Nasal packs have been routinely used after nasal surgeries to prevent postoperative bleeding and synechiae formation. The aim of this study is to evaluate and compare the outcomes of hydroxylated polyvinyl acetate (PVA) and medicated ribbon gauze packs after performing nasal surgeries. A prospective observational study was conducted in a tertiary care hospital of South India from 2017 to 2019. A total of 100 patients satisfying the study criteria were included and divided equally into two groups. Group A underwent PVA packs and group B underwent medicated ribbon gauze packs. Visual analog scale for pain (0–3), hemostasis score (0–5) and postoperative mucosal scores were measured. The mean VAS scores in the postoperative period were 1.46 ± 0.3 and 1.92 ± 0.4 (p = 0.000), respectively. After pack removal, mean VAS scores were 1.84 ± 0.4 and 2.4 ± 0.6, respectively (p = 0.000). The mean hemostasis scores of PVA and ribbon gauze group were 2.2 ± 0.95 and 1.64 ± 0.8, respectively (p = 0.119). The postoperative mucosal scores were 2.75 ± 0.6 and 2.9 ± 0.7 on day 14 (p = 0.35) and 1.2 ± 0.4 and 1.9 ± 0.7 on day 28, respectively (p = 0.001). We conclude that PVA packs caused lesser pain and had better postoperative healing when compared with ribbon gauze. Though ribbon gauze packs had better hemostasis control, the difference was not statistically significant.

Introduction: Unilateral sinonasal masses are frequently encountered and a benign appearance may conceal their true malignant nature. This study aimed to investigate the clinical presentations of unilateral sinonasal masses, analyze their radiological results, and establish a correlation with histological findings. Materials and methods: The study was conducted on 81 patients who presented with a unilateral sinonasal mass at our ENT department, Command Hospital Air Force Bengaluru, between 2014 and 2016. The patients had routine hematological and biochemical tests, diagnostic nasal endoscopy, and NCCT/MRI of the paranasal sinuses. A preoperative biopsy was performed if deemed necessary. Following the initial evaluation, the patient underwent either endoscopic or open operation. The histological examination and immunohistochemistry results were then analyzed and evaluated. Results and observations: The study revealed the presence of 44 cases of inflammatory polyps, 3 cases of adenoid cystic carcinoma, 19 cases of inverted papilloma, 5 cases of fungal sinusitis, and 3 cases of squamous carcinoma. Additionally, there was one case each of solitary fibrous tumor, angiofibroma, odontogenic keratinizing tumor, Non-Hodgkins lymphoma, adenocarcinoma, and acinic cell tumor. A detailed review of the clinical, radiographic, and histological data was conducted for all 81 cases of unilateral sinonasal mass. Conclusion: Thorough assessment of sinonasal masses using radiographic, histological, and immunohistochemical methods improves in precise diagnosis and appropriate treatment. Histopathology usually offers a definitive diagnosis; however, in certain cases, immunohistochemistry serves as the ultimate diagnostic method for correct identification.

Aim: To study the prevalence and pattern of allergic disorders and sensitization patterns in North India. Materials and methods: This observational cross-sectional study was conducted in a pediatric and allergy clinic at a tertiary care corporate hospital in Punjab, India. Data were collected using a structured questionnaire and patients presenting with signs and symptoms of allergy were tested using the skin prick test. The allergens were identified and sensitization patterns were compared across age-groups, gender, type of disorder, and states. Mean (SD) and proportions were reported for continuous and categorical data, respectively. Results: A total of 256 patients were analyzed. The mean age was 16.8 years and the majority were males (65.2%). The most common allergic disorders were allergic rhinitis [211 (82.4%)], atopic dermatitis [127 (49.6%)], and allergic asthma [120 (46.9%)]. Allergic rhinitis was significantly more prevalent in males compared to females (p < 0.001). The majority of the patients had ≥3 allergic disorders at a time [175 (68.4%)]. The most common triggers for allergic symptoms were consumption of a particular food item [102 (39.8%)] and dust or dusty atmosphere [80 (31.3%)]. Sensitization was most commonly observed with Dermatophagoides farina and D. pteronyssinus but there was variation in the number and types of allergens across age-groups, states, and allergic disorders. Conclusion: The burden of allergic disorders is high in the northern states of India with variation across states and age-groups given the different types of allergens. There is a need for advanced diagnostic and therapeutic interventions for these disorders. Clinical significance: Understanding the prevalence, patterns, and triggers of allergies will help clinicians provide appropriate preventive counseling and treatment to the patient.

Background: Coronavirus disease-2019 (COVID-19) pandemic has taken a toll on the healthcare system universally. With ongoing research and studies done to know the natural course of the disease along with its symptomatology, we are in urgent need of substantial knowledge for the control of this infection. Along with its specific clinical features, we tend to find more about the olfactory and gustatory dysfunction in these patients. Aim: To determine the prevalence of anosmia and ageusia and their prognostic significance among COVID-positive healthcare workers in a tertiary care institute. Materials and methods: An observational prospective study was conducted at VIMSAR, Burla Sambalpur, a tertiary care hospital in western Odisha, for a period of six months. All healthcare workers (HCWs) who were tested positive for COVID-19 infection were followed up. Detailed history regarding the symptoms, onset of anosmia and ageusia and its recovery, oxygen support requirement, and average symptomatic period was noted with the help of questionnaires and telephonic survey. Statistical analysis was done using Chi-square test and p-value less than 0.05 was considered significant. Results: Total 234 COVID-19-positive HCW patients were enrolled in the sample out of which 82.90% were symptomatic. The prevalence of anosmia and ageusia among them was 40.60 and 42.74%, respectively. Both were found to be statistically significant with p-value less than 0.05. The loss of smell and taste was temporary with a mean recovery time of 7.15 days. A total of 20 (8.54%) patients required oxygen support, signs of lung involvement, and average symptomatic period of 24.54 days, the majority (85%) of them had no loss of smell and/or taste sensation. Majority (97%) of the COVID-19-positive HCW patients in our study, having symptoms of anosmia and ageusia were fortunately recovered without any grievous complication with an average symptomatic period of 14.53 days, so these symptoms can be considered as a favorable prognostic indicator. Conclusion: Anosmia and ageusia in COVID-19-positive patients are hence found to be significant clinical symptoms. It can be used to aid early diagnosis and prompt treatment along with quick self-isolation to prevent the spread of the infection. The symptoms of anosmia and ageusia can be taken as a favorable prognostic indicator in COVID-19-positive patients.

Aims and objectives: This study aims to present the experience of our tertiary care facility in managing Rhino-orbital-cerebral Mucormycosis within Jammu Province, Jammu and Kashmir, India, and to examine the demographic and clinical characteristics of the cases. Materials and methods: We conducted a cross-sectional descriptive study at the Department of ENT, SMGS Hospital, GMC Jammu, with institutional ethical committee approval. The study included 19 patients from Jammu Province with biopsy-confirmed mucormycosis. Comprehensive clinical data which include demographics, comorbidities, clinical features, outcomes, and radiological findings were collected. The initial treatment involved liposomal amphotericin B (5 mg/kg/day), followed by surgery based on clinical and radiological evaluations. Results: The study comprised 19 patients with biopsy-confirmed mucormycosis, with a mean age of 52.42 ± 3.77 years and a male-to-female ratio of 1.4:1. All patients (100%) had received steroids as part of their COVID-19 treatment, and all had uncontrolled diabetes mellitus (100%). Additional comorbidities included hypertension in 6 patients (31.6%), diabetic ketoacidosis in 2 patients (10.5%), and chronic kidney disease in 1 patient (5.3%). Of the 19 patients, 18 (94.7%) were initially treated with liposomal amphotericin B, followed by surgical intervention. Histopathological analysis post-surgery confirmed mucormycosis in all 18 cases (100%). Follow-up revealed a mortality rate of 31.6% (6 patients) and a recovery rate of 68.4% (13 patients). Conclusion: A multidisciplinary approach is essential, including education on the warning signs and symptoms of mucormycosis, prompt diagnostic nasal endoscopy and direct microscopy of nasal swabs, contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI), and aggressive treatment with full-dose liposomal amphotericin B and appropriate surgical interventions.

Here, we review the most recent findings on the effects of coronavirus disease-2019 (COVID-19) pandemic on the work of otolaryngologists. The clinical symptoms related and impact of the infection on the ear nose and throat examination and surgeries is summarized in this review. Otolaryngologists are at much higher risk for contracting the disease due to the close contact with mucous membranes of the upper respiratory tract and they have been among the most affected healthcare workers in Wuhan, China as per the previous studies. In this literature review, we have discussed the role of an otolaryngologist in detail in this COVID-19 pandemic. To write this review, an extensive search and analysis of the literature was done based on role of otorhinolaryngologists in dealing with COVID-19 and its complications.

Atrophic rhinitis is a chronic inflammation of nose characterized by roomy nasal cavities with atrophy of nasal mucosa and turbinates. Loss of sensation predisposes to nasal myiasis which causes the destruction of surrounding soft tissue and bony structure. Here, we report one such case where a middle-aged female patient presented with bilateral progressive nasal obstruction, anosmia and recurrent episodic epistaxis. A detailed investigation revealed atrophic rhinitis characterized by palate erosion due to localized destruction caused by maggots. Treatment involved the manual extraction of maggots, surgical cleaning, modified Young's operation, and the use of a palatal obturator. The patient fully recovered, demonstrating the effectiveness of this combined approach, rendering surgical repair of the palatal perforation unnecessary.

Aim: To highlight the diagnosis and management of a delayed presentation of unilateral choanal atresia in adulthood. Background: Otorhinolaryngology hosts a spectrum of congenital anomalies, but not all are easy to diagnose. Unilateral choanal atresia is very rare and usually occurs without syndromic associations. It generally presents in late childhood as unilateral nasal obstruction, sometimes gets missed, and masquerades as other commoner causes in adulthood. It needs apt management by surgical reconstruction. Case description: A 22-year-old male presented with unilateral nasal obstruction and foul-smelling nasal discharge since childhood with no relief after using nasal sprays and drops. Clinically and radiologically, it was found to be a grossly deviated nasal septum and was taken up for surgery when we unearthed the true diagnosis as choanal atresia. It was then corrected by microdebrider-assisted neochoana creation, and a novel stent was made by refashioning the nasopharyngeal airway. Postoperatively, complete patency was obtained with an excellent outcome and symptomatic relief. Conclusion: The diagnosis of choanal atresia in adults is seldom easy; they may present with thick nasal discharge and gross posterior deviations, making even endoscopic evaluation difficult without first having to do septoplasty. Also, membranous and mixed atresias are not picked up by the scans due to a lack of radio-opacity, as we observed. Surgical correction is imperative for relief. Clinical significance: Diagnosing unilateral choanal atresia, that too in adults, requires immense clinical suspicion as a wide range of differentials may exist for the same presenting features. Performing a microdebrider-assisted removal of atresia without needing a posterior septectomy and using a simple, easily available nasopharyngeal airway by refashioning it as a stent gave a fine outcome. Restenosis was encountered in 70% of cases, as reported in the literature, but we found complete patency even after 6 months. Thus, choanal atresia must be kept in mind by the rhinologist in his daily practice while evaluating even adults with nasal obstruction.

Introduction and importance: Glomangiopericytoma (GPC) is a rare tumor in nasal cavity and paranasal sinuses (PNS) emerging from pericytes surrounding the capillaries and accounts for less than 0.5% of all sinonasal neoplasms. This neoplasm has low malignant potential and an excellent prognosis. Case presentation: We report a case of a 64-year-old woman who presented with nasal obstruction, nasal discharge, loss of sense of smell, headache, and one episode of nasal bleeding. Rhinoscopy revealed polypoid tissue in the left nasal cavity. Probing revealed tissue bleed on touch. A contrast-enhanced computed tomography (CECT) scan of the nose and PNS reported a well-defined soft tissue density lesion of size 30 × 18 × 40 mm in the left anterior nasal cavity showing mild peripheral heterogeneous contrast enhancement. Preoperative biopsy was suggestive of lobular capillary hemangioma. Complete surgical excision was done under general anesthesia, using external approach. Postoperative histopathology report suggested GPC. Discussion: Glomangiopericytoma has appearance similar to inflammatory nasal polyps, therefore can create confusion for clinicians. Histopathological tissue examination is the gold standard for definitive diagnosis. The preferred management option includes complete surgical excision having 5-year survival rate of 88%. Conclusion: Glomangiopericytoma is a rare sinonasal neoplasm with borderline or low malignant potential. As it is a rare tumor having ambiguous clinical and radiological signs, a high index of suspicion is required for the diagnosis of GPC. Complete surgical excision is the mainstay of treatment. Rare case reports are required to generate adequate data pool and making guidelines for diagnosis and treatment outcomes.

Aim: To present a clinical case of bilateral antrochoanal polyps (ACPs) in a 38-year-old patient without history of asthma or allergy. Background: Antrochoanal polyps are benign tumors that originate from the maxillary sinus mucosa and emerge from the nasal cavity, arriving at the nasopharynx. The bilateral form of this entity is extremely rare and frequently appears as a bilateral nasal blockage, as we report in our review of the literature. Case description: We report a case of a 38-year-old male with no antecedents of asthma nor allergy diagnosed with bilateral ACPs removed by functional endoscopic sinus surgery (FESS). We present the clinical and therapeutic approach as well as the outcome and possible causes of appearance. Conclusion: Antrochoanal bilateral polyps are an extremely infrequent entity. Its diagnostic confirmation must be performed by histology, and its management is surgical. The present article recommends keeping the differential diagnosis of bilateral ACPs in cases of chronic bilateral nasal blockage. Clinical significance: The patient that we present did not have a previous history of asthma, allergy, or any anatomical alteration. Given this fact, as well as the low prevalence of bilateral ACPs, we must take into consideration that this form can be caused by another physiopathological mechanism, yet to be determined, and that is why we consider it important to report this type of case.