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.

Chakraborty S, Verma D, Lade H, Malik NUD. Comparative Evaluation of Anatomical and Pathological Features on Computed Tomography Scan with Intraoperative Findings in Frontal Sinus Pathology. Clin Rhinol An Int J 2017;10(1):6-10.

Pandey AK, Bhardwaj A, Maithani T, Rathi S. Pleomorphic Adenoma of the Lateral Nasal Wall: An Unusual Entity. Clin Rhinol An Int J 2017;10(1):11-13.

Parry-Romberg syndrome is a rare neurocutaneous disorder, i.e., characterized by a slow and progressive atrophy of facial tissues, including muscles, bones, and skin of one or occasionally both sides of the face. Atrophy may be preceded by cutaneous discoloration of the affected skin, such as hyperpigmentation or depigmentation.

A 30-year-old female patient came with a chief complaint of progressive deformity of left-side face since 7 to 8 years. Progressive atrophy on left half face was noticed first at the age of 23 years as an area of hyperpigmentation on left malar region, which progressed with atrophy of the underlying fat and subcutaneous tissue resulting in disfigurement. Head and neck examination confirmed the asymmetry with flattening and hyperpigmentation on left side of face. There was an evident loss of underlying fat, muscle, and subcutaneous tissue giving a sunken appearance. Computed tomography scan revealed generalized atrophy of the soft tissue of the left hemi face resulting in asymmetry on the left side with deviated nasal septum. Another female patient of 35 years old came to the Department of Otorhinolaryngology with marked facial asymmetry on right side.

Two cases of PRS from different families are discussed. A 30-year-old female who presented with chief complaints of left side hemifacial atrophy and blackish pigmentation of overlying skin whose clinical features were consistent with PRS and a 35-year-old female with right-sided facial hemifacial atrophy.

Chandra M, Saxena S. Parry-Romberg Syndrome: A Case Study of Two Patients. Clin Rhinol An Int J 2017;10(1):14-16.

Fibrous dysplasia (FD) is a common benign osseous tumor that may affect the craniofacial skeletal. It is a slowly progressing disease, presenting with swelling and pressure effects on adjacent structure. Epistaxis as presenting symptom is rare. The literatures reviewed rarely mention it.

The aim of this article is to study the clinical presentation and management of extensive craniofacial FD along with review of literature, emphasizing ear, nose, and throat/endocrinal and orthopedic checkup and computer tomo graphy evaluation and related hematological workup. Serum alkaline phosphatase was also done to see its correlation to disease activity. Brief overview of management and its related complication is done.

Both patients were presented with 2year history. There was no predisposing factor. Both were from tribal area. They were having slowly progressive nasal obstruction, facial swelling, and proptosis. In Case 1, it was loosening of tooth and facial pain. In Case 2, it was epistaxis which was the presenting complaint of patient. Nasal obstruction, swelling, and epistaxis in teenager male usually suggest angiofibroma. Craniofacial FD may have epistaxis and pain due to cystic degeneration in FD. Both patients had proptosis; however, their vision was normal. Serum alkaline phosphates was marginally raised, thus not signifying active disease. Computed tomography (CT) scan was diagnostic in both cases, with ground glass appear ance. In Case 2, there was cystic degeneration present and CT was useful in diagnosing the disease, to show the extent of lesion and any intracranial extension. Fine needle aspiration cytology was inconclusive and incision biopsy is better to get representative sample. Lateral rhinotomy approach with lip splitting and gingival component gave good exposure. The tumor was totally removed with thin bone at periphery. The tumor was vascular, and bleeding was controlled by anterior nasal packing.

Sachdeva K. Extensive Cranio facial Fibrous Dysplasia: An Overview. Clin Rhinol An Int J 2017;10(1):1721.

Seth S, Kumar H. An Interesting Case of Button Battery causing Septal Perforation. Clin Rhinol An Int J 2017;10(1):22-24.

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.

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.

Osteomas can rarely occur in nasal turbinates and may be symptomatic requiring endoscopic/surgical removal.

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.

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.

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.

To present a unique case of ectopic orbital meningioma presenting in anteroinferior part of orbit.

Primary orbital meningiomas arise from the optic nerve sheath and constitute 10 to 30% of orbital meningiomas. Secondary orbital meningiomas represent 70 to 90% of orbital meningiomas and are the direct extension of intracranial meningiomas into the orbit. Rarely, ectopic rests of arachnoid cells give rise to meningiomas separate from optic nerve sheath. Ectopic orbit meningioma is a rare tumor arising from ectopic arachnoidal tissue. The present case report describes an elderly patient with ectopic orbital meningioma in anteroinferior quadrant.

A 70-year-old female patient presented with slowly growing mass in the inferior part of right orbit. This lesion was firm in consistency and not fixed to skin or bone. Computed tomography scan showed a homogeneous mass lesion in anteroinferior part of right orbit without any bony changes. The orbital mass was excised. Anatomic-pathologic evaluation of the excised specimen revealed a benign meningioma of a meningotheliomatous type.

Ectopic orbital meningioma may present in elderly patients in anteroinferior orbit.

An ectopic orbital meningioma should be considered in differential diagnosis of firm orbital mass presenting in anteroinferior orbit.

Gupta P, Kumar A, Moharana B, Vaiphei K, Ahuja C. Ectopic Inferior Orbital Meningioma. Clin Rhinol An Int J 2017;10(1):32-35.

Park SK, Kim DH. An Immunocom petent Patient with Isolated Cryptococcosis of the Nasal Cavity: Surgical Treatment without Systemic Antifungal Agents. Clin Rhinol An Int J 2017;10(1):36-38.

An inverted papilloma is a benign tumor that is found in the nasal cavity or paranasal sinuses. Inverted papilloma accounts for approximately 0.5 to 2.0% of all nasal tumors. While it is considered benign, an inverted papilloma can destroy the surrounding bone. In a small number of cases (5-15%), an inverted papilloma may be found with a squamous cell carcinoma; one such case is reported.

A 70-year-old male presented with complaints of right-sided nasal blockage, which progressively increased over time and nasal discharge since one and half years with occasional history of epistaxis. On anterior rhinoscopic examination, there was a fleshy polypoidal mass filling the right nasal cavity. Contrast-enhanced computed tomography revealed a soft tissue density mass filling maxillary sinus and posterior choana with mild enhancement. Endoscopic medial maxillectomy was performed with complete removal of mass. Histopathological diagnosis was given as inverted sinonasal papilloma with malignant transformation. The patient was referred to a cancer reference center for treatment and received combined radiotherapy and chemotherapy. Patient was disease free at 6-month follow-up.

An inverted papilloma is a benign tumor with a propensity for malignant change. For these reasons, inverted papilloma should be treated like malignant tumor of the nasal cavity and paranasal sinuses.

Prinja S, Davessar JL, Luthra H, Kaur M. Ringertz Tumor with Malignant Transformation. Clin Rhinol An Int J 2017;10(1):39-41.

To report a rare case of delayed spontaneous cerebrospinal fluid (CSF) leak through clival region in the sphenoid sinus.

A 35-year-old female presented to our outdoor clinic with watery right nasal discharge for past 2 months, which increased on bending forward. Her medical history, general physical and neurological examinations were unremarkable. High-resolution computed tomographic scan and magnetic resonance cisternography were performed and suggestive of defect in right cribriform plate and right sphenoid sinus. Endoscopic repair was done but same symptoms occurred after 1 month. Repeat magnetic resonance imaging showed fistula in the lateral wall of right sphenoid sinus. Revision endoscopic transnasal CSF rhinorrhea repair was done. Lumbar subarachnoid drain was left in place for 5 days. No recurrence was noted at 12-week follow-up.

Endoscopic transnasal approach is the best modality of treatment for midline skull base defects. Delayed leaks can present from previously weak areas and all the doubtful areas must be examined during surgery.

Mohindra S, Mohindra S, Joshi K, Sodhi HS. Delayed Spontaneous Cerebrospinal Leak through Clival Recess: Emphasis on Technique of Repair. Clin Rhinol An Int J 2017;10(1):42-44.