An International Journal of Otorhinolaryngology Clinics

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2018 | January-April | Volume 10 | Issue 1

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UP Santosh, KB Sunil Kumar, M Divyashree, DR Aravind

Significance of Tissue Eosinophil in Unilateral Nasal Polyp

[Year:2018] [Month:January-April] [Volume:10] [Number:1] [Pages:3] [Pages No:1 - 3]

Keywords: Allergy, Fisher's exact test, Inflammation.

   DOI: 10.5005/jp-journals-10003-1279  |  Open Access |  How to cite  | 


Introduction: Nasal polyp is an inflammatory condition of unknown etiology with a prevalence rate of about 4%. Unilateral nasal polyp is common in the ear, nose, and throat (ENT) practice and publications in the literature in this regard are few. Aim: The aim of this study was histological analysis of eosinophil cells in unilateral nasal polyp and to correlate its relationship of allergic etiology with unilateral nasal polyp. Materials and methods: The study conducted was a retrospective study where 70 patients diagnosed as unilateral nasal polyp were analyzed with their histopathology reports. It included patients of either sex with age between 6 and 65 years. All these patients had undergone surgery and polyp specimen was sent for histopathological examination. The patients were grouped as per their histopathological diagnosis as inflammatory polyp with tissue eosinophil and inflammatory polyp without tissue eosinophil and were compared. Tissue eosinophil grading was done according to Shioda and Mishima system. Data were analyzed and a conclusion was drawn. Results: In total 70 patients (100%) of unilateral nasal polyp, 33 patients (47%) showed presence of tissue eosinophil and 37 patients (53%) showed absence of tissue eosinophil in histopathological examination. Out of 33 patients with tissue eosinophil, 16 patients (48.5%) showed significant tissue eosinophil with p < 0.0000. Conclusion: Since the p-value is significant in our study, otorhinolaryngologists should consider allergy as an etiological factor in the management of unilateral nasal polyp.



Venkatesh Manikrao Patil, Rashmi M Patil, Vinayak V Rayakar, Ravindrakumar N Karadi

Antrochoanal Polyp Recurrence-free Management: Our Experience

[Year:2018] [Month:January-April] [Volume:10] [Number:1] [Pages:7] [Pages No:4 - 10]

Keywords: Antrochoanal polyp, Endoscopic sinus surgery, Mini Caldwell–Luc, Recurrence.

   DOI: 10.5005/jp-journals-10003-1280  |  Open Access |  How to cite  | 


The terminology “antrochoanal polyp” emerged from nasal polyp only when Killian in 1906 noted the antral connection of this polyp. Hence, it is also known as Killian's polyp. Many surgical techniques are described for the management of antrochoanal polyp: (1) Killian's avulsion of pedicle of polyp; (2) Caldwell–Luc surgery; (3) endoscopy sinus surgery. When polyp origin is broadly based or when base is located at unfavorable portion, such as anterior/inferior portion of maxillary sinus, recurrence occurs due to retention of diseased mucosa carrying mucous cyst. Propensity of polyp to recur after various methods of treatment has led to the development of a technique that causes least recurrence. A technique that prevents recurrence will be the best one.



Mariam Al-Amro

Can Mode of Delivery cause Septal Deviation? A Retrospective Study

[Year:2018] [Month:January-April] [Volume:10] [Number:1] [Pages:2] [Pages No:11 - 12]

Keywords: Cesarean section, Congenital septal deviation, Normal delivery.

   DOI: 10.5005/jp-journals-10003-1281  |  Open Access |  How to cite  | 


Objective: To establish whether septal deviation in infants with no previous trauma history is associated with the mode of their delivery. Materials and methods: Records of patients treated for a deviated nasal septum from March 2003 to October 2014 were reviewed; those with previous facial trauma were excluded. Information retrieved included basic demographic data, mode of delivery, sibling birthing order, type and date of surgery, and postoperational outcomes. Results: A total of 130 records were recovered. Comparison between normal delivery and cesarean section groups found no statistical significance (63 vs 67; p-value > 0.05). Conclusion: The mode of delivery, in uncomplicated cases, is not a cause of septal deviation.



Nariender K Mohindroo, Rajeev Gupta, Devraj Sharma

Comparison of Surgical Outcome in Endoscopic Dacryocystorhinostomy with and without Silicone Stent Placement: Comparative Case Analysis

[Year:2018] [Month:January-April] [Volume:10] [Number:1] [Pages:4] [Pages No:13 - 16]

Keywords: Dacryocystitis, Endoscopic dacryocystorhinostomy, Epiphora.

   DOI: 10.5005/jp-journals-10003-1282  |  Open Access |  How to cite  | 


Objective: The purpose of this study was to compare the longterm surgical outcome in endonasal dacryocystorhinostomy (DCR) with and without silicon stent placement. Materials and methods: A prospective comparative analysis of 66 patients who underwent primary endoscopic DCR with stenting (group I), revision endoscopic DCR with stenting (group II), and primary endoscopic DCR without stenting (group III) was done. Success was evaluated in the form of subjective and objective analysis with 6 months follow-up. Results: Out of the 66 patients, 34 underwent silicon stent placement (group I), 5 patients in revision underwent endoscopic DCR with stenting (group II) as against 27 patients in whom DCR was done without stenting (group III). Out of 34 patients of group I, 32 (94.12%) showed complete recovery of symptoms, all 5 patients of group II (100%) and 22 patients in group III (84.48%) out of 27 showed complete recovery of symptoms at 6 months follow-up. Patients with stent placements showed a slightly higher rate of success as compared with patients without stenting (94.12%/100%/84.48%). There was, however, no statistical difference in the success rate between groups I and III (p = 0.17) and between groups II and III (p = 0.78). Conclusion: Endoscopic DCR with stenting is the preferred treatment of choice in cases of chronic dacryocystitis, with higher success rate, minimal preoperative and postoperative complications. In the present study, advantages of stenting were that there was less hospital stay than without stenting and there was no need of long postoperative lacrimal syringing schedule which is important to maintain the neo-ostium to keep it patent, and without stenting it needed regular syringing for 3 months.



Mukund D Rahalkar, Anand M Rahalkar, Vardhan S Joshi, Kailash V Sant, Kourabhi B Zade

Computed Tomography Cisternography for the Management of Cerebrospinal Fluid Fistulae

[Year:2018] [Month:January-April] [Volume:10] [Number:1] [Pages:11] [Pages No:17 - 27]

Keywords: Cerebrospinal fluid fistula, Cerebrospinal fluid leak, Computed tomography cisternography, Cribriform plate, Functional endoscopic sinus surgery for rhinorrhea, Management of cerebrospinal fluid fistulae.

   DOI: 10.5005/jp-journals-10003-1283  |  Open Access |  How to cite  | 


Cerebrospinal fluid (CSF) fistula is an increasingly common condition these days with traumatic cause being commoner than either surgical or nonsurgical trauma. The patient usually presents either with rhinorrhea or less frequently otorrhea. Computed tomography (CT) cisternography is widely used in the diagnostic workup of such patients. It helps to localize the site of leak and to establish the underlying cause. The purpose of this article is to present an overview of CT cisternography findings in various types of CSF fistula, i.e., rhinorrhea, otorrhea, and otorhinorrhea and the management based on them. Magnetic resonance cisternography was not utilized as the CT provides bony detail much better, which is useful for the operating surgeon or endoscopist.



Sanjeev Saxena, Muniraju Bharath

Functional Endoscopic Sinus Surgery Outcome in Adults with Chronic Rhinosinusitis by Sino-nasal Outcome Test 20

[Year:2018] [Month:January-April] [Volume:10] [Number:1] [Pages:4] [Pages No:28 - 31]

Keywords: Chronic rhinosinusitis, Functional endoscopic sinus surgery, Outcome, Sino-nasal outcome test 20.

   DOI: 10.5005/jp-journals-10003-1284  |  Open Access |  How to cite  | 


Objective: This study is designed to compare the symptomatic profile of chronic rhinosinusitis (CRS) before and after functional endoscopic sinus surgery (FESS) by 20-item Sino-Nasal Outcome Test (SNOT-20) questionnaire. Study design: Open prospective observational study. Materials and methods: A group of 40 patients with symptoms of CRS were included in the study. They underwent FESS at the Department of ENT, Command Hospital, Air Force, Bengaluru, from July 2014 to December 2015. Patients were assessed for CRS symptoms preoperatively and postoperatively by SNOT-20 questionnaire. Follow-up of patients was done at 1 week, 2 weeks, 1 month, 3 months, and 6 months respectively, by SNOT-20 score. Results: There was a significant difference noted in overall SNOT-20 score as well as improvement in symptoms at the end of 6 months. Conclusion: A good objective outcome in terms of symptoms improvement can be obtained with FESS in patients with CRS by SNOT-20.



Bachi Hathiram, Vicky S Khattar, Sohil Gala

Tuberculous Osteomyelitis of Frontal Bone with Orbital Involvement: A Rare Case Presentation

[Year:2018] [Month:January-April] [Volume:10] [Number:1] [Pages:3] [Pages No:32 - 34]

Keywords: Frontal sinus, Orbital, Osteomyelitis, Tuberculosis.

   DOI: 10.5005/jp-journals-10003-1285  |  Open Access |  How to cite  | 


Introduction: Skeletal tuberculosis accounts for 1 to 3% of total cases of tuberculosis, out of which only 0.2 to 1.3% involve the calvarial bones, thus making it extremely rare. Materials and methods: We discuss a case of tuberculous osteomyelitis of the frontal bone with orbital involvement. The patient was effectively managed by antituberculous therapy with no need for any surgical intervention. Conclusion: With the advent of antituberculous chemotherapy and advanced diagnostic modalities, tuberculosis can be actively tackled, but still continues to be a leading public health problem in developing countries. A high index of suspicion in atypical cases must be considered.



MC Trupthi, Ajoy M Varghese, Rajavel Subbaraj

Multicentric Inverted Papilloma of Sinonasal Region and the Temporal Bone

[Year:2018] [Month:January-April] [Volume:10] [Number:1] [Pages:4] [Pages No:35 - 38]

Keywords: Inverted papilloma, Middle ear, Recurrent, Synchronous.

   DOI: 10.5005/jp-journals-10003-1286  |  Open Access |  How to cite  | 


Inverted papilloma is a benign but a locally aggressive sinonasal tumor. Inverted papilloma of the temporal bone, though rare, has been reported to occur either primarily or secondarily. Here we present a case of recurrent sinonasal inverted papilloma with synchronous lesion of the middle ear, having no connection through the eustachian tube.



Brajpal S Tyagi

Extranasopharyngeal Angiofibroma of the Nasal Septum in an Elderly Postmenopausal Female: A Very Rare Presentation

[Year:2018] [Month:January-April] [Volume:10] [Number:1] [Pages:3] [Pages No:39 - 41]

Keywords: Extranasopharyngeal angiofibroma, Females, Nasal septum.

   DOI: 10.5005/jp-journals-10003-1287  |  Open Access |  How to cite  | 


Nasopharyngeal angiofibromas (NPAs) are known to occur predominantly in males around puberty and adolescence. They are mostly commonly located in the region of the nasopharynx with their origin predominantly being the sphenopalatine foramen. The term extranasopharyngeal angiofibroma (ENPA) has been mainly applied to vascular, fibrous nodules that are found to occur outside of the nasopharynx. Extranasopharyngeal angiofibromas are known to be an uncommon entity. In this report, we describe the case of a 54-year-old woman who presented to us with history of a slowly progressing nasal obstruction of the left nasal cavity due to the presence of a mass. She also gave history of sudden episodes of epistaxis on and off. Typical radiological findings were found in computed tomography (CT) that showed presence of a mass adhering to the nasal septum. Initially, biopsy was done. The tumor was then successfully removed surgically and the subsequent histopathological examination confirmed the diagnosis to be of an ENPA. In follow-up, the patient is free of symptoms.



Georgios Karatzias, Silvestros Boukouvalas, Maria Manitsopoulou, Konstantinos Papadopoulos

An Outpatient Approach to the Management of Recurrent Epistaxis in Patients with Hereditary Hemorrhagic Telangiectasia

[Year:2018] [Month:January-April] [Volume:10] [Number:1] [Pages:4] [Pages No:42 - 45]

Keywords: Coblation, Epistaxis, Hereditary hemorrhagic telangiectasia, Rendu–Osler–Weber.

   DOI: 10.5005/jp-journals-10003-1288  |  Open Access |  How to cite  | 


Patients with Rendu–Osler–Weber syndrome, a relatively common inherited vascular disorder, usually appear with epistaxis. Treatment is supportive and conducive to the prevention of complications. There are several ways to manage this condition, including conservative, medical, or surgical/ procedural approaches. Three cases of outpatients with hereditary hemorrhagic telangiectasia (HHT) are presented, who reported recurrent episodes of nasal bleeding. Furthermore, this study focuses on the approach to control episodes of epistaxis in our outpatient department, using radiofrequency (RF) energy in order to achieve coblation. Specifically, the clinical methodology aims to decrease the severity and frequency of nasal bleeding in the long term, with minimal local and general side effects. This will subsequently improve the quality of life in these patients.


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