number:1] [Pages:58] [Pages No:28-32][No of Hits : 576]


ABSTRACT

Aims: To study the anatomical variations of osteomeatal complex and the importance of preoperative computed tomography (CT) in patients with chronic sinusitis undergoing functional endoscopic sinus surgery. We studied the different variations and their frequency of occurrence.

Materials and methods: A total of 100 patients undergoing endoscopic sinus surgery were studied by nasal endoscopy, CT scanning, and at the time of definitive surgery, variations were recorded.

Results: The frequency of occurrence of sinonasal anatomical variations was septal deviation in 76%, agger nasi cells in 71%, concha bullosa in 61%, medialized uncinate process in 48%, prominent bulla ethmoidalis in 41%, paradoxical middle turbinate in 33%, accessory maxillary ostium in 28%, frontal cell in 22%, intumescentia septi nasi anterior in 21%, lateralized uncinate in 15%, pneumatized uncinate process in 4%, Haller cells in 12%, and Onodi cells in 8%.

Conclusion: The high incidence of variations emphasizes the need for proper preoperative assessment for safe and effective endoscopic sinus surgery.

Keywords: Anatomic variation, Chronic sinusitis, Osteomeatal complex, Paranasal sinuses.

How to cite this article: Narendrakumar V, Subramanian V. Anatomical Variations in Osteomeatal Complex among Patients undergoing Functional Endoscopic Sinus Surgery. Clin Rhinol An Int J 2016;9(1):28-32.

Source of support: Nil

Conflict of Interest: None


 
Original Article
Santosh B Mane, Kalpana S Dasgupta

Sinonasal Polyposis and Its Effect on Eustachian Tube Function

[Year:2016] [Month:May-August] [Volumn:9 ] [Number:2] [Pages:49] [Pages No:77-80][No of Hits : 573]


ABSTRACT

Objective/hypothesis: Nasal and paranasal sinus disease can cause Eustachian tube (ET) dysfunction leading to middle ear (ME) hypoventilation. Persistent ME hypoventilation can result in ME conditions like retraction of tympanic membrane, otitis media with effusion, and chronic ME disease.

Aim: Aim of this study was to evaluate the ET function in cases of sinonasal polyposis. Evaluation was done by doing tympanometry.

Materials and methods: This was a hospital-based prospective study consisting of 42 patients (84 ears) of nasal polyposis, of which 27 patients had antrochoanal (AC) polyp and 15 patients had ethmoidal polypi. After thorough history and detail clinical examination, tympanometry was done in all patients 1 day prior to surgery and 4 to 6 weeks after surgery.

Results: Preoperatively in 30 ears (15 patients) of ethmoidal polypi had normal tympanogram (A type) in 40% ears and abnormal tympanogram (B and C) in 60% ears. Postoperatively 80% had A tympanograms and 20% had abnormal tympanogram. There was significant improvement on removal of polypi (p = 0.004). Preoperatively 54 ears (27 patients) of AC polyp had normal tympanogram (type A) in 55.56% ears and abnormal tympanogram (B and C) in 44.44% ears. Postoperatively normal tympanogram was seen in 81.48% and abnormal tympanogram in 18.52% ears, so there was significant improvement after functional endoscopic sinus surgery (p = 0.007).

Conclusion: Eustachian tube dysfunction was present preoperatively in 60 and 44.44% in ethmoidal and AC polypi respectively, while in postoperative period dysfunction was 20 and 18.52%. So function improves on removal of polyp.

Keywords: Eustachian tube, Nasal polyp, Otitis media with effusion, Tympanogram, Tympanometry.

How to cite this article: Mane SB, Dasgupta KS. Sinonasal Polyposis and Its Effect on Eustachian Tube Function. Clin Rhinol An Int J 2016;9(2):77-80.

Source of support: Nil

Conflict of interest: None


 
CASE SERIES
Anilkumar S Harugop, Ramesh S Mudhol, Shama A Bellad, Priti S Hajare, Dharmishtha R Kaku, Basavaraj Hiremath

Isolated Abducens Nerve Palsy Secondary to Isolated Sphenoid Sinus Disease: Case Series

[Year:2016] [Month:September-December] [Volumn:9 ] [Number:3] [Pages:45] [Pages No:137-140][No of Hits : 550]


ABSTRACT

Isolated sphenoid sinusitis is a rare entity. Due to noncharacteristic primary manifestations, most of the patients present with ophthalmic complications, most commonly proptosis and diplopia. We report here the case series of two patients who presented with diplopia, blurred vision, and headache. Diagnosis of isolated abducens nerve palsy secondary to isolated sphenoid sinus disease was made, and both the patients underwent endoscopic sinus surgery (ESS). We hereby propose that prompt diagnosis and treatment of isolated sphenoidal sinusitis is very important, and abducens nerve (CN6) palsy could be attributed to the disease condition as both the patients’ condition improved after surgery.

Keywords: Abducens nerve palsy, Case series, Endoscopic sinus surgery, Sphenoid sinus.

How to cite this article: Harugop AS, Mudhol RS, Bellad SA, Hajare PS, Kaku DR, Hiremath B. Isolated Abducens Nerve Palsy Secondary to Isolated Sphenoid Sinus Disease: Case Series. Clin Rhinol An Int J 2016;9(3):137-140.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Kiran Rao

Computed Tomography of Paranasal Sinus Pathologies with Functional Endoscopic Sinus Surgery/Nasal Endoscopy Correlation

[Year:2015] [Month:January-April] [Volumn:8 ] [Number:1] [Pages:45] [Pages No:15-19][No of Hits : 879]


ABSTRACT

A prospective study conducted on 50 patients in Sri Guru Ram Das (SGRD) Institute of Medical Sciences and Research, Amritsar, India, suffering from paranasal sinus diseases correlating the findings of computed tomography (CT) using Siemens somatom emotion 6 slice CT machine with diagnostic nasal endoscopy or functional endoscopic sinus surgery (FESS).
Infection of the paranasal sinuses is very common. Surgical clearance of these chronically infected sinuses while maintaining their ventilation and drainage is the treatment of choice. To achieve this goal, there should be some diagnostic modality which guides us towards exact diagnosis and safe intervention. Computed tomography proves to be the most reliable method of preoperative assessment of patients undergoing FESS as it delineates the extent of the disease, define any anatomical variants and relationship of the sinuses with the surrounding important structures. Thus, providing a road map for sinus surgery.
In our study, most patients were in the 3rd and 4th decades of their life with equal disease incidence in males and females. The most common sinus involved was anterior ethmoid sinus while sphenoid sinus was least commonly involved. Commonest pattern of inflammation was sinonasal polyposis followed by osteomeatal unit pattern. On correlating CT diagnosis with final diagnosis, chronic sinusitis has 86% sensitivity and 96.5% specificity. Polyps have sensitivity of 96.15% and specificity of 95.83%. Again for fungal sinusitis CT has lower sensitivity of 71.4% and specificity of 93.02%. For diagnosing benign and malignant lesions CT has 100% sensitivity, specificity, could be due to small number of masses evaluated. This study proved that CT is the modality of choice for evaluation and planning the management of symptomatic patients of paranasal sinus pathologies.

Keywords: Computed tomography scan, Functional endoscopic sinus surgery, Paranasal sinus pathology.

How to cite this article: Rao K. Computed Tomography of Paranasal Sinus Pathologies with Functional Endoscopic Sinus Surgery/Nasal Endoscopy Correlation. Clin Rhinol An Int J 2015;8(1):15-19.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Tanuj Thapar, Rahul R Gupta, Prarthna J Jagtap, RG Aiyer

Juvenile Nasopharyngeal Angiofibroma: Correlating Histology, Surgical Approach and Blood Loss

[Year:2015] [Month:May-August] [Volumn:8 ] [Number:2] [Pages:44] [Pages No:47-52][No of Hits : 869]


Abstract

Juvenile nasopharyngeal angiofibroma (JNA) is locally destructive benign vascular tumor for which surgical excision has always been the treatment of choice, in spite of the availability of various other treatment modalities. Complete removal at the maiden attempt has always been the key to a successful outcome. Recurrences (or rather residuals) discourage both the surgeon and patient.
This prospective study was carried out in the Department of Otorhinolaryngology, Sir Sayajirao General Hospital, Vadodara, Gujarat, between August 2002 and 2015. We have studied 28 patients with JNA for growth patterns, histological characteristics and to compare various surgical modalities. Besides other investigations a detailed histological examination of the tumor was performed which suggested that as the tumor ages, the stroma predominates and the vessels are compressed into slits. In actively growing tumor the vascular component predominates. The percentage of open vascular channels is directly proportional to the bleeding while the inter vascular fibrosis is inversely related. Surgical excision of JNA is the preferred modality of treatment. Surgical approach is sometimes the most tricky decision. Choosing the right approach is akin to walking on the thin rope with adequate exposure on one side and postoperative scar on the other.

Keywords: Adolescence, Angiogenic tumor, Epistaxis, Fibroangioma, Histopathology, Juvenile nasopharyngeal angiofibroma, Nasopharyngeal neoplasms, Surgical approval.

How to cite this article: Thapar T, Gupta RR, Jagtap PJ, Aiyer RG. Juvenile Nasopharyngeal Angiofibroma: Correlating Histology, Surgical Approach and Blood Loss. Clin Rhinol An Int J 2015;8(2):47-52.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Prateek Vijay Jain, Shrinivas S Chavan, Sunil D Deshmukh, Pramod Dhanakar, Dharmendrakumar Rai

Preventing Sino-orbital Cutaneous Fistula: A Novel Approach for Radical Maxillectomy

[Year:2015] [Month:May-August] [Volumn:8 ] [Number:2] [Pages:44] [Pages No:69-71][No of Hits : 820]


Abstract

The advantages of excellent exposure and minimal scarring of the classical Weber-Ferguson incision for radical maxillectomy have been timeworn. But late complication of sino-orbital cutaneous fistula following radiotherapy and delayed healing often results in less than ideal results. Most common site for this fistula is the tip near the medial canthus, which is the point where the scar bears maximum tension and results in fistula formation. Due to persistent mucopurulent drainage and poorly vascularized tissue in the irradiated area, the repair options are limited and difficult. Here, we are presenting a case report providing a novel way for better postoperative results.

Keywords: Modified Weber-Ferguson incision, Radical maxillectomy, Sino-orbital cutaneous fistula.

How to cite this article: Jain PV, Chavan SS, Deshmukh SD, Dhanakar P, Rai D. Preventing Sino-orbital Cutaneous Fistula: A Novel Approach for Radical Maxillectomy. Clin Rhinol An Int J 2015;8(2):69-71.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Abhishek Ramadhin

Evaluation of the Change in Recent Diagnostic Criteria of Chronic Rhinosinusitis: A Cross-sectional Study

[Year:2015] [Month:September-December] [Volumn:8 ] [Number:3] [Pages:42] [Pages No:110-114][No of Hits : 680]


ABSTRACT

There is an enormous economic burden of patients suffering from chronic rhinosinusitis (CRS), there is also significant patient morbidity in terms of quality of life and decreased overall productivity caused by CRS. But, the criteria’s to label a patient having CRS is not clearly defined. The definition of CRS is ever evolving. The purpose of this study was to evaluate the diagnosis of CRS according to recent clinical guideline set by the AAO-HNS and to determine the utility of nasal endoscopy for diagnosing the CRS.

Keywords: Chronic, Definition, Evaluation, Nasal endoscopy, Rhinosinusitis.

How to cite this article: Ramadhin A. Evaluation of the Change in Recent Diagnostic Criteria of Chronic Rhinosinusitis: A Cross-sectional Study. Clin Rhinol An Int J 2015;8(3):110-114.

Source of support: Nil

Conflict of interest: None