Silent sinus syndrome (SSS) is a rare and interesting clinical condition that is associated with spontaneous, painless, unilateral enophthalmos and hypoglobus resulting from downward bowing of the orbital floor, in the absence of any symptomatic sinonasal disease.
It generally affects younger patients between the third and fifth decades of life.
The pathogenesis of silent sinus syndrome is based on chronic maxillary sinus obstruction, related to occlusion of the maxillary infundibulum which results in a hypoventilated sinus and negative pressures. Endoscopic sinus surgery to create a wide maxillary antrostomy with or without orbital floor reconstruction is considered the gold standard treatment of choice.
Rhinosporidiosis is a rare chronic granulomatous disease caused by rhinosporidium seeberi. Nasal rhinosporidiosis presents with nasal mass, nasal obstruction and epistaxis. In this study, we present our experience in 17 patients of rhinosporidiosis. Diagnosis was made on clinicopathological features. Different clinical presentations, management by surgical, combined with medical line of treatment are discussed with review of literature
Ninety-eight cases of nasolacrimal duct obstruction including 6 bilateral cases were included in the study done at Postgraduate Institute of Medical Research, Chandigarh. All the cases had been divided into three groups with Group I including cases in which 12 endoscopic dacryocystorhinostomy (DCR) with dilatation and probing and stent insertion were performed. In Group II, 23 Endo DCR performed with intraoperative dilatation and probing but no stent insertion. Group III included 69 cases of Endo DCR without dilatation and probing and no stent insertion. Overall success rate was found to be 94.3% with Group III cases having a success rate of 97.1% and was found statistically significant on comparing with that of Group II (p value: 0.03).
Comparison of clinical and histopathological diagnosis of nasal masses.
Material and methods
A prospective randomized study conducted over a three years period on 100 patients of nasal mass selected from the inpatient department of Otorhinolaryngology, Dayanand Medical College and Hospital, Ludhiana.
A variety of pathological condition (ranging from benign lesions to malignant tumors) can present as nasal mass. The results show that the final diagnosis can be established only on histopathology.
It is concluded that for proper evaluation of a nasal mass, clinical and histopathological evaluation should be done conjointly in all the patients. Histopathology always gives a confirmatory diagnosis. Although rare, unexpected clinically relevant findings may be identified during routine histologic examination of nasal mass specimens.
Chronic rhinosinusitis and nasal polyposis is more common in the age group of 18 to 25 years. Urban population and housewives are more commonly affected. Common complains were headache and nasal blockage in 80% and 76.6% cases respectively. Polyps were common clinical finding in one third of cases. Subjective complete relief was seen in 83.3% of cases after FESS. Eight cases had minor postoperative complications
Allergic rhinitis in children is not an uncommon disease in India. Our objective was to evaluate the effect of allergic rhinitis on nasal mucociliary clearance. The nasal mucociliary clearance time (NMC) was studied using Andersen's saccharin method in fifty controls and fifty age and sex matched patients of allergic rhinitis. The nasal mucociliary clearance time in healthy controls was found to be 5.11 ± 1.51 minutes. A significant impairment (p < 0.01) in nasal mucociliary clearance time of 12.46 ± 3.74 minutes was observed in children suffering with allergic rhinitis, signifying that allergic rhinitis may predispose to sinusitis and pulmonary diseases.
Skull base chondrosarcomas are rare and account for approximately 0.15% of all intracranial tumors. Management of these tumors is challenging because of their potential to recur, and their proximity to vital structures such as major vessels and cranial nerves. We describe five patients with chondrosarcoma of the skull base who were managed at our institute between January 2002 and December 2009.
Ossifying fibroma is an uncommon tumor of the craniofacial skeleton presenting in several variant histopathological subtypes. Ossifying fibroma is a benign fibro-osseous lesion that commonly involves the maxilla.1 Ossifying fibromas occur predominantly in women, frequently during the 3rd and 4th decades of life.1 The overlapping clinical and histopathological features of these subtypes have led to diagnostic dilemma and confusion.1 Complete excision of this tumor has become a necessity since it is notorious for recurrence.1
To study and compare the clinical profiles of various types of ossifying fibroma and also the surgical approaches to the tumor. To discuss the diagnostic difficulties and controversies associated with the tumor.
Medical college referral hospital.
Case reports of 4 patients presenting to our medical college OPD.
Planned surgical excision based on criteria.
Four cases of different types of ossifying fibroma were successfully treated by various surgical approaches. 42 papers related to diagnostic and treatment aspects of ossifying fibroma were studied.
The diagnostic dilemma of ossifying fibroma can be overcome with a combination of clinical, radiological and pathological criteria. Complete surgical excision of the tumor is possible when surgery is based on preplanned criteria. Combination of 2 or more surgical approaches may be necessary in many cases in order to ensure complete clearance and prevent recurrence of the tumor.
The orbit is involved in 10% of all lymphomas. Paranasal sinuses and nose are other sites for extranodal lymphoma that are involved in upto 2.6 to 6.7% of lymphomas involving head and neck region and are second most common presentation of extranodal lymphoma. In nearly 22.5% of patients, sinonasal lymphoma and orbital lymphoma may coexist. The present report describes such patient with first presentation to an ophthalmologist with an attempt to review the present literature of coexistent orbital and paranasal sinuses lymphoma.
Capillary hemangioma of the maxillary sinus is a rare entity. It commonly presents as a sinonasal mass with nasal obstruction, intermittent epistaxis and occasionally as a cheek swelling. Computed tomography and angiography assist in making a correct diagnosis. Biopsy is not usually recommended as it can cause profuse bleeding and may yield false results. Selective arterial embolization followed by surgical resection forms the mainstay of treatment.
Meningiomas arise from arachnoid cells. They can occur at intracranial or extracranial sites. Extracranial meningiomas are very rare tumors. They may arise from nasal cavity, paranasal sinuses, middle ear, and subcutaneous tissues. The ectopic meningiomas of paranasal sinuses do not have any communication with intracranial meninges. They usually occurs in young males. Imaging studies shows no bone erosion or intracranial extension. Primary surgical excision is the treatment of choice. The present case is reported due to its rarity and presentation at an unusual age.
Aspergillosis of paranasal sinuses is a rare infection with invasion of surrounding soft tissues, orbit and anterior cranial base. Eighteen years old immunocompetent man presented with gross facial swelling, proptosis and unilateral blindness. Histopathology was reported as invasive aspergillosis. The patient was given systemic antifungal therapy in the form of liposomal amphotericin B. He died of cerebral infarction by fungal embolism. Aspergillus fumigatus was the causative organism.
Sneezing is usually the physiologic response to nasal irritation but intractable paroxysmal sneezing is very uncommon. Various causative factors have been identified in the literature; these include psychologic problems, cervical lymphadenitis, epilepsy, and allergy. Majority of cases of intractable sneezing are reported among adolescents and are psychogenic in origin. We report one young lady with intractable paroxysmal sneezing in whom the removal of psychogenic stressors resulted in complete remission. The sneezing was continuous but did not occur while talking or sleeping, and did not respond to antihistamines, steroids and bronchodilators. The authors discuss the patients’ treatment and outcomes and the pathophysiology of intractable paroxysmal sneezing.
Rhinolithiasis is an uncommon condition but attract attention because they can be confused with both benign and malignant nasal tumors. We report a case of incidental finding of a rhinolith for a patient being taken up for septoplasty.