Chauhan P, Sood A, Jain M, Dabla P, Sood S. Serum PCT and CRP Levels in Upper Respiratory Tract Infections as a Marker of Infection. Clin Rhinol An Int J 2013;6(1):1-4.

To evaluate the role of intraoperative mitomycin-C application in primary endoscopic endonasal dacryocystorhinostomy (DCR) and compare the results with conventional endoscopic endonasal DCR.

Prospective comparative interventional study.

Tertiary referral hospital.

Fifty patients in the age group of 16 to 50 years presenting with symptoms and signs suggestive of nasolacrimal duct blockage refractory to conventional medical treatment were included in the study. They were assigned randomly into two groups of 25 patients each. Group A patients underwent endoscopic endonasal DCR followed by application of mitomycin-C. Group B patients underwent endoscopic endonasal DCR without application of mitomycin-C. The two groups were compared with regard to success rate and complications. The main outcome measures for success were the resolution of epiphora and patency with lacrimal irrigation.

After 1 year, 24 patients (96%) in each group had complete relief from their symptoms while one patient (4%) had no relief. Syringing was patent in 24 patients (96%) in each group and blocked in one patient (4%) after 1 year of surgery.

The present study did not show any additional benefit of using mitomycin-C at the stoma site after primary endoscopic endonasal DCR in terms of success rate.

Wadhera R, Gulati SP, Khurana AK, Sharma H, Kalra V, Ghai A. A Comparative Study of Endoscopic Endonasal Dacryocystorhinostomy with and without Intraoperative Mitomycin-C Application. Clin Rhinol An Int J 2013;6(1):5-9.

Verma H, Rijuneeta, Gupta AK, Chakrabarti A. Allergic Fungal Rhinosinusitis Involving Frontal Sinus: A Prospective Study comparing Surgical Modalities. Clin Rhinol An Int J 2013;6(1):10-15.

The anatomical variations of the lateral wall of nose may create technical difficulties during surgery and increase predisposition for chronic rhinosinusitis (CRS). Various cadaveric and radiological studies have been carried out to identify the variations of critical landmarks in sinonasal anatomy. However, studies analyzing the nasal endoscopic examination of living patients are scarce.

The aim of the study was to compare the anatomical variations in the middle meatus of patients having CRS with that of normal population.

This was a prospective clinical study, where 700 subjects (1,400 middle meatus) were subjected to diagnostic nasal endoscopy, over a period of 2 years. A total of 350 subjects each with CRS and normal population were included in the case and control group, respectively. Endoscopic examination of nasal cavity was done to observe the middle meatus configuration.

The anatomical variations in the case group were significantly higher that of control. The most common atypical anatomical presentation in both the case and control group were atypical agger nasi (14 vs 7%, p-value = 0.0001), concha bullosa in middle turbinate (12 vs 9%, p-value = 0.0809), medially projected uncinate process (10 vs 4%, p-value = 0.0001), and sausage shaped ethmoid bulla (18 vs 10%, p-value = 0.0001). Interestingly, opening of ethmoid bulla was also observed in both the groups.

The prevalence of anatomic variations is significantly higher in the case group. However, the detection of a single anatomical variant itself does not establish the genesis of pathophysiology of CRS. Familiarity with such anatomy is important to optimize surgical treatment of sinus disease, while avoiding complications.

Bist SS, Varshney S, Bhagat S, Mishra S, Agrawal V, Kabdwal N. Study of the Anatomical Variations in the Middle Meatus on Nasal Endoscopy. Clin Rhinol An Int J 2013;6(1):16-21.

Hazra TK, Majumder A, Das C, Karmakar M, Paul D. Reconstruction of Depressed Dorsum including Tip of Nose by Autogenous Materials: Our Experience. Clin Rhinol An Int J 2013;6(1):22-27.

During past decades, fungal rhinosinusitis (FRS) has been diagnosed more frequently. Knowing the fungal flora and its prevalence in chronic rhinosinusitis (CRS) patients will allow a better understanding of this disease, diagnosis and treatment. We studied the prevalence of fungus in CRS patients in Delhi-NCR (National Capital Region) in a tertiary care hospital.

In this prospective study, a total of 180 patients having CRS were enrolled in which functional endoscopic sinus surgery was done. In 173 (96.1%) patients, polyps/tissue/mass were collected during surgery. In seven (3.9%) cases, sinus secretions were obtained. All the collected samples were sent for microbiology and pathology examination. Diagnosis of FRS was confirmed by direct mycological (10% KOH) and/or culture and/or pathology analysis.

Forty-eight cases were positive for fungus, out of these 180 patients of CRS. In patients of FRS, the most common presentation was nasal blockage followed by facial pain and facial fullness. The prevalence of FRS was found to be 26.6% in CRS and most common fungal pathogen isolated was Aspergillus flavus.

Delhi-NCR region falls under a moderate prevalence area for fungal infection in CRS patients as compared to other regions in India. Majority of cases were isolated in summer months, the dry and hot climate of the Delhi- NCR may be responsible for such prevalence.

Garg S, Songara P, Sherwal BL, Agarwal S, Rakshit P, Kumar S. Fungal Rhinosinusitis in Delhi- National Capital Region. Clin Rhinol An Int J 2013;6(1): 28-31.

Chronic rhinosinusitis (CRS) is diagnosed on the basis of symptoms, nasal endoscopic findings and computed tomography of the paranasal sinuses (CT PNS). Where indicated, functional endoscopic sinus surgery (FESS) is the surgical treatment.

To determine correlations between subjective symptom severity and objective endoscopic and radiologic findings in CRS and to compare these before and after FESS.

Analysis of prospectively collected data of 20 patients undergoing FESS at a tertiary care medical center followed up for a minimum period of 6 months after surgery. RSI questionnaire-based symptom score, Lund-Mackay system-based endoscopic and CT finding scores were recorded preoperatively and at 8 weeks and 6 months postoperatively.

Significant positive correlation was noted between the three parameters before surgery, especially endoscopic and radiological scores (r = 0.94 in the latter, p < 0.01 in all three). Postoperative improvement was statistically significant for all three parameters, even at the 6 months stage (p < 0.001). Postoperative correlations reduced significantly, especially between endoscopic and radiological scores.

This study showed the relevance of objective evaluation of routine parameters of CRS, preoperatively. It also confirmed the usefulness of FESS in indicated cases, in terms of statistical improvement of these parameters. However, repeat CT scans and the methods of scoring used by us may not be equally applicable in the long-term postoperative scenario.

Deepthi NV, Menon UK, Menon IR. Correlations and Comparison between Repeat Computed Tomography Scores, Endoscopy Scores and Symptomatic Improvement before and after Endoscopic Sinus Surgery: A Pilot Study. Clin Rhinol An Int J 2013;6(1):32-40.

Preetam C, Kumar R, Sikka K, Kumar R, Durgapal P. A Rare Association of Inflammatory Myofibroblastic Tumor of Maxilla and Idiopathic Orbital Inflammatory Disease. Clin Rhinol An Int J 2013;6(1):41-43.

Mohindra S, Dhingra S. Isolated Mucocele in an Infraorbital Ethmoidal Cell—Haller Cell: A Unique Presentation. Clin Rhinol An Int J 2013;6(1):44-46.

Nagpal T. Transnasal Endoscopic Removal of Malformation of the Odontoid Process in a Patient with Craniovertebral Anomaly. Clin Rhinol An Int J 2013;6(1): 47-50.

Ray CS, Mishra A, Khatua RK, Baliarsingh P. Primary Extramedullary Plasmacytoma of Maxillary Sinus. Clin Rhinol An Int J 2013;6(1):51-53.

Agarwal S, Mishra A, Jagade M, Kasbekar VG, Thorawade V, Joshi S. Sphenochoanal Polyp. Clin Rhinol An Int J 2013;6(1):54-55.

Gangaraj SS, Thimaiah AH. Rhinophyma: A Simple and Cost-effective Management. Clin Rhinol An Int J 2013;6(1):56-57.

The present study was undertaken to compare the efficacy of endoscopic removal with conventional techniques in nasal myiasis patients.

Out of 144, 72 nasal myiasis patients treated using Hopkins rigid nasal endoscope and visible caudal end of maggots was grasped with Blakesley forceps and removed during endoscopy. Rests were identified from crawling movements or the visible caudal end was buried in necrotic material. Complete clearance of cavernous cavity of maggots in affected nasal cavity from anterior nares to choanae was done and same was repeated on other side if needed.

The mean age in two groups was 57.5 years (range 40-60) in nasal myiasis patients whereas there were 20% males and 80% females. Mean duration of nasal symptom in both groups was 2 days. Endoscopically mean 120 maggots (range: 90-160) were removed in first sitting as compared to conventional technique where mean of 80 (range: 40-90) were achieved. The mean duration of endoscopic treatment was 2 days whereas in control group it was 5 days. The difference was statistically significant (p < 0.001).

Nasal endoscopic procedure is superior to the manual extraction method for removal of maggots. The larvae located in deep and inaccessible areas can be identified and removed easily. The disease was controlled in shorter time and in fewer sittings. Further the quick and complete eradication of myiasis ensures less damage to the intranasal tissues.

Ranga RK, Yadav SPS, Goyal A, Agrawal A. Endoscopic Management of Nasal Myiasis: A 10 years Experience. Clin Rhinol An Int J 2013;6(1):58-60.