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2016 | January-April | Volume 9 | Issue 1

RESEARCH ARTICLE

Editorial

[Year:2016] [Month:January-April] [Volume:9] [Number:1] [Pages:1] [Pages No:0 - 0]

PDF  |  DOI: 10.5005/aijcr-9-1-iv  |  Open Access |  How to cite  | 

RESEARCH ARTICLE

Kiran Rao

Computed Tomography of Paranasal Sinus Pathologies with Functional Endoscopic Sinus Surgery/Nasal Endoscopy Correlation

[Year:2016] [Month:January-April] [Volume:9] [Number:1] [Pages:5] [Pages No:1 - 5]

Keywords: Computed tomography scan,Functional endoscopic sinus surgery,Paranasal sinus pathology

PDF  |  DOI: 10.5005/jp-journals-10013-1253  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Rao K. Computed Tomography of Paranasal Sinus Pathologies with Functional Endoscopic Sinus Surgery/Nasal Endoscopy Correlation. Clin Rhinol An Int J 2016;9(1):1-5.

RESEARCH ARTICLE

Chidananda Ramappa Devasamudra, Chidananda R Devasamudra

Intermediate Osteotomy and other Unique Techniques used in Reduction Rhinoplasty

[Year:2016] [Month:January-April] [Volume:9] [Number:1] [Pages:7] [Pages No:6 - 12]

Keywords: Intermediate osteotomy,Medial lateral,Reduction rhinoplasty

PDF  |  DOI: 10.5005/jp-journals-10013-1254  |  Open Access |  How to cite  | 

Abstract

Background

A 25-year-old male patient came with a history of nasal obstruction on the left side. He was also concerned about his nasal framework deformities, such as gross deviation of the nose to left, hump over the nose, asymmetrical nostril, and overall bulky nose.

Materials and methods

Detailed history was taken and examination done to rule out contraindication to septorhinoplasty. Expectations, requirements, and postoperative results of the patient were understood. Open approach reduction rhinoplasty was carried out. Unique techniques, such as intermediate and transverse osteotomies were done to achieve the required results.

Results

Bulky deviated nose was reduced to an esthetically good-looking nose by humpectomy, four types of osteotomies, extended spreader grafts, columellar strut, and Tipplasty.

Conclusion

Surgical steps must be undertaken in order to achieve good esthetic results. Surgeries, such as humpectomy must be done before osteotomies, intermediate osteotomies must be done before lateral osteotomies, and Tipplasty must be done after osteotomies.

How to cite this article

Sagar NJ, Devasamudra CR. Intermediate Osteotomy and other Unique Techniques used in Reduction Rhinoplasty. Clin Rhinol An Int J 2016;9(1):6-12.

RESEARCH ARTICLE

Priyanko Chakraborty, Rajiv K Jain, Purnima Joshi, Rakhi Kumari, Sidharth Pradhan

Anatomic Variations of the Nose in Chronic Rhinosinusitis: Correlation between Nasal Endoscopic and Computerized Tomography Scan Findings and a Review of Literature

[Year:2016] [Month:January-April] [Volume:9] [Number:1] [Pages:5] [Pages No:13 - 17]

Keywords: Anatomic variation,Chronic rhinosinusitis,CT scan,Nasal endoscopy

PDF  |  DOI: 10.5005/jp-journals-10013-1255  |  Open Access |  How to cite  | 

Abstract

Background

Chronic rhinosinusitis (CRS) refers to a group of disorders characterized by inflammation of the mucosa of the paranasal sinuses. Nasal endoscopy and computed tomography (CT) scans are successfully used as diagnostic modalities of nose and paranasal sinus diseases. There have been many studies regarding the anatomic variations leading to pathogenesis of paranasal sinus diseases. Considerable progress has been made in the medical and surgical control of these conditions; however, a large number of questions relating to the diagnosis, evaluation, and treatment of the diseases remain unanswered.

Materials and methods

The study included 82 clinically diagnosed cases of CRS who underwent CT scan and were advised to undergo diagnostic endoscopy. The anatomical findings of the nose were compared to see correlation between nasal endoscopy and CT scan.

Results

The mean age (±standard error of the mean) of presentation was 34.11 (±1.42) years, while most patients were from the age group of 18 to 30 years. Males were predominating the study group with 62.2%, while 37.8% were females. The most common anatomic variation was deviated nasal septum with 92.68% CT reported patients. This was followed by inferior turbinate hypertrophy, septal spur, concha bullosa, and agger nasi cells.

Conclusion

Computed tomography scan is considered the gold standard for sinonasal imaging. Diagnostic endoscopy and CT scan are a must prior to any functional endoscopic sinus surgery. They help in assessing the extent of sinus disease and to know the variations and vital relations of the paranasal sinuses. Computed tomography scan assists the surgeon as a “road map” during endoscopic sinus surgery.

How to cite this article

Chakraborty P, Jain RK, Joshi P, Kumari R, Pradhan S. Anatomic Variations of the Nose in Chronic Rhinosinusitis: Correlation between Nasal Endoscopic and Computerized Tomography Scan Findings and a Review of Literature. Clin Rhinol An Int J 2016;9(1):13-17.

RESEARCH ARTICLE

Niru Moran, Debajit Das

Epistaxis—Incidence, Etiology, and Management: A Hospital-based Study

[Year:2016] [Month:January-April] [Volume:9] [Number:1] [Pages:3] [Pages No:18 - 20]

Keywords: Epistaxis,Rhinological,Blood transfusion

PDF  |  DOI: 10.5005/jp-journals-10013-1256  |  Open Access |  How to cite  | 

Abstract

How to cite this article

M oran N, D as D . E pistaxis—Incidence, Etiology, and Management: A Hospital-based Study. Clin Rhinol An Int J 2016;9(1):18-20.

RESEARCH ARTICLE

Rahul Shivaraj, Cimona Dsouza, George Pinto

Influence of Superior Attachment of the Uncinate Process on the Presence of Agger Nasi

[Year:2016] [Month:January-April] [Volume:9] [Number:1] [Pages:3] [Pages No:21 - 23]

Keywords: Agger nasi,Frontal sinus,Superior attachment of the uncinate process

PDF  |  DOI: 10.5005/jp-journals-10013-1257  |  Open Access |  How to cite  | 

Abstract

Objective

The superior attachment of the uncinate process and the agger nasi cell are important landmarks in frontal sinus surgery and are in close relation with each other. The aim of this study is to investigate the relationship between the two.

Study design

A retrospective radiological study.

Materials and methods

A total of 50 patients with features of chronic sinusitis were evaluated radiographically, i.e., by computed tomography. Hundred sides, i.e., 50 scans, were evaluated for superior attachment of the uncinate process and the presence of agger nasi. Chi-square test was used as a statistical tool for eliciting the relationship between the two.

Results

The agger nasi cell was found in 68 (68%) of 100 sides. The prevalence of agger nasi cell according to the superior attachment of uncinate process types was 64.1% for lamina papyracea, 79.41% for skull base, and 53.84% for middle turbinate. The presence of agger nasi cell according to the superior attachment types of uncinate process was not statistically significant (X2 = 3.5925, p = 0.16592).

Conclusion

The agger nasi cell was found in 68 sides (68%), and there was no statistical significance between the superior attachment of the uncinate process and the presence of agger nasi cell.

How to cite this article

Shivaraj R, Dsouza C, Pinto G. Influence of Superior Attachment of the Uncinate Process on the Presence of Agger Nasi. Clin Rhinol An Int J 2016;9(1):21-23.

RESEARCH ARTICLE

Virendra Kumar, Rohit Sharma, Jolly Agarwal

Morphometric Analysis and Degree of Satisfaction of Nasal Profiles in Young Medical Students in Northern India

[Year:2016] [Month:January-April] [Volume:9] [Number:1] [Pages:4] [Pages No:24 - 27]

Keywords: Anthropometry,Leptorrhine,Nasal shapes

PDF  |  DOI: 10.5005/jp-journals-10013-1258  |  Open Access |  How to cite  | 

Abstract

Background

The nose is the most prominent feature on the face, giving it an exaggerated importance than other facial features. Many people have some complaints about the shapes of their noses. There is increasing interest in cosmetic rhinoplasty in recent times, but reports of anthropometric measurements of the Indian population are limited.

Aims

The objective of this survey was to provide anthropometric data for reconstructive and cosmetic surgery, and medical esthetics.

Materials and methods

A random sample of medical students of both the sexes between the ages of 18 and 25 years from our medical college was obtained for this study. We measured the nasal height, nasal width, and anatomical nasal index. We also inquired about the degree of satisfaction and, in case of dissatisfaction, what an individual wants with his/her nose. The data were analyzed statistically.

Results

Nasal indices were leptorrhine type and showed sexual dimorphism (female vs male: 60.44 vs 67.79). Most of the individuals were satisfied with their nose. Those unsatisfied had larger nasal indices and wanted smaller noses.

Conclusion

This study can help in understanding the need of those who want a more “shapely” nose and can contribute to satisfactory results of cosmetic and reconstructive nasal surgery, anthropology, and forensic medicine.

How to cite this article

Agarwal J, Sharma R, Kumar V. Morphometric Analysis and Degree of Satisfaction of Nasal Profiles in Young Medical Students in Northern India. Clin Rhinol An Int J 2016;9(1):24-27.

RESEARCH ARTICLE

V Narendrakumar, V Subramanian

Anatomical Variations in Osteomeatal Complex among Patients undergoing Functional Endoscopic Sinus Surgery

[Year:2016] [Month:January-April] [Volume:9] [Number:1] [Pages:5] [Pages No:28 - 32]

Keywords: Anatomic variation,Chronic sinusitis,Osteomeatal complex,Paranasal sinuses

PDF  |  DOI: 10.5005/jp-journals-10013-1259  |  Open Access |  How to cite  | 

Abstract

Aims

To study the anatomical variations of osteomeatal complex and the importance of preoperative computed tomography (CT) in patients with chronic sinusitis undergoing functional endoscopic sinus surgery. We studied the different variations and their frequency of occurrence.

Materials and methods

A total of 100 patients undergoing endoscopic sinus surgery were studied by nasal endoscopy, CT scanning, and at the time of definitive surgery, variations were recorded.

Results

The frequency of occurrence of sinonasal anatomical variations was septal deviation in 76%, agger nasi cells in 71%, concha bullosa in 61%, medialized uncinate process in 48%, prominent bulla ethmoidalis in 41%, paradoxical middle turbinate in 33%, accessory maxillary ostium in 28%, frontal cell in 22%, intumescentia septi nasi anterior in 21%, lateralized uncinate in 15%, pneumatized uncinate process in 4%, Haller cells in 12%, and Onodi cells in 8%.

Conclusion

The high incidence of variations emphasizes the need for proper preoperative assessment for safe and effective endoscopic sinus surgery.

How to cite this article

Narendrakumar V, Subramanian V. Anatomical Variations in Osteomeatal Complex among Patients undergoing Functional Endoscopic Sinus Surgery. Clin Rhinol An Int J 2016;9(1):28-32.

RESEARCH ARTICLE

SS Bist, Sanjeev Bhagat, Himanshu Kala

A Clinical Study of Relationship of Body Mass Index with Allergic Rhinitis

[Year:2016] [Month:January-April] [Volume:9] [Number:1] [Pages:4] [Pages No:33 - 36]

Keywords: Allergic rhinitis,Body mass index,Obesity

PDF  |  DOI: 10.5005/jp-journals-10013-1260  |  Open Access |  How to cite  | 

Abstract

Objectives

Although the association between obesity and bronchial asthma (BA) has been gaining more attention, few studies have been conducted concerning the relationship between body mass index (BMI) and other allergic diseases. The purpose of this study is to determine the relationship between allergic rhinitis (AR) and BMI.

Materials and methods

This was a retrospective study. Two hundred and ten patients of AR (138 males and 72 females) and 424 healthy controls were included in the study. The BMI of patients and controls were calculated and correlated.

Results

The percentage of AR patients with a low BMI was 9.5%, whereas 57.6% had a normal BMI; 21% were preobese and 9.5% were obese. In the control group, 48.6% subjects had normal BMI range followed by preobese 21.2%, underweight 20.3%, and obese 9.9%. Among the overweight (preobese+ obese) category, the maximum number of subjects belonged to cases, i.e., 32.8% with an odds ratio (OR) of 0.95 (95% confidence interval (CI) 0.91-1.07). Thus, AR was not associated with high BMI. Among the underweight, the maximum number of subjects belonged to the control group, i.e., 20.3% with an OR of 2.13 (95% CI 1.24-3.68). Thus, AR had no relationship with lower BMI also. It was also observed that more of the female patients (18, 29.1, and 12.5% were underweight, preobese, and obese respectively) had deranged BMI than male patients (5.3, 20.2, and 7.9% were underweight, preobese, and obese respectively). A relative risk of 1.124 (95% CI 1.01-1.23) and 1.04 (95% CI 0.95-1.13) was present in female patients with low and high BMI respectively, which is statistically significant (p = 0.0008).

Conclusion

It was concluded that BMI was not associated with increased prevalence of AR. Among the underweight and overweight, AR was more common in females than in males. Thus, BMI had a significant association with AR among female patients. Overall, BMI had no significant association with AR.

How to cite this article

Kala H, Bhagat S, Varshney S, Bist SS. A Clinical Study of Relationship of Body Mass Index with Allergic Rhinitis. Clin Rhinol An Int J 2016;9(1):33-36.

RESEARCH ARTICLE

KB Gupta, Jyoti Yadav, Rupender K Ranga, Anuj K Goel

Mucociliary Clearance in Bronchiectasis

[Year:2016] [Month:January-April] [Volume:9] [Number:1] [Pages:3] [Pages No:37 - 39]

Keywords: Mucus,Nasal mucociliary clearance time,Bronchiectasis

PDF  |  DOI: 10.5005/jp-journals-10013-1261  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Yadav J, Ranga RK, Goel AK, Gupta KB. Mucociliary Clearance in Bronchiectasis. Clin Rhinol An Int J 2016;9(1):37-39.

RESEARCH ARTICLE

Sourabha K Patro, Anil K Dash, Subhranshu Patro, Rudra Narayan Biswal

Amphotericin B Emulsion in Rhino-orbital Mucormycosis: Is It Most Effective?

[Year:2016] [Month:January-April] [Volume:9] [Number:1] [Pages:3] [Pages No:40 - 42]

Keywords: Amphotericin,Mucormycosis,Rhino-orbital

PDF  |  DOI: 10.5005/jp-journals-10013-1262  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Dash AK, Patro S, Patro SK, Gupta AK, Biswal RN. Amphotericin B Emulsion in Rhino-orbital Mucormycosis: Is It Most Effective? Clin Rhinol An Int J 2016;9(1): 40-42.

REVIEW ARTICLE

Saurabh Srivastava, Mohd Shakeel, Prasoon Varshney

Maxillary Sinus Hypoplasia—A Not-so-uncommon Clinical Entity: A Review

[Year:2016] [Month:January-April] [Volume:9] [Number:1] [Pages:3] [Pages No:43 - 45]

Keywords: Anamoly,Maxillary sinus,Hypoplasia

PDF  |  DOI: 10.5005/jp-journals-10013-1263  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Bhargava A, Khanduri S, Shakeel M, Srivastava S, Varshney P. Maxillary Sinus Hypoplasia-A Not-so-uncommon Clinical Entity: A Review. Clin Rhinol An Int J 2016;9(1):43-45.

CASE REPORT

Muhammed JA Jalal, Shirley J Fernandez, Renu M Thomas, Julio C Kandathil, Murali K Menon, Gigy Kuruttukulam

Posaconazole: An Only Oral First-line Antifungal for Rhinocerebral Mucormycosis

[Year:2016] [Month:January-April] [Volume:9] [Number:1] [Pages:4] [Pages No:46 - 49]

Keywords: Headache,Oral antifungal therapy,Posaconazole,Rhinocerebral mucormycosis

PDF  |  DOI: 10.5005/jp-journals-10013-1264  |  Open Access |  How to cite  | 

Abstract

Introduction

Mucormycosis is a rare opportunistic invasive fungal infection. The most commonly reported form of the disease is rhinocerebral mucormycosis. Early diagnosis of the disease and aggressive medical and surgical intervention prevent the high morbidity and mortality associated with mucormycosis.

Case report

A 54-year-old diabetic and hypertensive male presented with severe frontal headache and retro-orbital pain of 4 days duration with high-grade fever. On examination, the patient was conscious and oriented with a blood pressure of 210/100 mm Hg. The pupils were anisocoric. Frontal sinus tenderness was present. Anterior rhinoscopy showed deviation of nasal septum to left without edema and nasal mucosal congestion. Eye examination revealed normal vision without any periorbital swelling and normal fundus. Plain axial computed tomography showed soft-tissue density material in sphenoid sinus with focal hyperdense component anteriorly. Cerebrospinal fluid study was negative for meningitis with a normal cerebrospinal fluid pressure. Axial T1-weighted image showed T1 intermediate to high signal soft tissue occluding the sphenoid sinus. Axial T2-weighted image showed T2 high signal soft tissue occluding the sphenoid sinus. Similar signal tissue was seen in the middle and posterior ethmoid air cells on both sides. Axial and coronal postcontrast T1-weighted fat-saturated images showed heterogeneously enhancing soft tissue in sphenoid and ethmoid sinuses. The patient underwent functional endoscopic sinus surgery and tissue sampling, following which antifungal therapy with posaconazole was initiated since biopsy from sinus mucosa was consistent with mucormycosis. The patient responded well to functional endoscopic sinus surgical evacuation of the fungal debris and posaconazole and is doing well on follow-up.

Conclusion

This report highlights the possibility of occurrence of this rapidly fatal condition even with normal-looking nasal mucosa. High index of suspicion is required to prevent the complications as the course of the disease is very rapid. This case report emphasizes the fact that posaconazole is the only available oral antifungal that can be used as a first-line agent in the management of mucormycosis, even in immunocompromised individuals.

How to cite this article

Jalal MJA, Fernandez SJ, Thomas RM, Kandathil JC, Menon MK, Kuruttukulam G. Posaconazole: An Only Oral First-line Antifungal for Rhinocerebral Mucormycosis. Clin Rhinol An Int J 2016;9(1):46-49.

CASE REPORT

Ravi Meher, Swati Tandon

Extramedullary Plasmacytoma of Nasal Cavity

[Year:2016] [Month:January-April] [Volume:9] [Number:1] [Pages:3] [Pages No:50 - 52]

Keywords: Extramedullary plasmacytoma,Nose,Paranasal sinuses

PDF  |  DOI: 10.5005/jp-journals-10013-1265  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Tandon S, Meher R, Chauhan A. Extramedullary Plasmacytoma of Nasal Cavity. Clin Rhinol An Int J 2016;9(1):50-52.

CASE REPORT

Sampurna Pati, Sudipta Pal, Surajit Biswas, Somnath Saha

Ectodermal Dysplasia presenting with Atrophic Rhinitis: A Report of Two Cases and a Review of the Literature

[Year:2016] [Month:January-April] [Volume:9] [Number:1] [Pages:3] [Pages No:53 - 55]

Keywords: Ectodermal dysplasia,Nasal myiasis,Atrophic rhinitis

PDF  |  DOI: 10.5005/jp-journals-10013-1266  |  Open Access |  How to cite  | 

Abstract

Aims

To present two rare cases of ectodermal dysplasia presenting with maggot infestation due to atrophic rhinitis.

Study design

Case report.

Setting

A tertiary care referral hospital.

Presentation

Two male children aged about 5 and 8 years presented to the ear, nose, and throat emergency with a history of maggot infestation of the nose.

Results

Clinical examination was suggestive of ectodermal dysplasia. Intranasal examination was suggestive of atrophic rhinitis. Maggots were removed in the conventional manner. Following a conservative treatment, skin biopsy and nasal mucosal biopsy were done, which confirmed the diagnosis of ectodermal dysplasia.

Conclusion

Any ectodermal dysplasia patient should be suspected of having atrophic rhinitis and intranasal conservative therapy should be initiated at the earliest to prevent complications like maggots in the nose.

How to cite this article

Pati S, Pal S, Saha S, Biswas S. Ectodermal Dysplasia presenting with Atrophic Rhinitis: A Report of Two Cases and a Review of the Literature. Clin Rhinol An Int J 2016;9(1):53-55.

CASE REPORT

Hitesh Verma, TM Arun, Amrinder Kaur

Changing Trends in Endoscopic Endonasal Medial Maxillectomy

[Year:2016] [Month:January-April] [Volume:9] [Number:1] [Pages:3] [Pages No:56 - 58]

Keywords: Endoscopic,Inferior turbinate,Medial maxillectomy,Nasolacrimal duct

PDF  |  DOI: 10.5005/jp-journals-10013-1267  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Verma H, Dass A, Singhal SK, Gupta N, Arun TM, Kaur A. Changing Trends in Endoscopic Endonasal Medial Maxillectomy. Clin Rhinol An Int J 2016;9(1):56-58.

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