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Schwannomas are tumors that arise from Schwann cells that are part of the peripheral nerve capsule and can arise from any myelinated nerve. Between 25% and 45% of them are in the head and neck, among which the eighth cranial nerve develops most frequently; Although it can also occur in other parts such as the scalp, face, parotid, oral cavity, pharynx, larynx and trachea, it is more common than in the region of the nasal sinuses, being common, representing 4% of all craniocervical schwannomas. At this level, the most common site of presentation is the ethmoid sinus, followed by the maxillary, nasal, and sphenoid sinuses. Development at the septum level is less common. The diagnosis is based on histopathological findings and the effective treatment is safe removal of the tumor. A 15-year-old male patient is reported to have had left nasal obstruction for weeks without other associated symptoms., Los schwannomas son tumores que surgen de las células de Schwann que forman parte de la cápsula del nervio periférico y pueden surgir de cualquier nervio mielinizado. Entre el 25% y el 45% de ellos se localizan en la cabeza y el cuello, entre los que se desarrolla con mayor frecuencia el octavo par craneal; aunque también puede presentarse en otras partes como cuero cabelludo, cara, parótida, cavidad bucal, faringe, laringe y tráquea, es más común que en la región de los senos nasales, siendo común representando el 4% de todos los schwannomas craneocervicales. A este nivel, el sitio de presentación más común es el seno etmoidal, seguido del seno maxilar, nasal y esfenoidal. El desarrollo a nivel del tabique es menos común. El diagnóstico se basa en los hallazgos histopatológicos y el tratamiento eficaz es la extirpación segura del tumor. Se reporta paciente masculino de 15 años obstrucción nasal izquierda de semanas de evolución sin otra sintomatología asociada.

The nasal septum, also known as septum or nasal septum in the medical field, is an anatomical structure formed by a combination of cartilage and bone that is lined by the internal skin or mucosa of the nostril. This structure is located inside the nose and serves to separate the two nostrils, extending from the visible anterior region to the back of the nose, known as the choana. The main function of the nasal septum is to provide structural support to the lower part of the nose, which is softer and lacks bone compared to the upper part, which is stronger due to its bony composition. This structural feature helps in performing the other functions of the nose, which include ventilation to allow air to pass through and the ability to perceive odors, known as olfaction. On the other hand, it is important to note that the anatomical arrangement of the nasal septum and sinuses in each individual influences the resonance of his or her voice, which contributes to each person having a unique and distinctive vocal tone that is capable of being identified. Deviation of the nasal septum, which is the bony and cartilaginous structure that separates the two nostrils, occurs when it moves from its usual position in the center of the nose, which can cause problems breathing through the nose, headaches, nasal obstruction and, in some cases, could result in a complication such as sinusitis. We present the case of a 50-year-old female patient, with no personal pathological history. She went to the otorhinolaryngology department for medical consultation because she presented 15 days ago epistaxis with a daily frequency of at least one episode per day., El tabique nasal, también conocido como septum o septo nasal en el ámbito médico, es una estructura anatómica formada por una combinación de cartílago y hueso que está revestida por la piel interna o mucosa de la fosa nasal. Esta estructura se encuentra en el interior de la nariz y sirve para separar las dos fosas nasales, extendiéndose desde la región anterior visible hasta la parte posterior de la nariz, conocida como coana. La principal función del tabique nasal es proporcionar soporte estructural a la parte inferior de la nariz, que es más suave y carece de hueso en comparación con la parte superior, que es más resistente debido a su composición ósea. Esta característica estructural ayuda en la realización de las demás funciones de la nariz, que incluyen la ventilación para permitir el paso de aire y la capacidad de percibir olores. Por otro lado, es importante tener en cuenta que la disposición anatómica del tabique nasal y los senos paranasales en cada individuo influye en la resonancia de su voz, lo que contribuye a que cada persona tenga un tono vocal único y distintivo que es capaz de ser identificado. La desviación del tabique nasal, que es la estructura ósea y cartilaginosa que separa las dos fosas nasales, ocurre cuando se mueve de su posición habitual en el centro de la nariz, lo que puede causar problemas para respirar por la nariz, cefaleas, obstrucción nasal y, en algunos casos, podría resultar en una complicación como la rinosinusitis. Se presenta el caso de una paciente de sexo femenino de 50 años, sin antecedentes patológicos personales Acude a consulta médica servicio de otorrinolaringología al presentar hace 15 días de evolución epistaxis con una frecuencia diaria de al menos un episodio por día.

Adenoid hypertrophy is the most common condition in children in many countries of the world, partially or completely obstructing the ability to breathe and causing health problems that affect quality of life. The growth of the adenoids helps the human body fight infection by preventing the entry of bacteria, germs and viruses. The most common symptoms caused by enlarged adenoids include mouth breathing, often at night and in some people even during the day, restlessness during sleep, sleep apnea, persistent snoring and nasal congestion. The diagnosis of adenoid hypertrophy is based on specific symptoms and x-rays showing the size of the tumor, and treatment will depend on the degree of hypertrophy and obstruction that may be caused by the condition, which may be mild or moderate. or severe form and must be treated with special medication or surgery to remove it. The aim of this article is to demonstrate the degree of adenoid hypertrophy. We present a male pediatric patient with nasal obstruction and recurrent tonsillit., La hipertrofia adenoidea es la afección más común en niños en muchos países del mundo, obstruyendo parcial o completamente la capacidad de respirar y causando problemas de salud que afectan la calidad de vida. El crecimiento de las adenoides ayuda al cuerpo humano a combatir infecciones impidiendo la entrada de bacterias, gérmenes y virus. Los síntomas más comunes causados ​​por la hipertrofia de adenoides incluyen respiración bucal, a menudo durante la noche y en algunas personas incluso durante el día, inquietud durante el sueño, apnea del sueño, ronquidos persistentes y congestión nasal. El diagnóstico de la hipertrofia adenoidea se basa en síntomas específicos y radiografías que muestran el tamaño del tumor, y el tratamiento dependerá del grado de hipertrofia y obstrucción que pueda causar la afección, que puede ser leve o moderada o forma grave y debe tratarse con medicación especial o cirugía para extirparlo. El objetivo del presente artículo es evidenciar el grado de hipertrofia adenoidea. Se presenta un paciente pediátrico masculino que refiere presentar obstrucción nasal más amigdalitis recurrentes.

In 2019 and 2023, two randomised controlled trials (RCTs) on the effectiveness of septoplasty were published (1,2). Part of the rationale for both studies was that the value of septoplasty had been questioned by policymakers, health insurance carriers and health care providers. The results of both studies showed that patients undergoing septoplasty had a better outcome than patients in the control group. Without questioning these results or the general perception in the rhinology community that septoplasty is of great value to the right patient, we still see the need for caution when interpreting the outcome of the RCTs and when rhinologists try to transfer the results to routine clinical practice. Van Egmond et al. draw the conclusion that the results from their RCT should be applicable to all patients with nasal obstruction due to a deviated septum.

BackgroundObstructive sleep apnea (OSA) is a prevalent disorder and symptoms of nasal obstruction are highly prevalent in OSA. Treatment of nasal obstruction in OSA patients has shown modest and variable outcomes in reducing the apnea hypopnea index (AHI), but significant improvements in other indicators, such as sleep quality and daytime sleepiness as well as reductions in arousals have been observed. We hypothesize that the nose plays a more prominent role in sleep-disordered breathing than previously recorded.MethodsThree prospective randomized case-control studies of OSA patients diagnosed through a type III sleep study. In study I, patients were examined with 4-phase rhinomanometry (4-PR) and for study II with 4-PR and acoustic rhinometry. The first two studies examined if these common objective methods for measuring nasal patency were associated with respiratory indices in sleep studies. The third study investigated if these differences were associated with a low arousal threshold endotype.ResultsOSA Patients with more hypopneas relative to apneas were more likely to have increased nasal resistance. Acoustic rhinometry measurements were significantly associated with 4-PR but not between the acoustic rhinometry and respiratory variables analyzed in the sleep studies. OSA patients with increased nasal resistance were associated with a low arousal threshold endotype.ConclusionsOSA patients demonstrating increased nasal resistance are associated with a low arousal endotype and display significant differences in respiratory disturbance during sleep compared to those with normal nasal resistance. This project has demonstrated suitable objective measures to detect these differences which has implications for the future stratification of OSA patients.

Study Objectives: The aim was to evaluate nasal polyposis as a risk factor for nonadherence to continuous positive airway pressure (CPAP) treatment in patients with obstructive sleep apnea (OSA). Methods: This was a population-based, longitudinal analysis of patients starting CPAP treatment for OSA in the Swedish quality registry Swedevox between 2010 and 2018. Data were cross-linked with national registries. The impact of nasal polyposis on CPAP adherence was analyzed using uni-and multivariable logistic and linear regression models. Relevant confounders (age, sex, usage of nasal and oral steroids) were identified using a direct acyclic graph. Results: Of 20,521 patients with OSA on CPAP treatment (29.5% females), 331 (1.6%) had a diagnosis of nasal polyposis at baseline. At the 1-year follow-up, nasal polyposis was associated with an increased risk of CPAP usage < 4 hours/night (unadjusted odds ratio [OR] 1.21; 95% confidence interval [CI] 0.95-1.55); adjusted OR 1.38; 95% CI 1.08-1.77). In this group, unadjusted nocturnal mean CPAP usage was 15.4 minutes (95% CI-31.62 to 0.83) shorter and was an adjusted 24.1 minutes (95% CI-40.6 to-7.7) shorter compared with patients with OSA without nasal polyposis. Conclusions: Nasal polyposis is associated with reduced CPAP usage per night. These results highlight the importance of diagnosing nasal polyposis in patients with OSA before the start of CPAP treatment. Treatment of the condition may improve adherence, efficacy, and patient outcomes.

Inferior turbinate reduction procedures have been performed for decades. After significant evolution, turbinoplasty and other mucosal-sparing techniques have become the main method to successfully reduce turbinate hypertrophy. The debate of which technique produces the most effective and durable outcomes is ongoing. During this critical era of widespread communicable diseases, including but not limited to COVID-19, HIV, and hepatitis, additional attention is necessary to balance outcomes with a degree of generation of airborne particles when selecting a technique. This review article aims to identify the optimal method for inferior turbinate reduction that weighs both outcomes and aerosol production. The MEDLINE database was searched to discover relevant publications through August 2022. Key search terms included inferior turbinate hypertrophy, turbinate reduction surgery, turbinoplasty methods, surgical management of turbinate hypertrophy, surgical aerosol generation, COVID-19 surgery, surgery smoke plume, SARS-CoV-2 transmission during surgery, and nasal procedures COVID-19 aerosols. Surgical management of the inferior turbinates includes radiofrequency ablation (RFA), microdebrider-assisted turbinoplasty (MAIT), electrocautery, laser, and ultrasound. Piezo-assisted turbinoplasty and a turbinate-specific coblation wand are new additions to the literature. All techniques appear to improve patient symptoms of nasal obstruction. MAIT and RFA are comparable, although MAIT demonstrated better long-term outcomes in some studies and appears to generate fewer airborne particles. Studies evaluating the production of aerosols due to RFA are lacking. Ultrasound outcomes are also excellent and generate no aerosols, but the technique has not been compared against the microdebrider. Electrocautery can result in increased pain and crusting for patients and causes the highest amount of aerosols. Deficiencies of current studies, including a lack of comparison of aerosol generation

INTRODUCTION Prospective Observational Study in 34 Patients from December 2018 till November 2022 in Tertiary Care Hospital to objectively assess diagnostic utility of anterior rhinomanometry in symptomatic patients undergoing Adenoidectomy preoperatively and postoperatively and subjectively compare changes in quality of life. MATERIALS AND METHODS Patients with clinical history of adenoid hypertrophy managed clinically for 2 months, posted for adenotonsillectomy were performed Anterior Rhinomanometry using M/s GENESIS MEDICAL SYSTEMS NASOBALANCE – P 5 to calculate both baseline and post decongestion resistance values. Postoperatively anterior rhinomanometry is performed after 12 weeks and compared with preoperative nasal resistance values. Quality of Life measured by Visual Analogue Scale. RESULTS Comparison of Preop post decongestion and postop pre decongestion of nasal resistance following adenoidectomy revealed nasal resistance significantly reduced (p<0.05). When nasal resistance preoperatively compared with X ray nasopharynx there was proportionate increase in nasal resistance as soft tissue narrowing of airway increases. CONCLUSION Visual Analogue Scale reveals improvement of quality of life in 28/34 = 82.35% patients. Comparison of Pre and post decongestion values following adenoidectomy in isolated asymptomatic patients revealed p value is insignificant which is established by anterior rhinomanometry suggesting values of nasal airway resistance remained similar in isolated adenoid hypertrophy patients.

Objectives: The Nasal Obstruction Symptom Evaluation (NOSE) scale is a symptom-specific quality-of-life questionnaire for patients suffering from nasal obstruction. The instrument is designed specifically for patients with septal deviation and for the evaluation of the outcome of septoplasty. The aim of this study was to validate a Swedish version of the NOSE instrument for use in clinical practice and research.Methods: A Swedish version of the NOSE was tested in a case group consisting of 125 subjects with nasal obstruction (of which 31 underwent septoplasty) and a control group consisting of 65 healthy subjects. Base line data for the case and control groups were used to evaluate face validity, known groups validity, construct validity, internal consistency and factor structure analysis. Fifty participants in both the case groups and control groups were assessed both at baseline and after 2 weeks to evaluate test-retest reliability. The participants who underwent septoplasty were assessed at baseline and after 3-6 months to evaluate responsiveness.Results: The S-NOSE was found to be reliable, valid, and responsive. Both Cronbach's alpha and McDonald Omega coefficients were > 0.7, and the intra class coefficient was 0.942. The S-NOSE scores were significantly correlated with nasal patency VAS in both the case group and the control group (p < .001 and p = .018, respectively). After septoplasty, the mean S-NOSE score were significantly improved (p < .001). Furthermore, the S-NOSE was shown to have excellent and robust psychometric properties.Conclusion: The S-NOSE can be recommended in both clinical practice and research to evaluate the outcome of septoplasty in Swedish-speaking populations.

Bakalářská práce je zaměřena na objektivizaci nosní průchodnosti pomocí flowmetru. Vyšetření se využívá u pacientů s nosní obstrukcí z různých příčin. Jedná se o neinvazivní, nebolestivé a časově nenáročné vyšetření. Flowmetrie vyžaduje pouze minimální spolupráci ze strany pacienta. Cílem práce je zhodnotit a porovnat standardizované metody vizuální analogovou škálu a Peak nasal inspiratory flow s flowmetrií., The thesis is focused on the objectification of nasal patency using flowmetry. Examination is using for patients with nasal obstruction of different causes. Examination is non-invasive, painless and timesaving. Flowmetry requires only minimal cooperation of patient. The aim of thesis is evaluate and compare standardized methods visual analogue scale and Peak nasal inspiratory flow with flowmetry., Fakulta zdravotnických studií, Student/ka úspěšně obhájil/a bakalářskou práci, odpověděl/a na doplňující otázky oponenta., Dokončená práce s úspěšnou obhajobou

INTRODUCTION Prospective Observational Study in 34 Patients from December 2018 till November 2022 in Tertiary Care Hospital to objectively assess diagnostic utility of anterior rhinomanometry in symptomatic patients undergoing Adenoidectomy preoperatively and postoperatively and subjectively compare changes in quality of life. MATERIALS AND METHODS Patients with clinical history of adenoid hypertrophy managed clinically for 2 months, posted for adenotonsillectomy were performed Anterior Rhinomanometry using M/s GENESIS MEDICAL SYSTEMS NASOBALANCE – P 5 to calculate both baseline and post decongestion resistance values. Postoperatively anterior rhinomanometry is performed after 12 weeks and compared with preoperative nasal resistance values. Quality of Life measured by Visual Analogue Scale. RESULTS Comparison of Preop post decongestion and postop pre decongestion of nasal resistance following adenoidectomy revealed nasal resistance significantly reduced (p<0.05). When nasal resistance preoperatively compared with X ray nasopharynx there was proportionate increase in nasal resistance as soft tissue narrowing of airway increases. CONCLUSION Visual Analogue Scale reveals improvement of quality of life in 28/34 = 82.35% patients. Comparison of Pre and post decongestion values following adenoidectomy in isolated asymptomatic patients revealed p value is insignificant which is established by anterior rhinomanometry suggesting values of nasal airway resistance remained similar in isolated adenoid hypertrophy patients.

INTRODUCTION Prospective Observational Study in 34 Patients from December 2018 till November 2022 in Tertiary Care Hospital to objectively assess diagnostic utility of anterior rhinomanometry in symptomatic patients undergoing Adenoidectomy preoperatively and postoperatively and subjectively compare changes in quality of life. MATERIALS AND METHODS Patients with clinical history of adenoid hypertrophy managed clinically for 2 months, posted for adenotonsillectomy were performed Anterior Rhinomanometry using M/s GENESIS MEDICAL SYSTEMS NASOBALANCE – P 5 to calculate both baseline and post decongestion resistance values. Postoperatively anterior rhinomanometry is performed after 12 weeks and compared with preoperative nasal resistance values. Quality of Life measured by Visual Analogue Scale. RESULTS Comparison of Preop post decongestion and postop pre decongestion of nasal resistance following adenoidectomy revealed nasal resistance significantly reduced (p<0.05). When nasal resistance preoperatively compared with X ray nasopharynx there was proportionate increase in nasal resistance as soft tissue narrowing of airway increases. CONCLUSION Visual Analogue Scale reveals improvement of quality of life in 28/34 = 82.35% patients. Comparison of Pre and post decongestion values following adenoidectomy in isolated asymptomatic patients revealed p value is insignificant which is established by anterior rhinomanometry suggesting values of nasal airway resistance remained similar in isolated adenoid hypertrophy patients.

Mechanical nasal obstruction (MNO) is a prevalent condition with a high impact on patient's quality-of-life (QoL) and socio-economic burden. The aim of this study was to determine the usefulness of both subjective and objective criteria in the appropriate management of MNO, either alone or associated to upper airway inflammatory diseases such as allergic rhinitis (AR) or chronic rhinosinusitis with nasal polyps (CRSwNP).A long debate persists about the usefulness of subjective and objective methods for making decisions on the management of patients with nasal obstruction. Establishing standards and ranges of symptom scales and questionnaires is essential to measure the success of an intervention and its impact on QoL. To our knowledge this is the first real-life study to describe the management of MNO using both subjective and objective criteria in MNO isolated or associated to upper airway inflammatory diseases (AR or CRSwNP). Medical treatment (intranasal corticosteroids) has a minor but significant improvement in MNO subjective outcomes (NO, NOSE, and CQ7) with no changes in loss of smell and objective outcomes. After surgery, all MNO patients reported a significant improvement in both subjective and objective outcomes, this improvement being higher in CRSwNP. We concluded that in daily clinical practice, the therapeutic recommendation for MNO should be based on both subjective and objective outcomes, nasal corrective surgery being the treatment of choice in MNO, either isolated or associated to upper airway inflammatory diseases, AR or CRSwNP.© 2023. The Author(s).

Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of respiratory distress in newborns. This paper reports a case of severe CNPAS that required endotracheal intubation immediately after birth, and eventually, surgical intervention. At birth, the width of the pyriform aperture was only 4 mm, and the patient was completely unable to breathe through his nose. We performed tracheostomy at 23 days of age and waited for the patient to grow, but at 56 days of age, the width of the pyriform aperture was not sufficient (6 mm) for the patient to breathe through his nose. Therefore, surgical dilation of the pyriform aperture by a sublabial approach was performed on day 79 after birth, and the width was increased to 14 mm. Postoperative stent placement was performed for two weeks. After the removal of the stents, the patient could finally breathe through his nose, and the postoperative course was uneventful, with no restenosis after four months. CNPAS is a rare cause of nasal obstruction, but it can cause respiratory distress in infants because they are dependent on nasal breathing. Conservative treatments are initially recommended for CNPAS; however, in severe cases where conservative treatments are ineffective, surgical treatment is recommended.

Obstructive rest apnea (OSA) is a typical rest related breathing issue with significant impacts on the wellbeing and personal satisfaction of people experiencing it. Orthodontists ought to be very much aware of the side effects of this issue and adequately capable to perceive its signs and indications. Orthodontics is appropriate for treatment of obstructive sleep apnea patients because of their skill and information with respect to development and improvement of Oro-facial and dento-facial designs just as muscular, orthodontic and careful revision of the jaws and other supporting tissues. The point of this article is to give a standpoint to the fundamental job of orthodontists in the treatment of obstructive sleep apnea.

Obstructive rest apnea (OSA) is a typical rest related breathing issue with significant impacts on the wellbeing and personal satisfaction of people experiencing it. Orthodontists ought to be very much aware of the side effects of this issue and adequately capable to perceive its signs and indications. Orthodontics is appropriate for treatment of obstructive sleep apnea patients because of their skill and information with respect to development and improvement of Oro-facial and dento-facial designs just as muscular, orthodontic and careful revision of the jaws and other supporting tissues. The point of this article is to give a standpoint to the fundamental job of orthodontists in the treatment of obstructive sleep apnea.

Obstructive rest apnea (OSA) is a typical rest related breathing issue with significant impacts on the wellbeing and personal satisfaction of people experiencing it. Orthodontists ought to be very much aware of the side effects of this issue and adequately capable to perceive its signs and indications. Orthodontics is appropriate for treatment of obstructive sleep apnea patients because of their skill and information with respect to development and improvement of Oro-facial and dento-facial designs just as muscular, orthodontic and careful revision of the jaws and other supporting tissues. The point of this article is to give a standpoint to the fundamental job of orthodontists in the treatment of obstructive sleep apnea.

Obstructive rest apnea (OSA) is a typical rest related breathing issue with significant impacts on the wellbeing and personal satisfaction of people experiencing it. Orthodontists ought to be very much aware of the side effects of this issue and adequately capable to perceive its signs and indications. Orthodontics is appropriate for treatment of obstructive sleep apnea patients because of their skill and information with respect to development and improvement of Oro-facial and dento-facial designs just as muscular, orthodontic and careful revision of the jaws and other supporting tissues. The point of this article is to give a standpoint to the fundamental job of orthodontists in the treatment of obstructive sleep apnea.

BACKGROUND: Nasal irrigation is widely used in infants to relieve nasal obstruction. However, the nasal irrigation technique has not been standardized, and nasal irrigation practice habits (NIPH) in infants have not been investigated. Our objective was to provide an overview of NIPH in infants among parents, childcare workers, and healthcare professionals living in Belgium. METHODS: Parents, childcare workers, physiotherapists, nurses, pharmacists, and physicians were invited to fill in an electronic survey questioning their NIPH in infants. The survey was disseminated through social networks, practitioners' associations, and creches. RESULTS: The questionnaire was fully completed by 359 participants. A ready-made solution was used by 93% of participants, of whom 92% used physiological saline. The prophylactic use of nasal irrigation was considered appropriate or very appropriate by 65% of all participants. The irrigation frequency was particularly heterogeneous among participants. The optimal solution propulsion speed and solution volume to be used depended on the group of participants being interviewed. At least 37% of parents and 20% of physicians did not take a stand on the optimal irrigation volume to use in each age category. On average, 83% of participants described performing nasal irrigation by lying the infant on one side and delivering the solution through the top nostril. Finally, 74% of respondents declared that no risk was associated with this technique. CONCLUSION: Although some common NIPH viewpoints among the surveyed participants were identified, several disagreements were reported, reflecting the absence of a standardized method of nasal irrigation.

Objectives To investigate a possible relationship between altered nasal flow and chronic otitis media (COM) using computational fluid dynamics (CFD). Study Design Retrospective case series. Methods Retrospective cohort sample of CT scans from patients with COM and controls without COM to compare the results of various nasal airflow parameters determined by CFD between a group of patients with COM (N = 60) and a control group of subjects without any evidence of ear disease (N = 81). The CT were subjected to various procedures to carry out CFD studies, determining the resistance to nasal flow, the proportion of flow through the right and left nasal cavity, and two nondimensional estimators. The results of CFD studies between patients with COM and controls were compared. Results Whereas only 12.3% of the controls had CFD alteration (10 out of 81), 43.3% of the patients suffering COM displayed alterations of our nondimensional parameters urn:x-wiley:0023852X:media:lary29882:lary29882-math-0001 (26 out of 60). Conclusions According to our results, the incidence of alterations in nasal airflow by studying with CFD is significantly higher in patients with COM than in controls. To our knowledge, this is the first article linking nasal cavity and COM using a CFD approach. Our results support the hypothesis that nasal flow alterations could be implicated in the etiopathogenesis of the COM.

Obstructive rest apnea (OSA) is a typical rest related breathing issue with significant impacts on the wellbeing and personal satisfaction of people experiencing it. Orthodontists ought to be very much aware of the side effects of this issue and adequately capable to perceive its signs and indications. Orthodontics is appropriate for treatment of obstructive sleep apnea patients because of their skill and information with respect to development and improvement of Oro-facial and dento-facial designs just as muscular, orthodontic and careful revision of the jaws and other supporting tissues. The point of this article is to give a standpoint to the fundamental job of orthodontists in the treatment of obstructive sleep apnea.

Obstructive rest apnea (OSA) is a typical rest related breathing issue with significant impacts on the wellbeing and personal satisfaction of people experiencing it. Orthodontists ought to be very much aware of the side effects of this issue and adequately capable to perceive its signs and indications. Orthodontics is appropriate for treatment of obstructive sleep apnea patients because of their skill and information with respect to development and improvement of Oro-facial and dento-facial designs just as muscular, orthodontic and careful revision of the jaws and other supporting tissues. The point of this article is to give a standpoint to the fundamental job of orthodontists in the treatment of obstructive sleep apnea.

Obstructive rest apnea (OSA) is a typical rest related breathing issue with significant impacts on the wellbeing and personal satisfaction of people experiencing it. Orthodontists ought to be very much aware of the side effects of this issue and adequately capable to perceive its signs and indications. Orthodontics is appropriate for treatment of obstructive sleep apnea patients because of their skill and information with respect to development and improvement of Oro-facial and dento-facial designs just as muscular, orthodontic and careful revision of the jaws and other supporting tissues. The point of this article is to give a standpoint to the fundamental job of orthodontists in the treatment of obstructive sleep apnea.

Objective: Several methods have been reported to correct caudal deviation of the nasal septum, including open septorhinoplasty (OSR) and septoplasty with Killian incision (KI). In general, OSR is applied instead of KI for caudal deviation. However, there is little objective evidence own on the effects of OSR and KI for caudal deviation. In this study, we compared surgical outcomes between OSR and KI by quantifying nasal septum deviation using two simple and objective parameters on routine paranasal sinus CT scans. Methods: We retrospectively analyzed 18 patients who underwent OSR and 11 patients who underwent septoplasty with KI between April 2006 and October 2019. Caudal deviation was defined on the basis of the "Anterior-posterior Position of the most deviated point of the nasal septum (AP)," which was measured on computerized tomography. The deformation rate (DR) of the nasal septum was also calculated. Nasal airway resistance and visual analogue scale (VAS) score for nasal obstruction were examined. Results: The AP was significantly correlated with the VAS score (r =-0.58, p = 0.017). The DR in patients with caudal septal deviation was significantly decreased by OSR (0.14 +/- 0.06 to 0.03 +/- 0.03, p = 0.004), but not by KI (0.09 +/- 0.08 to 0.04 +/- 0.03, p = 0.25). OSR also improved nasal airway resistance (1.10 +/- 0.44 to 0.42 +/- 0.15, p = 0.02), and the VAS score (79.11 +/- 14.74 to 5.78 +/- 7.89, p = 0.004). Conclusion: Nasal obstruction is more severe in patients with the caudal deviation. OSR corrects caudal deviation of the nasal septum more effectively than does KI. The AP could be useful for the evaluation of the deviation of the nasal septum and help in selecting the appropriate septoplastic technique . (C) 2021 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.

Objectives To investigate a possible relationship between altered nasal flow and chronic otitis media (COM) using computational fluid dynamics (CFD). Study Design Retrospective case series. Methods Retrospective cohort sample of CT scans from patients with COM and controls without COM to compare the results of various nasal airflow parameters determined by CFD between a group of patients with COM (N = 60) and a control group of subjects without any evidence of ear disease (N = 81). The CT were subjected to various procedures to carry out CFD studies, determining the resistance to nasal flow, the proportion of flow through the right and left nasal cavity, and two nondimensional estimators. The results of CFD studies between patients with COM and controls were compared. Results Whereas only 12.3% of the controls had CFD alteration (10 out of 81), 43.3% of the patients suffering COM displayed alterations of our nondimensional parameters urn:x-wiley:0023852X:media:lary29882:lary29882-math-0001 (26 out of 60). Conclusions According to our results, the incidence of alterations in nasal airflow by studying with CFD is significantly higher in patients with COM than in controls. To our knowledge, this is the first article linking nasal cavity and COM using a CFD approach. Our results support the hypothesis that nasal flow alterations could be implicated in the etiopathogenesis of the COM.

Objective: Several methods have been reported to correct caudal deviation of the nasal septum, including open septorhinoplasty (OSR) and septoplasty with Killian incision (KI). In general, OSR is applied instead of KI for caudal deviation. However, there is little objective evidence own on the effects of OSR and KI for caudal deviation. In this study, we compared surgical outcomes between OSR and KI by quantifying nasal septum deviation using two simple and objective parameters on routine paranasal sinus CT scans. Methods: We retrospectively analyzed 18 patients who underwent OSR and 11 patients who underwent septoplasty with KI between April 2006 and October 2019. Caudal deviation was defined on the basis of the "Anterior-posterior Position of the most deviated point of the nasal septum (AP)," which was measured on computerized tomography. The deformation rate (DR) of the nasal septum was also calculated. Nasal airway resistance and visual analogue scale (VAS) score for nasal obstruction were examined. Results: The AP was significantly correlated with the VAS score (r =-0.58, p = 0.017). The DR in patients with caudal septal deviation was significantly decreased by OSR (0.14 +/- 0.06 to 0.03 +/- 0.03, p = 0.004), but not by KI (0.09 +/- 0.08 to 0.04 +/- 0.03, p = 0.25). OSR also improved nasal airway resistance (1.10 +/- 0.44 to 0.42 +/- 0.15, p = 0.02), and the VAS score (79.11 +/- 14.74 to 5.78 +/- 7.89, p = 0.004). Conclusion: Nasal obstruction is more severe in patients with the caudal deviation. OSR corrects caudal deviation of the nasal septum more effectively than does KI. The AP could be useful for the evaluation of the deviation of the nasal septum and help in selecting the appropriate septoplastic technique . (C) 2021 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.

Introduction The impact of the nasal septum morphology on the severity of obstruction symptoms has not been fully explored. Objective This study aimed to investigate whether the morphology of the deviated nasal septum assessed by computed tomography may explain nasal obstruction severity. Methods The study included 386 patients who were referred to the computed tomography examination of the paranasal sinuses. Patient selection criteria were the absence of facial anomalies, facial trauma, nasal surgery, and sinonasal tumors. Computed tomography images were used to estimate deviated nasal septum prevalence, the prevalence of Mladina's seven types of deviated nasal septum, and to measure the deviated nasal septum angle. Nasal obstruction severity was assessed by the nasal obstruction symptom evaluation, NOSE scale. The relationship between NOSE score, deviated nasal septum morphology, and deviated nasal septum angle was performed by a statistical regression model on the reduced sample of 225 patients. Results The prevalence of deviated nasal septum was 92.7%. Type 7 deviated nasal septum was the most frequent (34.2%) followed by type 5 (26.2%) and type 3 (23.6%). The worst NOSE scores were recorded in the type 2 deviated nasal septum (45.00 ± 28.28). The mean deviated nasal septum angle in patients with nasal obstruction was 8.5° ± 3.24. NOSE scores were not significantly associated with deviated nasal septum types and angles. Conclusion Patients with different types of deviated nasal septum have different NOSE scores. Computed tomography morphology of the deviated nasal septum could not fully explain the severity of nasal obstruction.

Objectives To investigate a possible relationship between altered nasal flow and chronic otitis media (COM) using computational fluid dynamics (CFD). Study Design Retrospective case series. Methods Retrospective cohort sample of CT scans from patients with COM and controls without COM to compare the results of various nasal airflow parameters determined by CFD between a group of patients with COM (N = 60) and a control group of subjects without any evidence of ear disease (N = 81). The CT were subjected to various procedures to carry out CFD studies, determining the resistance to nasal flow, the proportion of flow through the right and left nasal cavity, and two nondimensional estimators. The results of CFD studies between patients with COM and controls were compared. Results Whereas only 12.3% of the controls had CFD alteration (10 out of 81), 43.3% of the patients suffering COM displayed alterations of our nondimensional parameters urn:x-wiley:0023852X:media:lary29882:lary29882-math-0001 (26 out of 60). Conclusions According to our results, the incidence of alterations in nasal airflow by studying with CFD is significantly higher in patients with COM than in controls. To our knowledge, this is the first article linking nasal cavity and COM using a CFD approach. Our results support the hypothesis that nasal flow alterations could be implicated in the etiopathogenesis of the COM.

Objective: Several methods have been reported to correct caudal deviation of the nasal septum, including open septorhinoplasty (OSR) and septoplasty with Killian incision (KI). In general, OSR is applied instead of KI for caudal deviation. However, there is little objective evidence own on the effects of OSR and KI for caudal deviation. In this study, we compared surgical outcomes between OSR and KI by quantifying nasal septum deviation using two simple and objective parameters on routine paranasal sinus CT scans. Methods: We retrospectively analyzed 18 patients who underwent OSR and 11 patients who underwent septoplasty with KI between April 2006 and October 2019. Caudal deviation was defined on the basis of the "Anterior-posterior Position of the most deviated point of the nasal septum (AP)," which was measured on computerized tomography. The deformation rate (DR) of the nasal septum was also calculated. Nasal airway resistance and visual analogue scale (VAS) score for nasal obstruction were examined. Results: The AP was significantly correlated with the VAS score (r =-0.58, p = 0.017). The DR in patients with caudal septal deviation was significantly decreased by OSR (0.14 +/- 0.06 to 0.03 +/- 0.03, p = 0.004), but not by KI (0.09 +/- 0.08 to 0.04 +/- 0.03, p = 0.25). OSR also improved nasal airway resistance (1.10 +/- 0.44 to 0.42 +/- 0.15, p = 0.02), and the VAS score (79.11 +/- 14.74 to 5.78 +/- 7.89, p = 0.004). Conclusion: Nasal obstruction is more severe in patients with the caudal deviation. OSR corrects caudal deviation of the nasal septum more effectively than does KI. The AP could be useful for the evaluation of the deviation of the nasal septum and help in selecting the appropriate septoplastic technique . (C) 2021 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.

Obstructive rest apnea (OSA) is a typical rest related breathing issue with significant impacts on the wellbeing and personal satisfaction of people experiencing it. Orthodontists ought to be very much aware of the side effects of this issue and adequately capable to perceive its signs and indications. Orthodontics is appropriate for treatment of obstructive sleep apnea patients because of their skill and information with respect to development and improvement of Oro-facial and dento-facial designs just as muscular, orthodontic and careful revision of the jaws and other supporting tissues. The point of this article is to give a standpoint to the fundamental job of orthodontists in the treatment of obstructive sleep apnea.

Purpose: Humans have a preference for nasal breathing during sleep. This 10-year prospective study aimed to determine if nasal symptoms can predict snoring and also if snoring can predict development of nasal symptoms. The hypothesis proposed is that nasal symptoms affect the risk of snoring 10 years later, whereas snoring does not increase the risk of developing nasal symptoms. Methods: In the cohort study, Respiratory Health in Northern Europe (RHINE), a random population from Denmark, Estonia, Iceland, Norway, and Sweden, born between 1945 and 1973, was investigated by postal questionnaires in 1999-2001 (RHINE II, baseline) and in 2010-2012 (RHINE III, follow-up). The study population consisted of the participants who had answered questions on nasal symptoms such as nasal obstruction, discharge, and sneezing, and also snoring both at baseline and at follow-up (n = 10,112). Results: Nasal symptoms were frequent, reported by 48% of the entire population at baseline, with snoring reported by 24%. Nasal symptoms at baseline increased the risk of snoring at follow-up (adj. OR 1.38; 95% CI 1.22-1.58) after adjusting for age, sex, BMI change between baseline and follow-up, and smoking status. Snoring at baseline was associated with an increased risk of developing nasal symptoms at follow-up (adj. OR 1.22; 95% CI 1.02-1.47). Conclusion: Nasal symptoms are independent risk factors for development of snoring 10 years later, and surprisingly, snoring is a risk factor for the development of nasal symptoms.

Purpose: Humans have a preference for nasal breathing during sleep. This 10-year prospective study aimed to determine if nasal symptoms can predict snoring and also if snoring can predict development of nasal symptoms. The hypothesis proposed is that nasal symptoms affect the risk of snoring 10 years later, whereas snoring does not increase the risk of developing nasal symptoms. Methods: In the cohort study, Respiratory Health in Northern Europe (RHINE), a random population from Denmark, Estonia, Iceland, Norway, and Sweden, born between 1945 and 1973, was investigated by postal questionnaires in 1999-2001 (RHINE II, baseline) and in 2010-2012 (RHINE III, follow-up). The study population consisted of the participants who had answered questions on nasal symptoms such as nasal obstruction, discharge, and sneezing, and also snoring both at baseline and at follow-up (n = 10,112). Results: Nasal symptoms were frequent, reported by 48% of the entire population at baseline, with snoring reported by 24%. Nasal symptoms at baseline increased the risk of snoring at follow-up (adj. OR 1.38; 95% CI 1.22-1.58) after adjusting for age, sex, BMI change between baseline and follow-up, and smoking status. Snoring at baseline was associated with an increased risk of developing nasal symptoms at follow-up (adj. OR 1.22; 95% CI 1.02-1.47). Conclusion: Nasal symptoms are independent risk factors for development of snoring 10 years later, and surprisingly, snoring is a risk factor for the development of nasal symptoms.

Purpose: Humans have a preference for nasal breathing during sleep. This 10-year prospective study aimed to determine if nasal symptoms can predict snoring and also if snoring can predict development of nasal symptoms. The hypothesis proposed is that nasal symptoms affect the risk of snoring 10 years later, whereas snoring does not increase the risk of developing nasal symptoms. Methods: In the cohort study, Respiratory Health in Northern Europe (RHINE), a random population from Denmark, Estonia, Iceland, Norway, and Sweden, born between 1945 and 1973, was investigated by postal questionnaires in 1999-2001 (RHINE II, baseline) and in 2010-2012 (RHINE III, follow-up). The study population consisted of the participants who had answered questions on nasal symptoms such as nasal obstruction, discharge, and sneezing, and also snoring both at baseline and at follow-up (n = 10,112). Results: Nasal symptoms were frequent, reported by 48% of the entire population at baseline, with snoring reported by 24%. Nasal symptoms at baseline increased the risk of snoring at follow-up (adj. OR 1.38; 95% CI 1.22-1.58) after adjusting for age, sex, BMI change between baseline and follow-up, and smoking status. Snoring at baseline was associated with an increased risk of developing nasal symptoms at follow-up (adj. OR 1.22; 95% CI 1.02-1.47). Conclusion: Nasal symptoms are independent risk factors for development of snoring 10 years later, and surprisingly, snoring is a risk factor for the development of nasal symptoms.

Purpose: Humans have a preference for nasal breathing during sleep. This 10-year prospective study aimed to determine if nasal symptoms can predict snoring and also if snoring can predict development of nasal symptoms. The hypothesis proposed is that nasal symptoms affect the risk of snoring 10 years later, whereas snoring does not increase the risk of developing nasal symptoms. Methods: In the cohort study, Respiratory Health in Northern Europe (RHINE), a random population from Denmark, Estonia, Iceland, Norway, and Sweden, born between 1945 and 1973, was investigated by postal questionnaires in 1999–2001 (RHINE II, baseline) and in 2010–2012 (RHINE III, follow-up). The study population consisted of the participants who had answered questions on nasal symptoms such as nasal obstruction, discharge, and sneezing, and also snoring both at baseline and at follow-up (n = 10,112). Results: Nasal symptoms were frequent, reported by 48% of the entire population at baseline, with snoring reported by 24%. Nasal symptoms at baseline increased the risk of snoring at follow-up (adj. OR 1.38; 95% CI 1.22–1.58) after adjusting for age, sex, BMI change between baseline and follow-up, and smoking status. Snoring at baseline was associated with an increased risk of developing nasal symptoms at follow-up (adj. OR 1.22; 95% CI 1.02–1.47). Conclusion: Nasal symptoms are independent risk factors for development of snoring 10 years later, and surprisingly, snoring is a risk factor for the development of nasal symptoms.

Purpose: Humans have a preference for nasal breathing during sleep. This 10-year prospective study aimed to determine if nasal symptoms can predict snoring and also if snoring can predict development of nasal symptoms. The hypothesis proposed is that nasal symptoms affect the risk of snoring 10 years later, whereas snoring does not increase the risk of developing nasal symptoms. Methods: In the cohort study, Respiratory Health in Northern Europe (RHINE), a random population from Denmark, Estonia, Iceland, Norway, and Sweden, born between 1945 and 1973, was investigated by postal questionnaires in 1999–2001 (RHINE II, baseline) and in 2010–2012 (RHINE III, follow-up). The study population consisted of the participants who had answered questions on nasal symptoms such as nasal obstruction, discharge, and sneezing, and also snoring both at baseline and at follow-up (n = 10,112). Results: Nasal symptoms were frequent, reported by 48% of the entire population at baseline, with snoring reported by 24%. Nasal symptoms at baseline increased the risk of snoring at follow-up (adj. OR 1.38; 95% CI 1.22–1.58) after adjusting for age, sex, BMI change between baseline and follow-up, and smoking status. Snoring at baseline was associated with an increased risk of developing nasal symptoms at follow-up (adj. OR 1.22; 95% CI 1.02–1.47). Conclusion: Nasal symptoms are independent risk factors for development of snoring 10 years later, and surprisingly, snoring is a risk factor for the development of nasal symptoms.

Purpose: Humans have a preference for nasal breathing during sleep. This 10-year prospective study aimed to determine if nasal symptoms can predict snoring and also if snoring can predict development of nasal symptoms. The hypothesis proposed is that nasal symptoms affect the risk of snoring 10 years later, whereas snoring does not increase the risk of developing nasal symptoms. Methods: In the cohort study, Respiratory Health in Northern Europe (RHINE), a random population from Denmark, Estonia, Iceland, Norway, and Sweden, born between 1945 and 1973, was investigated by postal questionnaires in 1999–2001 (RHINE II, baseline) and in 2010–2012 (RHINE III, follow-up). The study population consisted of the participants who had answered questions on nasal symptoms such as nasal obstruction, discharge, and sneezing, and also snoring both at baseline and at follow-up (n = 10,112). Results: Nasal symptoms were frequent, reported by 48% of the entire population at baseline, with snoring reported by 24%. Nasal symptoms at baseline increased the risk of snoring at follow-up (adj. OR 1.38; 95% CI 1.22–1.58) after adjusting for age, sex, BMI change between baseline and follow-up, and smoking status. Snoring at baseline was associated with an increased risk of developing nasal symptoms at follow-up (adj. OR 1.22; 95% CI 1.02–1.47). Conclusion: Nasal symptoms are independent risk factors for development of snoring 10 years later, and surprisingly, snoring is a risk factor for the development of nasal symptoms.

Purpose: Humans have a preference for nasal breathing during sleep. This 10-year prospective study aimed to determine if nasal symptoms can predict snoring and also if snoring can predict development of nasal symptoms. The hypothesis proposed is that nasal symptoms affect the risk of snoring 10 years later, whereas snoring does not increase the risk of developing nasal symptoms. Methods: In the cohort study, Respiratory Health in Northern Europe (RHINE), a random population from Denmark, Estonia, Iceland, Norway, and Sweden, born between 1945 and 1973, was investigated by postal questionnaires in 1999-2001 (RHINE II, baseline) and in 2010-2012 (RHINE III, follow-up). The study population consisted of the participants who had answered questions on nasal symptoms such as nasal obstruction, discharge, and sneezing, and also snoring both at baseline and at follow-up (n = 10,112). Results: Nasal symptoms were frequent, reported by 48% of the entire population at baseline, with snoring reported by 24%. Nasal symptoms at baseline increased the risk of snoring at follow-up (adj. OR 1.38; 95% CI 1.22-1.58) after adjusting for age, sex, BMI change between baseline and follow-up, and smoking status. Snoring at baseline was associated with an increased risk of developing nasal symptoms at follow-up (adj. OR 1.22; 95% CI 1.02-1.47). Conclusion: Nasal symptoms are independent risk factors for development of snoring 10 years later, and surprisingly, snoring is a risk factor for the development of nasal symptoms.

Third-party payers request objective confirmation of the nasal septum deviation (NSD) severity by computed tomography (CT) before authorizing financial support for septoplasty. Previous studies have provided contradictory results related to the link between obstruction severity and CT-measured angle of the NSD. The aim of this study was to investigate whether the diverse CT morphology of NSDs (including previously neglected types and shapes) could predict obstruction severity. The study included 225 patients with NSD. The CT morphology of the septum was analyzed using 5 different classifications of NSD that are commonly used in the clinical practice and research. The angle of NSD was also measured. Nasal obstruction was assessed by the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire. A relationship between CT morphology and the angle of the NSD and NOSE scores was analyzed using appropriate regression models. Patients with NSDs located in the anterior part of the septum always have some degree of nasal obstruction, while those with posterior NSDs did not necessarily report obstruction symptoms no matter how complicated NSD they have. Regression analysis did not reveal any causal relationship between NOSE scores and CT morphology and the angle of NSD. The presence of spurs and whether they divide nasal passages have no statistically significant predictive effect on the obstruction severity. The CT morphology and the angle of the NSD could not predict severity of the nasal obstruction. Requesting CT examination just to objectively confirm nasal obstruction is not justified.

Purpose: Humans have a preference for nasal breathing during sleep. This 10-year prospective study aimed to determine if nasal symptoms can predict snoring and also if snoring can predict development of nasal symptoms. The hypothesis proposed is that nasal symptoms affect the risk of snoring 10 years later, whereas snoring does not increase the risk of developing nasal symptoms. Methods: In the cohort study, Respiratory Health in Northern Europe (RHINE), a random population from Denmark, Estonia, Iceland, Norway, and Sweden, born between 1945 and 1973, was investigated by postal questionnaires in 1999–2001 (RHINE II, baseline) and in 2010–2012 (RHINE III, follow-up). The study population consisted of the participants who had answered questions on nasal symptoms such as nasal obstruction, discharge, and sneezing, and also snoring both at baseline and at follow-up (n = 10,112). Results: Nasal symptoms were frequent, reported by 48% of the entire population at baseline, with snoring reported by 24%. Nasal symptoms at baseline increased the risk of snoring at follow-up (adj. OR 1.38; 95% CI 1.22–1.58) after adjusting for age, sex, BMI change between baseline and follow-up, and smoking status. Snoring at baseline was associated with an increased risk of developing nasal symptoms at follow-up (adj. OR 1.22; 95% CI 1.02–1.47). Conclusion: Nasal symptoms are independent risk factors for development of snoring 10 years later, and surprisingly, snoring is a risk factor for the development of nasal symptoms.

Purpose: Humans have a preference for nasal breathing during sleep. This 10-year prospective study aimed to determine if nasal symptoms can predict snoring and also if snoring can predict development of nasal symptoms. The hypothesis proposed is that nasal symptoms affect the risk of snoring 10 years later, whereas snoring does not increase the risk of developing nasal symptoms. Methods: In the cohort study, Respiratory Health in Northern Europe (RHINE), a random population from Denmark, Estonia, Iceland, Norway, and Sweden, born between 1945 and 1973, was investigated by postal questionnaires in 1999–2001 (RHINE II, baseline) and in 2010–2012 (RHINE III, follow-up). The study population consisted of the participants who had answered questions on nasal symptoms such as nasal obstruction, discharge, and sneezing, and also snoring both at baseline and at follow-up (n = 10,112). Results: Nasal symptoms were frequent, reported by 48% of the entire population at baseline, with snoring reported by 24%. Nasal symptoms at baseline increased the risk of snoring at follow-up (adj. OR 1.38; 95% CI 1.22–1.58) after adjusting for age, sex, BMI change between baseline and follow-up, and smoking status. Snoring at baseline was associated with an increased risk of developing nasal symptoms at follow-up (adj. OR 1.22; 95% CI 1.02–1.47). Conclusion: Nasal symptoms are independent risk factors for development of snoring 10 years later, and surprisingly, snoring is a risk factor for the development of nasal symptoms.

Introduction Inferior turbinate hypertrophy (ITH) is one of the major causes of nasal airway obstruction. Nasal obstruction due to inferior turbinate hypertrophy is noted in around 20% of the population. Surgical reduction of the hypertrophied inferior turbinate is required when medical treatment fails. This study aimed to compare the Nasal obstruction symptom evaluation (NOSE) scores and complications of inferior turbinate reduction by turbinectomy and turbinoplasty. Materials and Methods In this prospective observational randomized controlled study, 30 patients underwent turbinectomy and 30 underwent turbinoplasty. Pre and postoperative NOSE scores and incidence of postoperative bleeding and crusting were compared at first week and six months. Results The mean preoperative NOSE score of turbinectomy group was 75.83 and that of turbinoplasty group was 76.83. Both the groups showed statistically significant improvement (p< 0.05) in NOSE score post-operatively. Functional outcome is achieved with turbinoplasty by sparing the nasal mucosa and submucosa along with retention of function bearing structures (inferior turbinate). Though not statistically significant, the incidence of post-operative bleeding and crusting were lower after turbinoplasty, in comparison to turbinectomy. Conclusion Inferior turbinoplasty provides excellent outcome in a wide variety of patients with minimal morbidity. Turbinoplasty is associated with lesser mucosal injury, post-operative bleeding and crusting, and excellent outcome in terms of symptomatic relief and functionality. Hence, we recommend that it can be done for the treatment of ITH.

Introduction Inferior turbinate hypertrophy (ITH) is one of the major causes of nasal airway obstruction. Nasal obstruction due to inferior turbinate hypertrophy is noted in around 20% of the population. Surgical reduction of the hypertrophied inferior turbinate is required when medical treatment fails. This study aimed to compare the Nasal obstruction symptom evaluation (NOSE) scores and complications of inferior turbinate reduction by turbinectomy and turbinoplasty. Materials and Methods In this prospective observational randomized controlled study, 30 patients underwent turbinectomy and 30 underwent turbinoplasty. Pre and postoperative NOSE scores and incidence of postoperative bleeding and crusting were compared at first week and six months. Results The mean preoperative NOSE score of turbinectomy group was 75.83 and that of turbinoplasty group was 76.83. Both the groups showed statistically significant improvement (p< 0.05) in NOSE score post-operatively. Functional outcome is achieved with turbinoplasty by sparing the nasal mucosa and submucosa along with retention of function bearing structures (inferior turbinate). Though not statistically significant, the incidence of post-operative bleeding and crusting were lower after turbinoplasty, in comparison to turbinectomy. Conclusion Inferior turbinoplasty provides excellent outcome in a wide variety of patients with minimal morbidity. Turbinoplasty is associated with lesser mucosal injury, post-operative bleeding and crusting, and excellent outcome in terms of symptomatic relief and functionality. Hence, we recommend that it can be done for the treatment of ITH.

Introduction The Sino-nasal mass is a common clinical entity. Although it has varied aetiology ranging from non-neoplastic to neoplastic, clinical presentation is overlapping that poses diagnostic dilemma. Objective of the study was to study the clinical profile of Sino-nasal masses in terms of demographic profile, clinical presentation and clinicopathological diagnosis. Materials and Methods A descriptive study was carried out at tertiary care hospital for 2 years. Clinically diagnosed cases of sino-nasal masses were included in the study. Previously treated cases, congenital lesions were excluded. Provisional diagnosis was made based on clinical and radiological evaluation. Diagnosis on histopathological examination was considered as definitive. Results Total of 75 patients were included in the study. Demographic data showed slight male predominance (M:F= 1.08:1), with most patients from age group 31-40 years (26.67%). Nasal obstruction was the most common presenting symptom. The number of patients with non-neoplastic lesion was 48; 17 patients had neoplastic benign lesions while 6 patients had neoplastic malignant lesions. Conclusion Large number of patients presents with trivial symptoms but need careful examination and appropriate diagnosis. Inflammatory lesions outnumbered neoplastic lesions in our study. Clinical suspicion and appropriate investigations can guide in timely intervention and management of these patients reducing the morbidity and mortality in these patients.

Introduction Inferior turbinate hypertrophy (ITH) is one of the major causes of nasal airway obstruction. Nasal obstruction due to inferior turbinate hypertrophy is noted in around 20% of the population. Surgical reduction of the hypertrophied inferior turbinate is required when medical treatment fails. This study aimed to compare the Nasal obstruction symptom evaluation (NOSE) scores and complications of inferior turbinate reduction by turbinectomy and turbinoplasty. Materials and Methods In this prospective observational randomized controlled study, 30 patients underwent turbinectomy and 30 underwent turbinoplasty. Pre and postoperative NOSE scores and incidence of postoperative bleeding and crusting were compared at first week and six months. Results The mean preoperative NOSE score of turbinectomy group was 75.83 and that of turbinoplasty group was 76.83. Both the groups showed statistically significant improvement (p< 0.05) in NOSE score post-operatively. Functional outcome is achieved with turbinoplasty by sparing the nasal mucosa and submucosa along with retention of function bearing structures (inferior turbinate). Though not statistically significant, the incidence of post-operative bleeding and crusting were lower after turbinoplasty, in comparison to turbinectomy. Conclusion Inferior turbinoplasty provides excellent outcome in a wide variety of patients with minimal morbidity. Turbinoplasty is associated with lesser mucosal injury, post-operative bleeding and crusting, and excellent outcome in terms of symptomatic relief and functionality. Hence, we recommend that it can be done for the treatment of ITH.

Introduction The Sino-nasal mass is a common clinical entity. Although it has varied aetiology ranging from non-neoplastic to neoplastic, clinical presentation is overlapping that poses diagnostic dilemma. Objective of the study was to study the clinical profile of Sino-nasal masses in terms of demographic profile, clinical presentation and clinicopathological diagnosis. Materials and Methods A descriptive study was carried out at tertiary care hospital for 2 years. Clinically diagnosed cases of sino-nasal masses were included in the study. Previously treated cases, congenital lesions were excluded. Provisional diagnosis was made based on clinical and radiological evaluation. Diagnosis on histopathological examination was considered as definitive. Results Total of 75 patients were included in the study. Demographic data showed slight male predominance (M:F= 1.08:1), with most patients from age group 31-40 years (26.67%). Nasal obstruction was the most common presenting symptom. The number of patients with non-neoplastic lesion was 48; 17 patients had neoplastic benign lesions while 6 patients had neoplastic malignant lesions. Conclusion Large number of patients presents with trivial symptoms but need careful examination and appropriate diagnosis. Inflammatory lesions outnumbered neoplastic lesions in our study. Clinical suspicion and appropriate investigations can guide in timely intervention and management of these patients reducing the morbidity and mortality in these patients.

Introduction The Sino-nasal mass is a common clinical entity. Although it has varied aetiology ranging from non-neoplastic to neoplastic, clinical presentation is overlapping that poses diagnostic dilemma. Objective of the study was to study the clinical profile of Sino-nasal masses in terms of demographic profile, clinical presentation and clinicopathological diagnosis. Materials and Methods A descriptive study was carried out at tertiary care hospital for 2 years. Clinically diagnosed cases of sino-nasal masses were included in the study. Previously treated cases, congenital lesions were excluded. Provisional diagnosis was made based on clinical and radiological evaluation. Diagnosis on histopathological examination was considered as definitive. Results Total of 75 patients were included in the study. Demographic data showed slight male predominance (M:F= 1.08:1), with most patients from age group 31-40 years (26.67%). Nasal obstruction was the most common presenting symptom. The number of patients with non-neoplastic lesion was 48; 17 patients had neoplastic benign lesions while 6 patients had neoplastic malignant lesions. Conclusion Large number of patients presents with trivial symptoms but need careful examination and appropriate diagnosis. Inflammatory lesions outnumbered neoplastic lesions in our study. Clinical suspicion and appropriate investigations can guide in timely intervention and management of these patients reducing the morbidity and mortality in these patients.

Purpose: Humans have a preference for nasal breathing during sleep. This 10-year prospective study aimed to determine if nasal symptoms can predict snoring and also if snoring can predict development of nasal symptoms. The hypothesis proposed is that nasal symptoms affect the risk of snoring 10 years later, whereas snoring does not increase the risk of developing nasal symptoms. Methods: In the cohort study, Respiratory Health in Northern Europe (RHINE), a random population from Denmark, Estonia, Iceland, Norway, and Sweden, born between 1945 and 1973, was investigated by postal questionnaires in 1999-2001 (RHINE II, baseline) and in 2010-2012 (RHINE III, follow-up). The study population consisted of the participants who had answered questions on nasal symptoms such as nasal obstruction, discharge, and sneezing, and also snoring both at baseline and at follow-up (n = 10,112). Results: Nasal symptoms were frequent, reported by 48% of the entire population at baseline, with snoring reported by 24%. Nasal symptoms at baseline increased the risk of snoring at follow-up (adj. OR 1.38; 95% CI 1.22-1.58) after adjusting for age, sex, BMI change between baseline and follow-up, and smoking status. Snoring at baseline was associated with an increased risk of developing nasal symptoms at follow-up (adj. OR 1.22; 95% CI 1.02-1.47). Conclusion: Nasal symptoms are independent risk factors for development of snoring 10 years later, and surprisingly, snoring is a risk factor for the development of nasal symptoms.

Introduction Rhinolith is a calcic deposition formed by mineralization of salts in an impacted nasal foreign body. It is a benign condition that can be troublesome owing to its size and extent of impact. Case Report A 35-year-old man with a history of right nasal obstruction with occasional foul-smelling discharge and right eye pain since ten years was diagnosed with rhinolith. During its removal, it was three times bigger than what could be visualized in nasal endoscopy. Conclusion Proper history, examination, and a high suspicion can clinch the diagnosis in almost all cases. A rigid diagnostic nasendoscopy is an important tool in the diagnosis. The treatment of choice is endoscopic removal under local or general anaesthesia.