An International Journal Clinical Rhinology

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2012 | September-December | Volume 5 | Issue 3

RESEARCH ARTICLE

Editorial

[Year:2012] [Month:September-December] [Volume:5] [Number:3] [Pages:1] [Pages No:0 - 0]

PDF  |  DOI: 10.5005/aijcr-5-3-v  |  Open Access |  How to cite  | 

RESEARCH ARTICLE

Bandar Al Qahtani, Yazeed Al Suliman

The Effectiveness of Local Gentamicin and Dexamethasone Drops in Posterior Choanoplasty

[Year:2012] [Month:September-December] [Volume:5] [Number:3] [Pages:4] [Pages No:87 - 90]

Keywords: Garasone drops,Choanal atresia repair,Posterior choanoplasty,Local gentamicin and local steroid drops

PDF  |  DOI: 10.5005/jp-journals-10013-1125  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Al Qahtani B, Al Suliman Y. The Effectiveness of Local Gentamicin and Dexamethasone Drops in Posterior Choanoplasty. Clin Rhinol An Int J 2012;5(3): 87-90.

RESEARCH ARTICLE

Asmita Chopra

To Study the Utilization Pattern of Nasal Decongestants and their Effects on Heart Rate and Blood Pressure

[Year:2012] [Month:September-December] [Volume:5] [Number:3] [Pages:4] [Pages No:91 - 94]

Keywords: Nasal decongestants,Xylometazoline,Pseudoephedrine,Allergic rhinitis

PDF  |  DOI: 10.5005/jp-journals-10013-1126  |  Open Access |  How to cite  | 

Abstract

Background

Nasal decongestants (NDs) are frequently prescribed over the counter (OTC) drugs for cough and cold. These are sympathomimetic drugs, which act through α1 and β1 adrenoceptors to cause vasoconstriction and positive inotropic, chronotropic and dromotropic effect on the heart. This study was conducted to assess the pattern of utilization of the NDs and their effect on heart rate (HR) and blood pressure (BP). Patients were observed for any other adverse drug reactions (ADRs).

Materials and methods

Randomly 100 prescriptions containing NDs were collected from the otorhinolaryngology OPD and were analyzed. All these patients were examined for HR and BP on day 0, 3 and 7 of administration of NDs. Any ADRs were also recorded.

Results

Mean ND used per patient was 1.08/patient. Commonly prescribed NDs were phenylephrine (72.2%), pseudoephedrine (12.9%), phenylpropanolamine (6.5%), xylometazoline (6.5%) and oxymetazoline (1.8%). Eight patients received two NDs orally and/or topically. There was a significant rise in heart rate on day 7 (p < 0.05). However, the rise in BP was insignificant both on days 3 and 7. Frequently observed ADR's included headache, palpitations and dizziness.

Discussion

Some NDs are known to raise the HR and BP. Baseline BP monitoring should be done to avoid any further rise in BP and HR. being an OTC drug there are more chances of adverse effects of these NDs. It is suggested that NDs should be prescription only drugs, till adequate evidence is available regarding their safety.

How to cite this article

Rehan HS, Chopra A, Kumar S. To Study the Utilization Pattern of Nasal Decongestants and their Effects on Heart Rate and Blood Pressure. Clin Rhinol An Int J 2012;5(3):91-94.

RESEARCH ARTICLE

Neelima Gupta, PP Singh, Lakshmi Vaid, Manish Arya, Rumpa Saha

Impact of Biofilms on Quality of Life of Rhinosinusitis Patients after Endoscopic Sinus Surgery

[Year:2012] [Month:September-December] [Volume:5] [Number:3] [Pages:8] [Pages No:95 - 102]

Keywords: Biofilm,Rhinosinusitis,Functional endoscopic sinus surgery

PDF  |  DOI: 10.5005/jp-journals-10013-1127  |  Open Access |  How to cite  | 

Abstract

Introduction

The chronic and recalcitrant nature of rhinosinusitis has been known from many years. Many reasons for this have been implicated and biofilms have now been established as one of the cause for its recurrent and persistent nature. Little literature and studies exist confirming this effect. This study presents analysis of sinonasal mucosal samples and correlates presence of biofilms with surgical outcomes.

Materials and methods

An analysis of mucosal samples collected during endoscopic sinus surgery from 40 patients of chronic rhinosinusitis (CRS) was done. Preoperative symptoms, endoscopic and radiological scores were documented and mucosal samples collected intraoperatively were sent for biofilm detection. Biofilm detection was performed using microtiter plate method. Postoperatively patients were followed up for minimum of 3 months with endoscopic evaluation and presence of ongoing symptoms was also recorded.

Results

Thirteen patients out of 40 patients showed positive bacterial culture. Eight out of 13, i.e. 61.53% bacteria produced biofilms and five out of 13, i.e. 38.46% bacteria did not produce biofilms. Patients with biofilms had significantly worse preoperative and postoperative symptom and endoscopic scores. Thus, presence of biofilms was related to poor outcomes.

Conclusion

This study showed that the presence of biofilms was correlated with higher symptom scores and poorer surgical outcomes. Also, more recurrences were found in patients with positive biofilms. This strengthens the belief that biofilms may play an active role in persisting mucosal inflammation and persistent symptoms in some patients of CRS. Treatment modalities aiming removal of biofilms may be important in management of CRS.

How to cite this article

Vaid L, Arya M, Gupta N, Singh PP, Saha R. Impact of Biofilms on Quality of Life of Rhinosinusitis Patients after Endoscopic Sinus Surgery. Clin Rhinol An Int J 2012;5(3):95-102.

RESEARCH ARTICLE

Daisy Sahni, Anjali Aggarwal, Tulika Gupta

Morphometric Evaluation of the Middle Turbinate in Relation to Endoscopic Sinus Surgery

[Year:2012] [Month:September-December] [Volume:5] [Number:3] [Pages:4] [Pages No:103 - 106]

Keywords: Middle turbinate resection,Endoscopic sinus surgery,Limen nasi

PDF  |  DOI: 10.5005/jp-journals-10013-1128  |  Open Access |  How to cite  | 

Abstract

Objective

Partial middle turbinectomy during endoscopic sinus surgery is done for better access and to avoid postoperative complications of lateralization of the middle turbinate. There are only few cadaveric studies available in literature describing the middle turbinate morphometry with surgical perspective. Therefore, the present study was planned to record morphometry and relevant surgical distances for the middle turbinate.

Materials and methods

Thirty-two midsagittal sections of cadaver heads from adult males were dissected. Middle turbinate measurements and shapes were taken. Reference distances and angles were measured.

Results

The average length of the middle turbinate was 20.4 ± 3.9 mm, while the height of the middle turbinate was taken at three specific points (13.1, 9.7, 6.1 mm). The most common shape found was the type 2. The mean value for the distance between limen nasi and the anterior and posterior attachments of the middle turbinate was found to be 32.1 ± 3.2 mm, with mean angle of 65o with the horizontal and 43.6 ± 4.2 mm, with mean angle of 39.4o with the horizontal respectively.

Conclusion

This baseline data may aid endoscopic surgeons in better planning and execution of the middle turbinate resection.

How to cite this article

Gupta T, Aggarwal A, Sahni D. Morphometric Evaluation of the Middle Turbinate in Relation to Endoscopic Sinus Surgery. Clin Rhinol An Int J 2012;5(3): 103-106.

RESEARCH ARTICLE

Sudhir Naik, Sarika S Naik

Acute Dacryocystitis with Abscess: Endonasal Dacryocystorhinostomy, the Primary Treatment of Choice

[Year:2012] [Month:September-December] [Volume:5] [Number:3] [Pages:7] [Pages No:107 - 113]

Keywords: Dacryocystitis,Lacrimal abscess,Incision and drainage,Endoscopic dacryocystorhinostomy

PDF  |  DOI: 10.5005/jp-journals-10013-1129  |  Open Access |  How to cite  | 

Abstract

Background/objectives

Acute dacryocystitis, or inflammation of the lacrimal sac with abscess, is almost always secondary to nasolacrimal duct obstruction. The standard practice for treatment is incision and drainage because of concerns about the risks of exacerbation and spread of infection. Here, we tried to evaluate primary endoscopic dacryocystorhinostomy (EnDCR) as a treatment for acute dacryocystitis with abscess formation.

Materials and methods

This is comparative case series analysis study done during the study period of 54 months from January 2007 to May 2011. A total of 46 cases of acute dacryocystitis with lacrimal abscess managed were included in the study. Twenty-one cases were operated primarily with EnDCR. Rest of the 25 cases was managed conventionally by incision and drainage and later by an external DCR.

Results

Swelling disappeared intraoperatively in all EnDCR cases while medial canthal edema and erythema completely reduced within 2 to 3 days postoperatively. While in incision and drainage swelling disappeared partially intraoperatively and repeated draining was needed on the 2nd and 3rd day. The mean visual analog scale (VAS) score on first postoperative day was 3.14 in group A and was 4.64 in group B. Group A had faster pain relief with 95.23% improvement in epiphora while group B had slower pain relief but epiphora remained. Mean intraoperative blood was 65 ml in group A and minimal in group B.

Conclusion

Primary EnDCR is successful as a procedure of choice for acute dacryocystitis with abscess preventing further episodes of abscess formation and epiphora in the patients. We recommend EnDCR as the treatment of choice for acute dacryocystitis with lacrimal abscess.

How to cite this article

Naik SM, Naik SS. Acute Dacryocystitis with Abscess: Endonasal Dacryocystorhinostomy, the Primary Treatment of Choice. Clin Rhinol An Int J 2012;5(3):107-113.

RESEARCH ARTICLE

Vinit Kumar Sharma, Rohit Sharma, Rajneesh Madhok, Tanu Agarwal, Ashish Mehrotra, Anisha Kochhar

Uncommon and Atypical Sinonasal Masses: Diagnostic and Therapeutic Challenges

[Year:2012] [Month:September-December] [Volume:5] [Number:3] [Pages:4] [Pages No:114 - 117]

Keywords: Sinonasal mass,Histopathology,Computed tomographic scan,Endoscopic techniques,Uncommon

PDF  |  DOI: 10.5005/jp-journals-10013-1130  |  Open Access |  How to cite  | 

Abstract

Introduction

Sinonasal masses are a wide range of pathologies ranging from simple nasal polyps to rare tumors like esthesioneuroblastomas. Early symptoms of all of them are similar to common nasal and sinus problems, hence, producing a delay in diagnosis.

Materials and methods

All the patients presenting with sinonasal masses in the Department of ENT and Head/Neck Surgery, SRMS Institute of Medical Sciences, Bareilly, were included in the study. The study was carried out between January 2007 and December 2011. Detailed history and ENT examination were recorded. Radiological investigation was carried out in the form of computed tomographic (CT) scan of nose and paranasal sinuses. Final diagnosis was made by histopathological examination either before instituting any form of treatment or by a postsurgical biopsy where surgery was carried out. Immunohistochemistry was done in some cases as deemed necessary by the pathologist. Thus, their modes of presentation, radiological and histopathological profiles were studied along with dilemmas in diagnosis and management.

Results

A total of 189 nasal masses were observed during this period. Out of which 126 were diagnosed as nasal polyps and were excluded from the study. Thus, 63 uncommon nasal masses were seen in the study period. A large number of uncommon sinonasal masses had atypical presentation and/or presented in an advanced stage to pose a diagnostic and surgical challenge. Endoscopic techniques are becoming a gold standard in surgical resection in most of them. Interdepartmental cooperation is highly essential.

How to cite this article

Sharma R, Sharma VK, Madhok R, Agarwal T, Mehrotra A, Kochhar A. Uncommon and Atypical Sinonasal Masses: Diagnostic and Therapeutic Challenges. Clin Rhinol An Int J 2012;5(3):114-117.

RESEARCH ARTICLE

Sumit Gupta, Sudhir Naik, Nanjundappa , Rajshekar Halkud, Srihariprasad , K Sidappa, Clementina Rama Rao

Sinonasal Teratocarcinosarcoma: A Rare Clinical Entity managed by Medial Maxillectomy and Adjuvant Chemoradiation

[Year:2012] [Month:September-December] [Volume:5] [Number:3] [Pages:5] [Pages No:118 - 122]

Keywords: Multimodality treatment,Teratocarcinosarcoma,Sinonasal,Immunohistochemistry,Medial maxillectomy

PDF  |  DOI: 10.5005/jp-journals-10013-1131  |  Open Access |  How to cite  | 

Abstract

Background/objectives

Sinonasal teratocarcinosarcoma is a rare aggressive malignant tumor arising in the sinonasal tract and a malignant neoplasm of uncertain histogenesis. As the tumor contains various components of teratoma, sarcoma and carcinoma arising from cells of embryonic origin majority of the patients suffer locoregional failure.

Case report

A 35-year-old patient reported with history of left-sided nasal obstruction since 2 months. A polypoid mass was seen in the left nasal cavity and a clinical diagnosis of infected antrochoanal polyp endoscopic sinus surgery was done. Histopathology with immunohistochemistry confirmation yielded the report as teratocarcinosarcoma.

Intervention

Medial maxillectomy with a Moure's incision was done with adjuvant intensity modulated radiotherapy and chemotherapy. Histopathological analysis of the specimen confirmed the earlier pathology.

Conclusion

Sinonasal teratocarcinosarcoma has a proven poor prognosis with locoregional recurrence. The disease free survival rate is nearly 28% and overall survival rate is of 46%. Optimal resection margins are to be defined and multimodality treatment in the form of postoperative radiotherapy and chemotherapy are to be standardized.

How to cite this article

Naik SM, Nanjundappa, Halkud R, Srihariprasad, Sidappa K, Gupta S, Rao CR. Sinonasal Teratocarcinosarcoma: A Rare Clinical Entity managed by Medial Maxillectomy and Adjuvant Chemoradiation. Clin Rhinol An Int J 2012;5(3):118-122.

CASE REPORT

Ashok Gupta, Rijuneeta , Grace Budhiraja, Abhilash Alex Francis

Nasal Dermoid Sinus Cyst expanding into Frontal Sinus: A Rare Presentation

[Year:2012] [Month:September-December] [Volume:5] [Number:3] [Pages:4] [Pages No:123 - 126]

Keywords: Nasal dermoid sinus cyst,Frontal sinus,Endoscopy

PDF  |  DOI: 10.5005/jp-journals-10013-1132  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Gupta R, Gupta A, Budhiraja G, Francis AA. Nasal Dermoid Sinus Cyst expanding into Frontal Sinus: A Rare Presentation. Clin Rhinol An Int J 2012;5(3):123-126.

CASE REPORT

Dharmendra Kumar Gupta, Samvartika Somavanshi, Arti Agrawal, Rajni Bharti, Neetu Shree

Capillary Hemangioma of the Lateral Nasal Wall: An Unusual Location

[Year:2012] [Month:September-December] [Volume:5] [Number:3] [Pages:3] [Pages No:127 - 129]

Keywords: Capillary hemangioma,Epistaxis,Lateral nasal wall,Hormonal imbalance

PDF  |  DOI: 10.5005/jp-journals-10013-1133  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Gupta DK, Somavanshi S, Agrawal A, Bharti R, Shree N. Capillary Hemangioma of the Lateral Nasal Wall: An Unusual Location. Clin Rhinol An Int J 2012;5(3): 127-129.

CASE REPORT

N Brian Shunyu, Zaren Lynrah, Amit Goyal, Vandana Raphal

Small-Cell Neuroendocrine Carcinoma of Nasopharynx

[Year:2012] [Month:September-December] [Volume:5] [Number:3] [Pages:2] [Pages No:130 - 131]

Keywords: Small-cell neuroendocrine carcinoma,Extrapulmonary,Nasopharynx

PDF  |  DOI: 10.5005/jp-journals-10013-1134  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Shunyu NB, Lynrah Z, Goyal A, Raphal V. Small-Cell Neuroendocrine Carcinoma of Nasopharynx. Clin Rhinol An Int J 2012;5(3):130-131.

CASE REPORT

SH Chandrashekharayya, Prakash S Handi, Mohammed Riyas

Bilateral Congenital Choanal Atresia in an 11-year-old Girl: An Unusual Presentation

[Year:2012] [Month:September-December] [Volume:5] [Number:3] [Pages:3] [Pages No:132 - 134]

Keywords: Choanal atresia,Bilateral,Transnasal endoscopic approach

PDF  |  DOI: 10.5005/jp-journals-10013-1135  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Chandrashekharayya SH, Handi PS, Riyas M. Bilateral Congenital Choanal Atresia in an 11-year-old Girl: An Unusual Presentation. Clin Rhinol An Int J 2012;5(3):132-134.

CASE REPORT

Rajashri Shailendra Mane, Balasaheb Chougonda Patil, Anjana Avinash Mohite

Rhinocerebral Mucormycosis Presenting as Oroantral Fistula

[Year:2012] [Month:September-December] [Volume:5] [Number:3] [Pages:3] [Pages No:135 - 137]

Keywords: Chronic rhinocerebral mucormycosis,Oroantral fistula,Rhinocerebral mucormycosis,Mucormycosis

PDF  |  DOI: 10.5005/jp-journals-10013-1136  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Mane RS, Patil BC, Mohite AA. Rhinocerebral Mucormycosis Presenting as Oroantral Fistula. Clin Rhinol An Int J 2012;5(3):135-137.

CASE REPORT

Satish Chandra Tripuraneni

Melanotic Neuroectodermal Tumor of Infancy

[Year:2012] [Month:September-December] [Volume:5] [Number:3] [Pages:2] [Pages No:138 - 139]

Keywords: Melanotic neuroectodermal tumor of infancy,Vanillylmandelic acid,Neural crest,Weber-Ferguson

PDF  |  DOI: 10.5005/jp-journals-10013-1137  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Tripuraneni SC. Melanotic Neuroectodermal Tumor of Infancy. Clin Rhinol An Int J 2012;5(3):138-139.

RESEARCH ARTICLE

Radiology Quiz

[Year:2012] [Month:September-December] [Volume:5] [Number:3] [Pages:1] [Pages No:140 - 140]

PDF  |  DOI: 10.5005/jp-journals-10013-1138  |  Open Access |  How to cite  | 

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