Search

We report a rare case of multiple benign minor salivary gland tumors in a 60-year-old woman, presenting with progressive left nasal obstruction, intermittent anterior nasal discharge, and postnasal drip. Diagnostic nasal endoscopy and computed tomography (CT) scan revealed sessile, pale, non-pulsating masses in the left nasal cavity, septum, and nasopharynx. Histopathological examination confirmed ectopic minor salivary glands. The tumors were successfully removed via endoscopic excision, and the patient experienced resolution of symptoms with no evidence of recurrence during follow-up. This case highlights the importance of a systematic approach involving clinical assessment, imaging, and histopathological analysis for accurate diagnosis and management of nasal salivary masses. [ABSTRACT FROM AUTHOR]

To investigate the efficacy of endoscopic membranous nasolacrimal duct resection combined with retrograde lacrimal stent in the treatment of extremely inferior lacrimal duct obstruction. Retrospective cohort study at Nanchang University's Affiliated Eye Hospital. Experimental Group: Endoscopic membranous nasolacrimal duct resection combined with retrograde lacrimal stent implantation; Control group: Conventional endoscopic dacryocystorhinostomy combined with bicanalicular Silicone Stent implantation.The duration of the surgical procedure, postoperative comfort score, irrigation of the lacrimal passage after extubation, and Munk score of curative effect at six months post-operation were recorded. The data were quantified and analyzed using SPSS 26.0 statistical software. The symptoms of epiphora showed significant improvement following surgery. There were notable differences in operation time and postoperative comfort between the experimental group and the control group who underwent conventional endoscopic dacryocystorhinostomy (P < 0.05). However, there was no significant difference in efficacy and lacrimal duct irrigation after extubation or at six months post-operation (P > 0.05). The cure rate of the experimental group reached 70%, while the control group achieved a cure rate of 78%. Furthermore, the effective rate in the experimental group was found to be 81%, whereas it was 89% in the control group.No evident complications were observed in the experimental group. The combination of endoscopic membranous nasolacrimal duct resection and retrograde lacrimal stent reduces the invasiveness of the lacrimal duct structure, shortens the operation time, improves patient comfort, and achieves favorable therapeutic outcomes. This approach is recommended for patients with extremely Inferior lacrimal duct obstruction. [ABSTRACT FROM AUTHOR]

Propose: This study aims to present long-term outcomes in a specific patient population experiencing epiphora due to low-level nasolacrimal duct obstruction (NLDO) following endonasal endoscopic nasolacrimal duct rhinostomy, and to propose a surgical selection paradigm for varying locations of NLDO. Methods: Between September 1, 2017 and February 28, 2023, a retrospective analysis was conducted on 26 patients diagnosed with primary acquired nasolacrimal duct obstruction (PANDO) who underwent endonasal endoscopic nasolacrimal duct rhinostomy for low-level NLDO (defined as obstruction below the plane of the superior border of the inferior turbinate attachment). The study assessed surgical success through objective measures of anatomical patency and subjective measures of functional patency during a postoperative follow-up period of at least six months. Additionally, any complications that arose during this follow-up period were documented. Results: The study included a cohort of 26 patients, consisting of 24 women and 2 men, with a mean age of 47.58 ± 3.09 years (range: 8–75). All patients underwent endoscopic nasolacrimal duct rhinostomy, with 10 eyes having previously undergone tear duct recanalization procedures. Anatomical patency was achieved in 88.5% (23/26) of cases, while functional patency was achieved in 80.8% (21/26) after an average follow-up period of 41.9 ± 22.1 months. No significant complications were observed in any of the patients during the follow-up period. Conclusion: Endonasal endoscopic nasolacrimal duct rhinostomy is effective in treating epiphora in over 80% of cases with low-level NLDO. Tailoring the surgery to the location of the obstruction can improve outcomes and minimize damage. [ABSTRACT FROM AUTHOR]

ABSTRACT To explore the diagnostic and therapeutic strategies of chronic invasive fungal sinusitis involving the skull base or orbit based on the background of multidisciplinary team discussion and to provide a basis for clinical practice. The clinical data of five patients with chronic invasive fungal sinusitis involving the skull base or orbit admitted to the Department of Otorhinolaryngology, Head and Neck Surgery of Drum Tower Hospital affiliated with Nanjing University School of Medicine from July 2017 to February 2024, were retrospectively analysed. The diagnosis and treatment strategies were all formulated after the MDT discussion. Nasal endoscopic surgery dominated the treatment protocol. Surgery was completed while ensuring the integrity of the dura mater or orbital periosteum. During surgery, we remove the lesion as thoroughly as possible and open the sinuses to improve their drainage function. The efficacy of the surgery was comprehensively analysed in the postoperative period. None of the five patients had serious complications such as ocular motor or visual dysfunction, cerebrospinal fluid leakage or intracranial infection after surgery. Four of them were cured after comprehensive treatment and had no recurrence after 5–84 months of follow‐up; one case had a wider range of lesions, but the patient did not follow the recommended antifungal treatment after surgery and had a recurrence 5 months after surgery; after the recurrence, the patient underwent a second endoscopic surgery and actively cooperated with the antifungal treatment, there were no complications after the second surgery and there was no recurrence after 78 months of follow‐up. For patients with chronic invasive fungal sinusitis involving the skull base or orbits, the diagnosis and treatment plan are formulated through MDT discussion before surgery, and the lesions are resected with the assistance of image navigation and the plasma system to protect the natural barrier of the dura mater or orbital periosteum from being breached, so as to achieve the purpose of removing the lesions and clearing the sinus drainage, and then supplemented with antifungal treatment. In this way, we can achieve satisfactory therapeutic effects while reducing nose–brain and nose–eye complications and improving the prognosis. [ABSTRACT FROM AUTHOR]

Background: Chronic rhinosinusitis (CRS) is often diagnosed based on clinical features. Assurance in this context is based on the finding of inflammatory features during nasal endoscopy and computed tomography (CT) scans of the paranasal sinuses. While a CT scan is considered the most reliable method, research has shown that nasal endoscopy is also valuable and can sometimes provide additional information to supplement the CT scan in diagnosing CRS. Objective: The study goal was to demonstrate the comparative reliability of nasal endoscopy and computed tomography scans in diagnosing chronic rhinosinusitis in adult patients treated at Baqubah Teaching Hospital. Patients and Methods: The study sample consisted of consecutive adult participants clinically diagnosed with chronic rhinosinusitis. Patients who had a computed tomography scan of the paranasal sinuses and a nasal endoscopy during three months were the subjects of this investigation; the outcomes were linked. Results: Study results exhibit that the most prevalent symptoms seen in the study participants were nasal discharge and nasal obstruction, reported by 95% and 90%, respectively; the most prevailing observation during nasal endoscopy was middle meatus purulent discharge, noticed in 58% of the patients. Maxillary sinus was most often affected, seen in 65% of the patients on a CT scan, and 40% had obstruction of the osteomeatal complex on CT imaging. The nasal endoscopy had a sensitivity of 73.3%, specificity of 85.3%, positive predictive value of 92.7%, and negative predictive value of 55.8%. The research also found no significant differences in positive predictive value (PPV) between nasal endoscopy and CT scan. In contrast, the sensitivity of nasal endoscopy was significantly greater than that of CT scan. Conclusion: The study found that nasal endoscopic findings for patients with positive clinical features were purulent (cream-colored) discharge and middle meatus polyps, which is sufficient for diagnosing chronic rhinosinusitis; the study showed that Nasal endoscopy is almost as accurate as CT scans and CT scan findings are well correlates with sinus endoscopy, due to its precision, cheap cost, and radiation dosage. [ABSTRACT FROM AUTHOR]

Objective: Critical components of the nasal endoscopic examination have not been definitively established for either the normal examination or for clinical disorders. This study aimed to identify concordance among rhinologists regarding the importance of examination findings for various nasal pathologies. Study Design: A consortium of 19 expert rhinologists across the United States was asked to rank the importance of findings on nasal endoscopy for 5 different sinonasal symptom presentations. Setting: An online questionnaire was distributed in July 2023. Methods: The questionnaire utilized JotForm® software and featured 5 cases with a set of 4 identical questions per case, each covering a common indication for nasal endoscopy. Rankings were synthesized into Normalized Attention Scores (NASs) and Weighted Normalized Attention Scores (W‐NASs) to represent the perceived importance of each feature, scaled from 0 to 1. Results: General concordance was found for examination findings on nasal endoscopy within each case. The perceived features of importance differed between cases based on clinical presentation. For instance, in evaluating postnasal drip, the middle meatus was selected as the most important structure to examine (NAS, 0.73), with mucus selected as the most important abnormal finding (W‐NAS, 0.66). The primary feature of interest for mucus was whether it was purulent or not (W‐NAS, 0.67). Similar analyses were performed for features in each case. Conclusion: The implicit framework existing among rhinologists may help standardize examinations and improve diagnostic accuracy, augment the instruction of trainees, and inform the development of artificially intelligent algorithms to enhance clinical decision‐making during nasal endoscopy. [ABSTRACT FROM AUTHOR]

Abstract To investigate the efficacy of endoscopic membranous nasolacrimal duct resection combined with retrograde lacrimal stent in the treatment of extremely inferior lacrimal duct obstruction. Retrospective cohort study at Nanchang University’s Affiliated Eye Hospital. Experimental Group: Endoscopic membranous nasolacrimal duct resection combined with retrograde lacrimal stent implantation; Control group: Conventional endoscopic dacryocystorhinostomy combined with bicanalicular Silicone Stent implantation.The duration of the surgical procedure, postoperative comfort score, irrigation of the lacrimal passage after extubation, and Munk score of curative effect at six months post-operation were recorded. The data were quantified and analyzed using SPSS 26.0 statistical software. The symptoms of epiphora showed significant improvement following surgery. There were notable differences in operation time and postoperative comfort between the experimental group and the control group who underwent conventional endoscopic dacryocystorhinostomy (P 0.05). The cure rate of the experimental group reached 70%, while the control group achieved a cure rate of 78%. Furthermore, the effective rate in the experimental group was found to be 81%, whereas it was 89% in the control group.No evident complications were observed in the experimental group. The combination of endoscopic membranous nasolacrimal duct resection and retrograde lacrimal stent reduces the invasiveness of the lacrimal duct structure, shortens the operation time, improves patient comfort, and achieves favorable therapeutic outcomes. This approach is recommended for patients with extremely Inferior lacrimal duct obstruction .

Abstract Background Chronic rhinosinusitis is a common disease entity seen by ENT surgeons as well as general practitioners all over the world. This study is aimed to evaluate and validate whether the clinical guideline symptoms (set by AAO-HNS 2015) alone and/or nasal endoscopic findings can predict the diagnosis of CRS, taking CT as the gold standard. Methods A total of 118 patients with symptoms of chronic rhinosinusitis were taken. They were divided into two groups on the basis of whether they fulfilled the Guideline symptom criteria laid down by AAO-HNS in 2015 for diagnosing chronic rhinosinusitis. Each group underwent diagnostic nasal endoscopy (DNE), and patients with either purulence, edema in the middle meatus or ethmoid, and polyps in the nasal cavity or middle meatus were considered positive for DNE. A Lund-Mackay CT score of > 4 was considered diagnostic of CRS. Each group was analyzed separately. Sensitivity, specificity, and positive predictive value of guideline symptom with and without the addition of nasal endoscopy was recorded taking CT as the gold standard. Results Nasal obstruction was the most common seen in all cases (100%) followed by headache in 45 (38.1%), facial pain in 32 (27.1%), anterior nasal discharge in 28 (23.7%), decreased sense of smell in 22 (18.6%), and posterior nasal discharge in 19 (16.1%). Two-thirds of patients (78, 66.1%) fulfilled the clinical guideline symptoms criteria, and one-third of patients (40, 33.9%) did not fulfill the clinical guideline symptoms criteria. A positive finding on DNE was found in 59.3% (n = 70) of patients. More than half of patients (62, 52.5%) had mild grade on endoscopic examination, while only 8 (6.8%) had moderate grade, and none had severe grade. Guideline symptoms have a high sensitivity (80%) but a low specificity (50.94%) in the diagnosis of CRS, with a fair level of agreement with CT diagnosis (Kappa = 0.32). DNE has a moderate sensitivity (72.31%) but a low specificity (56.60%) in the diagnosis of CRS, with a fair level of agreement with CT diagnosis (Kappa = 0.29). Sensitivity and specificity were 80.77% and 57.69% respectively when guideline symptoms and DNE findings are taken in series. Conclusion We conclude that neither Guideline Symptom Criteria nor DNE is independently sufficient enough to have a high diagnostic accuracy for CRS. Comparing the diagnostic efficiency among various modalities, we report that in patients who meet guideline symptom criteria for CRS, the addition of nasal endoscopy turned out to be a cost-effective diagnostic approach and improves the diagnostic accuracy of DNE for CRS reasonably, hence should be emphasized as a diagnostic tool in the evaluation of patients for CRS.

KEY POINTS AI‐enabled augmentation of nasal endoscopy video images is feasible in the clinical setting. Edge computing hardware can interface with existing nasal endoscopy equipment. Real‐time AI performance can achieve an acceptable balance of accuracy and efficiency. AI‐enabled augmentation of nasal endoscopy video images is feasible in the clinical setting.Edge computing hardware can interface with existing nasal endoscopy equipment.Real‐time AI performance can achieve an acceptable balance of accuracy and efficiency. [ABSTRACT FROM AUTHOR]

Purpose: This large retrospective, single-center, follow-up study investigated the endoscopic prelacrimal recess approach (PLRA) for treating maxillary sinus inverted papilloma (MSIP). Methods: Between January 2007 and November 2022, patients with MSIP treated with PLRA were enrolled. Data on clinical manifestations, imaging, and surgical procedures were collected. The visual analog scale (VAS) scores for maxillofacial numbness and nasal symptoms and the SNOT-22 nasal symptom scores were statistically analyzed. Result: Of 122 patients (68 males and 54 females) enrolled in the study, with a mean age of 50.75 ± 12.84 years (26–80 years), 111 patients underwent PLRA, nine underwent modified PLRA, one converted to an endoscopic medial maxillectomy (EMM), and one to an endoscopic modified Denker's approach. The average follow-up was 86.60 (13–192) months, the recurrence rate was 3.28%, and 29 patients (23.77%) complained of maxillofacial numbness one month postoperatively, which disappeared in most cases one year after surgery. Five patients (4.10%) experienced mild numbness at the end of the follow-up period. Maxillary sinus ostium contracture or atresia occurred in two cases (1.64%). After surgery, the VAS nasal symptom scores improved significantly (P < 0.001). SNOT-22 indicated that the most common postoperative symptom was thick nasal discharge. Conclusion: PLRA is a flexible first-choice surgical treatment for maxillary sinus inverted papilloma and can be modified according to the extent of the lesion, the surgeon's experience and technique, and surgical instruments. That can help achieve complete resection and reduce recurrence and surgical complications. Upper teeth numbness, the most common postoperative complication, tends to disappear after 1 year. [ABSTRACT FROM AUTHOR]

Key points: A convolutional neural network (CNN)‐based model can accurately localize and segment turbinates in images obtained during nasal endoscopy (NE).This model represents a starting point for algorithms that comprehensively interpret NE findings. [ABSTRACT FROM AUTHOR]

Summary: Despite the widespread adoption of nasal endoscopy (NE) in the evaluation of sinonasal disease, its diagnostic potential may still be underutilized. Developments in endoscopic technology have led to significant improvements in video quality and maneuverability. However, there is concern that NE continues to be used primarily for the identification of gross pathology, with relative neglect of more subtle findings such as surface features of inflammation and mucus. With fewer technical limitations to perceive these abnormalities, there is potential to greatly improve the diagnostic value of NE. The reader is herein asked to consider several important visual nuances encountered during NE, with the hope that this engenders an appreciation of the versatility of NE as a diagnostic tool. [ABSTRACT FROM AUTHOR]

Objective：To analyze the clinical efficacy of low temperature plasma radiofrequency ablation of Krouse T2 and T3 nasal inverted papilloma (NIP) under nasal endoscope. Methods：Clinical data of 141 cases with Krouse T2 and T3 NIP treated with endoscopic surgery at the Department of Otolaryngology Head and Neck Surgery, the Affiliated Nanjing Hospital of Nanjing Medical University (Nanjing First Hospital)from October 2012 to October 2022, were retrospectively analyzed, and the tumor was resected and treated with or wthout low temperature plasma radiofrequency ablation during the operation. They were divided into observation group using low temperature plasma radiofrequency ablation and control group without low temperature plasma radiofrequency ablation. The operative time, intraoperative blood loss, average length of hospital stay, postoperative visual analogue scale (VAS) score of pain, postoperative complications and postoperative recurrence rate were compared between the two groups. Results：The average operation time of NIP patients with T2+T3 and T3 stage in the observation group was less than that of the corresponding control group, but the difference was not statistically significant (P > 0.05)；the average operation time of NIP patients with T2 stage in the observation group was less than that of the corresponding control group, and the difference was statistically significant (P < 0.05). The average intraoperative blood loss, the average length of hospitalization, and postoperative pain VAS scores of patients with T2+T3, T2 and T3 stage in the observation group were lower than those in the corresponding control group，and the difference was statistically significant (P < 0.05). There was no statistical significance in the postoperative complications of patients with T2+T3，T2 and T3 stage in the observation group compared with the corresponding control group (P > 0.05). The postoperative recurrence rate of patients with T2+T3 and T3 stage in the observation group was lower than that of the control group，with statistical significance (P < 0.05)，while the postoperative recurrence rate of patients with T2 stage in the observation group was lower than that of the control group，with no statistical significance (P > 0.05). Conclusion：Low temperature plasma radiofrequency ablation under nasal endoscope can treat Krouse T2 and T3 stage NIP and its base under a clear surgical field of view. It has the advantages of less intraoperative blood loss, shorter length of hospitalization，less pain and lower recurrence rate，compared with routine operation. And it has satisfactory clinical efficacy，which is worthy of popularization and application. [ABSTRACT FROM AUTHOR]

Background: Allergic fungal rhinosinusitis (AFRS) is a distinct type of chronic polypoid rhinosinusitis that affects atopic individuals. The incidence worldwide ranges from 5% to 10%, with geographic variation in epidemiology. It imposes a significant negative impact on quality of life, concomitantly generating socioeconomic losses. Failure to remove all sinus disease increases the likelihood of relapse; thus, the best outcome is achieved through coordinated medical-surgical care. The antifungal activity of itraconazole in addition to standard steroid therapy may provide greater relief to patients with AFRS following functional endoscopic sinus surgery (FESS) by decreasing the chances of recurrence and long-term use of steroids. Therefore, this study has been taken up. Aim and Objectives: The aims and objectives of the study are to evaluate the efficacy of oral itraconazole as an add-on to the standard steroid therapy in allergic fungal rhinosinusitis from baseline to 6 weeks. Materials and Methods: This study was conducted among 60 patients who underwent FESS and were administered medications postoperatively. The efficacy was measured by the sinonasal outcome test-20 score, the nasal endoscopic grade, and the Lund and Mackay score from baseline to 6 weeks. Continuous data were analyzed using the unpaired t-test, repeated measure analysis of variance, and paired t-test, whereas categorical data were analyzed using the Chi-square test. Results: Comparable efficacy was observed between the group treated with standard steroids alone and the group receiving a combination of standard steroids and itraconazole. No significant improvement was seen with oral itraconazole as an add-on therapy when compared with standard steroids at the end of 6 weeks. Conclusion: Oral itraconazole as an add-on therapy will reduce the chances of recurrence such as steroids, but in this study, there was no statistically significant reduction. The disease has a long natural course, and further follow-up is needed to establish the importance of itraconazole. [ABSTRACT FROM AUTHOR]

Background: Chronic rhinosinusitis is a common disease entity seen by ENT surgeons as well as general practitioners all over the world. This study is aimed to evaluate and validate whether the clinical guideline symptoms (set by AAO-HNS 2015) alone and/or nasal endoscopic findings can predict the diagnosis of CRS, taking CT as the gold standard. Methods: A total of 118 patients with symptoms of chronic rhinosinusitis were taken. They were divided into two groups on the basis of whether they fulfilled the Guideline symptom criteria laid down by AAO-HNS in 2015 for diagnosing chronic rhinosinusitis. Each group underwent diagnostic nasal endoscopy (DNE), and patients with either purulence, edema in the middle meatus or ethmoid, and polyps in the nasal cavity or middle meatus were considered positive for DNE. A Lund-Mackay CT score of > 4 was considered diagnostic of CRS. Each group was analyzed separately. Sensitivity, specificity, and positive predictive value of guideline symptom with and without the addition of nasal endoscopy was recorded taking CT as the gold standard. Results: Nasal obstruction was the most common seen in all cases (100%) followed by headache in 45 (38.1%), facial pain in 32 (27.1%), anterior nasal discharge in 28 (23.7%), decreased sense of smell in 22 (18.6%), and posterior nasal discharge in 19 (16.1%). Two-thirds of patients (78, 66.1%) fulfilled the clinical guideline symptoms criteria, and one-third of patients (40, 33.9%) did not fulfill the clinical guideline symptoms criteria. A positive finding on DNE was found in 59.3% (n = 70) of patients. More than half of patients (62, 52.5%) had mild grade on endoscopic examination, while only 8 (6.8%) had moderate grade, and none had severe grade. Guideline symptoms have a high sensitivity (80%) but a low specificity (50.94%) in the diagnosis of CRS, with a fair level of agreement with CT diagnosis (Kappa = 0.32). DNE has a moderate sensitivity (72.31%) but a low specificity (56.60%) in the diagnosis of CRS, with a fair level of agreement with CT diagnosis (Kappa = 0.29). Sensitivity and specificity were 80.77% and 57.69% respectively when guideline symptoms and DNE findings are taken in series. Conclusion: We conclude that neither Guideline Symptom Criteria nor DNE is independently sufficient enough to have a high diagnostic accuracy for CRS. Comparing the diagnostic efficiency among various modalities, we report that in patients who meet guideline symptom criteria for CRS, the addition of nasal endoscopy turned out to be a cost-effective diagnostic approach and improves the diagnostic accuracy of DNE for CRS reasonably, hence should be emphasized as a diagnostic tool in the evaluation of patients for CRS. [ABSTRACT FROM AUTHOR]

To investigate the utility of a hand-held digital otoscope for nasal endoscopy and as a pedagogy tool for residents and fellows in patients undergoing external dacryocystorhinostomy (DCR) surgery A digital otoscope (MS450-NTE, Teslong Inc., USA) comprising a digital screen device and a connectible camera probe was used for performing nasal endoscopy. Inspection of nasal cavities was performed pre-, intra-, and post-operatively in sequential patients with nasolacrimal duct obstruction, who underwent DCR or lacrimal probing. Images (1920 × 1080 pixels) and videos (1280 × 720 pixels) were captured. The device was also used for training residents and fellows in performing nasal endoscopy, and to teach basic concepts. The digital otoscope could be used for routine outpatient nasal examination and for performing minor procedures. 53.8% (n = 13) of ophthalmology trainees had never observed nasal endoscopy and 84.6% could not identify more than one major structure correctly prior to the current training. Post-training, all trainees could independently perform nasal endoscopy with the device and 76.9% identified all structures correctly. A digital otoscope with a camera probe is a handy tool for nasal endoscopy and pedagogy. Low-cost gadgets such as this device can effectively be used for performing outpatient nasal endoscopy when expensive endoscopes are unavailable and in peripheral healthcare centers. [ABSTRACT FROM AUTHOR]

Background: Nasal septal perforations (NSP) can have a heterogeneous appearance on endoscopic examination with varying degrees of crusting, inflammatory change, and associated septal deviation. The clinical applicability of these findings as contributors to patient symptoms may be enhanced by use of a standardized assessment. Methods: Video nasal endoscopy recordings were obtained from 40 patients with NSP. Five raters with varied levels of training ranging from a senior resident to an experienced septal perforation surgeon independently reviewed the videos for the following exam findings: crusting, scarring, granulation tissue, septal deviation, and edema. Scoring for each item was reported on a 3‐point (0–2) scale, and each reviewer repeated scoring at a 14‐day interval. Interrater and intrarater agreement were calculated using Fleiss kappa for each item and the total scores. Additionally, endoscopy scores were correlated with patient‐reported NOSE‐Perf symptom scores. Results: Interrater agreement for the overall instrument was in the "fair‐to‐moderate" range with the following interrater agreement for each item: crusting (0.458–0.575), scarring (0.286–0.308), granulation (0.403–0.406), deviation (0.487–0.494), and edema (0.253–0.406). Intrarater agreement was generally "substantial" for individual items as well as the overall instrument (0.688). The NSP endoscopy scores were moderately correlated with NOSE‐Perf scores (r = 0.44, p = 0.008). Conclusions: An endoscopic evaluation of NSP comprising five exam findings has acceptable interrater and intrarater reliability and correlates with patient‐reported outcomes. NSP endoscopy may be applied to future clinical studies for characterization of NSP and assessment of treatment outcomes. Level of Evidence: 3 Laryngoscope, 134:3049–3053, 2024 [ABSTRACT FROM AUTHOR]

Background: Chronic rhinosinusitis (CRS) is often diagnosed based on clinical features. Assurance in this context is based on the finding of inflammatory features during nasal endoscopy and computed tomography (CT) scans of the paranasal sinuses. While a CT scan is considered the most reliable method, research has shown that nasal endoscopy is also valuable and can sometimes provide additional information to supplement the CT scan in diagnosing CRS. Objective: The study goal was to demonstrate the comparative reliability of nasal endoscopy and computed tomography scans in diagnosing chronic rhinosinusitis in adult patients treated at Baqubah Teaching Hospital. Patients and Methods: The study sample consisted of consecutive adult participants clinically diagnosed with chronic rhinosinusitis. Patients who had a computed tomography scan of the paranasal sinuses and a nasal endoscopy during three months were the subjects of this investigation; the outcomes were linked. Results: Study results exhibit that the most prevalent symptoms seen in the study participants were nasal discharge and nasal obstruction, reported by 95% and 90%, respectively; the most prevailing observation during nasal endoscopy was middle meatus purulent discharge, noticed in 58% of the patients. Maxillary sinus was most often affected, seen in 65% of the patients on a CT scan, and 40% had obstruction of the osteomeatal complex on CT imaging. The nasal endoscopy had a sensitivity of 73.3%, specificity of 85.3%, positive predictive value of 92.7%, and negative predictive value of 55.8%. The research also found no significant differences in positive predictive value (PPV) between nasal endoscopy and CT scan. In contrast, the sensitivity of nasal endoscopy was significantly greater than that of CT scan. Conclusion: The study found that nasal endoscopic findings for patients with positive clinical features were purulent (cream-colored) discharge and middle meatus polyps, which is sufficient for diagnosing chronic rhinosinusitis; the study showed that Nasal endoscopy is almost as accurate as CT scans and CT scan findings are well correlates with sinus endoscopy, due to its precision, cheap cost, and radiation dosage.

Abstract Purpose To report a rare variant of the posterior septal artery (PSA), which supplies blood to the posterior mucosa of the contralateral nasal septum. Case report A 31‐year‐old female patient underwent suture removal 14 days after septoplasty and developed left‐sided epistaxis 6 h after suture removal. To safely and effectively relieve the patient from epistaxis, the cauterization of the left PSA was performed under general anesthesia. However, 24 h after the first surgical hemostasis, the patient experienced epistaxis again in the right nasal cavity. We have reviewed the patient's sinus computed tomography again and found a rare variant of PSA, which is the right‐sided PSA passing through a bony canal in the left‐sided nasal septum. Discussion The variant of PSA well explained the failure of the first hemostatic surgery. Therefore, we again performed a cauterization of the right‐sided PSA, after which the patient recovered and no further epistaxis occurred. Conclusion When cauterization of PSA is used to manage posterior epistaxis, it is necessary to pay attention to the possible variation in PSA.

Abstract Background Nasal polyps and inverted papillomas often look similar. Clinically, it is difficult to distinguish the masses by endoscopic examination. Therefore, in this study, we aimed to develop a deep learning algorithm for computer-aided diagnosis of nasal endoscopic images, which may provide a more accurate clinical diagnosis before pathologic confirmation of the nasal masses. Methods By performing deep learning of nasal endoscope images, we evaluated our computer-aided diagnosis system’s assessment ability for nasal polyps and inverted papilloma and the feasibility of their clinical application. We used curriculum learning pre-trained with patches of nasal endoscopic images and full-sized images. The proposed model’s performance for classifying nasal polyps, inverted papilloma, and normal tissue was analyzed using five-fold cross-validation. Results The normal scores for our best-performing network were 0.9520 for recall, 0.7900 for precision, 0.8648 for F1-score, 0.97 for the area under the curve, and 0.8273 for accuracy. For nasal polyps, the best performance was 0.8162, 0.8496, 0.8409, 0.89, and 0.8273, respectively, for recall, precision, F1-score, area under the curve, and accuracy. Finally, for inverted papilloma, the best performance was obtained for recall, precision, F1-score, area under the curve, and accuracy values of 0.5172, 0.8125, 0.6122, 0.83, and 0.8273, respectively. Conclusion Although there were some misclassifications, the results of gradient-weighted class activation mapping were generally consistent with the areas under the curve determined by otolaryngologists. These results suggest that the convolutional neural network is highly reliable in resolving lesion locations in nasal endoscopic images.

Background: Nasal polyps and inverted papillomas often look similar. Clinically, it is difficult to distinguish the masses by endoscopic examination. Therefore, in this study, we aimed to develop a deep learning algorithm for computer-aided diagnosis of nasal endoscopic images, which may provide a more accurate clinical diagnosis before pathologic confirmation of the nasal masses. Methods: By performing deep learning of nasal endoscope images, we evaluated our computer-aided diagnosis system's assessment ability for nasal polyps and inverted papilloma and the feasibility of their clinical application. We used curriculum learning pre-trained with patches of nasal endoscopic images and full-sized images. The proposed model's performance for classifying nasal polyps, inverted papilloma, and normal tissue was analyzed using five-fold cross-validation. Results: The normal scores for our best-performing network were 0.9520 for recall, 0.7900 for precision, 0.8648 for F1-score, 0.97 for the area under the curve, and 0.8273 for accuracy. For nasal polyps, the best performance was 0.8162, 0.8496, 0.8409, 0.89, and 0.8273, respectively, for recall, precision, F1-score, area under the curve, and accuracy. Finally, for inverted papilloma, the best performance was obtained for recall, precision, F1-score, area under the curve, and accuracy values of 0.5172, 0.8125, 0.6122, 0.83, and 0.8273, respectively. Conclusion: Although there were some misclassifications, the results of gradient-weighted class activation mapping were generally consistent with the areas under the curve determined by otolaryngologists. These results suggest that the convolutional neural network is highly reliable in resolving lesion locations in nasal endoscopic images. [ABSTRACT FROM AUTHOR]

Copyright of China Journal of Oral & Maxillofacial Surgery is the property of Shanghai Jiao Tong University, College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Endoscopy-related musculoskeletal injuries (ERIs) are frequent among gastrointestinal, pulmonary, nasal, and urologic endoscopists, impacting the healthcare system. The present review aims to compare the ERI rates, risk factors, and ergonomic recommendations in the different endoscopic fields. A review was conducted using PubMed and Cochrane Library for articles based on surveys and published until 10 January 2024. Demographic, work, and ERI data from 46 publications were included, covering 10,539 responders. The ERI incidence ranged between 14% and 97%, highlighting the need of intervention independent of the specialties. The neck, back, and shoulder were the most frequent ERI locations, while gender, age, years of experience, and procedure volume the most common risk factors. Ergonomic recommendations suggest concentrating on endoscope design changes, especially in gastrointestinal endoscopy, to increase the comfort, adaptability of the equipment in the operating room, and workflow/institutional policy changes. The inclusion of an ergonomic timeout guarantees the correct equipment positioning, the neutralisation of the endoscopist's posture, and an indirect break between procedures. Ergonomic training to increase awareness and best practice should be promoted, also using new technologies. Future research should concentrate on intervention and comparative studies to evaluate to which extent prevention measures and newly designed equipment could reduce ERI incidence. [ABSTRACT FROM AUTHOR]

Introduction Despite the high level of patient satisfaction with functional endoscopic sinus surgery (FESS) and the clinical improvement, polyp recurrence is observed in 23% to 87% of patients and requires reoperation. Objective To assess the prognostic value of polypoid changes of the middle turbinate (PCMT) in relapse of paranasal sinus polyps in patients with chronic rhinosinusitis with nasal polyp (CRSwNP) after FESS and the effect of partial middle turbinectomy (PMT) on the outcome of surgery. Methods We conducted a prospective clinical study on 60 patients with CRSwNP with and without PCMT. The patients were allocated into three groups: group I included twenty patients without PCMT; group II, twenty patients with PCMT; and group III included twenty patients with PCMT submitted to PMT. The patients were evaluated endoscopically according to the Lund-Kennedy endoscopic scoring system, radiologically according to the Lund-Mackay scoring system, and symptomatically through the 22-item Sinonasal Outcome Test (SNOT-22). Results The total postoperative Lund-Kennedy score differed significantly among the 3 groups (p < 0.001), with a group II presenting a significantly higher total score compared to groups I and III. The Preoperative SNOT-22 score differed significantly among the three groups (p = 0.013), with group II presenting a significantly higher score compared to group I. There was a significant association involving the 3 groups and relapse at 12 months (p = 0.029); relapse was higher in group II (50.0%) than in groups I (20%) and III (15.0%). Conclusion There was a significant association between PCMT and the relapse of nasal polyps. Also, nasal polyposis recurred at a lower rate in the group submitted to middle turbinate resection compared to the group in whom it was preserved. [ABSTRACT FROM AUTHOR]

Rhinocerebralmucormycosis, is a progressive fungal invasion of a hard palate, paranasal sinuses, orbit, and brain. Post covid the huge number of mucor cases reported in our institute. To combat them a uniform assessment scale was needed as multiple healthcare workers were involved. Thus, a novel linear grading system on nasal endoscopy was developed for the early management of patients to prevent morbidity and mortality. A Prospective study of 650 patients in Epidemic duration from April to June 2021 in a tertiary health center, Central India. Patients subjected to Nasal Endoscopy with 0degree 4 mm Telescope and classified into 5 categories according to the severity of the disease. In a novel grading system, minimum patients were of grade 0, maximum was in Grade I. Maxillary sinus was most commonly involved. This novel grading system on nasal endoscopy makes the management of patients much easier in an epidemic, reducing human errors, morbidity, and mortality of the fulminant disease. [ABSTRACT FROM AUTHOR]

Abstract Background Mucormycosis in the setting of COVID-19 has given rise to the concept of “epidemic within a pandemic.” Once known to be a rare fungal disease, mucormycosis has now been regrouped under emerging pathogens. It has got special affinity for the immunocompromised, which is one of the main reasons for the flare up of the fungus during the second wave of COVID. The burden of the disease was felt globally, and India is facing the major brunt owing to our population and healthcare services ratio. Objective In our study, we have made an attempt to evaluate the clinical and radiological findings in patients of rhino-orbito-cerebral mucormycosis (ROCM) and to formulate a management protocol which will benefit such patients in forthcoming years. Methods This is a retrospective single-center study in Northern India. A total of 350 patients, affected by ROCM, were included in the study. Medical records of these patients were reviewed. Their clinical manifestations, nasal endoscopic findings, microbiological and radiological records, extent of disease, treatment profile, surgical interventions, and outcomes were analyzed. Nasal swab which was sent for KOH mount/fungal culture revealed broad aseptate filamentous fungi branching at right angles. All patients received intravenous amphotericin B and had undergone extensive surgical debridement endoscopically. The maxillary sinus was the commonest paranasal sinus involved followed by the ethmoid sinuses. Tissue sent for histopathological examination confirmed mucormycosis, except for 3 cases. Results The commonest presenting symptoms were cheek swelling with ophthalmoplegia, diminution of vision, and headache. The mean duration of follow-up was 8 months. The maxillary sinus was found to be involved in around 71% of the cases followed by the ethmoids and sphenoid. Thirty percent of the cases had visual complaints including diplopia and vision loss, whereas the palate was involved in around 35%. Nine patients had no perception of light in one eye on presentation, whereas 21 patients had perception of light only; 24 patients could count fingers close to face, and the rest had ambulatory vision. Three patients presented with facial palsy. All patients had favorable outcome except six who succumbed due to cerebral involvement and uncontrolled blood glucose levels. Conclusion A definite management protocol was formulated for ROCM which requires a multidisciplinary approach.

Purpose: To investigate the safety and efficacy of propofol in combination with remifentanil for controlled hypotension during pediatric nasal endoscopic surgery. Methods: The study involved 30 patients who underwent controlled hypotension measures with remifentanil during the operation (study group), and 30 patients who did not receive controlled hypotension measures (control group). Various parameters including vital signs, operation time, intraoperative bleeding, surgical field quality, anesthesia quality, postoperative recovery time, adverse reaction rate, pain scores, and serum C-reactive protein levels were compared between the two groups. Results: The results revealed a significant decrease in mean arterial pressure and heart rate in the study group during the operation compared to control group. Moreover, study group exhibited improved operation time, reduced intraoperative bleeding, and better surgical field quality compared to control group. Pain scores and serum C-reactive protein levels were also lower in the study group. However, there were no significant differences in recovery time, anesthesia quality, postoperative adverse reaction rate, or cognitive function between the two groups. Conclusion: Propofol in combination with remifentanil for controlled hypotension is a safe and effective anesthesia approach for pediatric nasal endoscopic surgery. Future studies will require larger sample size from different study centers to improve the robustness of the findings of this study. [ABSTRACT FROM AUTHOR]

Symptomatic nasopharyngeal cysts are relatively uncommon. Here is a case report of 50 years of age female with hearing loss secondary to the nasopharyngeal cyst. She underwent endoscopic marsupialization and achieved normal hearing postoperatively.The study aims to determine the incidence of hearing loss, radiological patterns and histopathological findings associated with the nasopharyngeal cyst. [ABSTRACT FROM AUTHOR]

Introduction Patients with chronic rhinitis suffer from postnasal drip (PND) but this symptom is not well addressed. Nasal endoscopy may aid in identifying PND. Well described endoscopic features of PND are presence of secretions in the posterior nasal cavity, diffuse erythema, and hemorrhagic spots in the nasopharynx, but these have not been formally studied. Objectives The present study aims to assess the association of nasal endoscopic features with PND among rhinitis patients. This will guide clinicians to interpret the nasal endoscopic findings appropriately. Methods Adults (≥ 18 years old) with chronic rhinitis were consecutively recruited at an Otorhinolaryngology outpatient clinic in a tertiary referral center. The patients were grouped into either "Rhinitis with PND" or "Rhinitis only." The endoscopic features of PND were scored as: Secretions in the posterior nasal cavity (yes/no), erythema in the nasopharynx (none, roof only, diffuse), hemorrhagic spots (yes/no), then were compared between groups. Results There were 98 patients included (age 32.32 ± 11.33 years old, 61.2% female, 61.2% PND). Presence of secretions in the posterior nasal cavity was associated with PND ("Rhinitis with PND" versus "Rhinitis only," 78.3 versus 55.3; p = 0.02; Odds ratio: 2.81; 95% confidence interval [CI]: 1.08–7.32). Diffuse erythema of the nasopharynx was more frequent in "rhinitis only" compared with those with PND (76.3 versus 53.3%; p = 0.02). Hemorrhagic spots were equally present in both groups (11.7 versus 18.4%; p = 0.35). Conclusion Presence of secretions in the posterior nasal cavity may indicate bothersome PND among patients with rhinitis. Diffuse erythema of the nasopharynx and hemorrhagic spots are a nonspecific sign of inflammation. [ABSTRACT FROM AUTHOR]

Background: Frontal sinus stents have been introduced to reduce frontal sinus re-stenosis after surgery and to improve outcomes. Method: This study was a retrospective analysis of 19 patients who had endoscopic sinus surgery with approach to the frontal sinus and insertion of a soft sinus stent. Results: The frontal recess was patent in 78.9 per cent and stenosed in 21.1 per cent of patients; no completely closed recesses were observed. Mean follow up was 20.7 months, and time period of stenting was 9.8 months on average; complications were observed in 47.4 per cent of the patients, with post-operative sinonasal infection being the most common. Conclusion: In the authors' experience, indications for frontal sinus stenting include recalcitrant chronic rhinosinusitis after multiple functional endoscopic sinus surgeries (especially in chronic rhinosinusitis with nasal polyps), patients with history of important craniofacial surgery or trauma, and recurrent mucoceles. The stent was overall well tolerated as only minor complications were observed. Close clinical follow up is mandatory. [ABSTRACT FROM AUTHOR]

Objective: Create an aerosol containment mask (ACM) for common otolaryngologic endoscopic procedures which also provides nanoparticle‐level protection to patients. Study Design: Prospective feasibility study. Setting: In‐person testing with a novel ACM. Methods: The mask was designed in Solidworks and 3‐dimensional printed. Measurements were made on 100 consecutive clinic patients who underwent medically necessarily endoscopy, 50 rigid nasal and 50 flexible, by 9 surgeons. Results: Of the 50 patients who underwent rigid nasal endoscopy with the ACM, 0 of 25 patients with the suction off and 0 of 25 patients with the suction on had evidence of leakage of 0.3 μm particles. Of the 50 patients who underwent flexible endoscopy with the ACM, 0 of 25 patients with the suction off and 0 of 25 patients with the suction on had evidence of leakage of 0.3 μm particles. In terms of comfort, 73% of patients found the ACM somewhat or very comfortable without suction, compared to 86% with the suction on. Surgeons were able to visualize all necessary anatomic areas in 98% of procedures. In 97% of procedures, the masks were able to be placed easily. Conclusion: ACM can accommodate rigid nasal and flexible endoscopes and may prevent leakage of patient‐generated aerosols, thus avoiding contamination of the room and protecting health care workers from airborne contagions. Level of Evidence: The level of evidence is 2. [ABSTRACT FROM AUTHOR]

Introduction: Isolated fractures of the frontal bone constitute 5-15% of traumatic facial fractures, with frontal sinus fractures being divided into those of the anterior wall, the posterior wall, and complex fractures. The approach is selected according to the type of fracture and the displacement of the bone fragment. This paper summarizes the surgical management of patients with isolated and complex fractures of the anterior wall of the frontal sinus. Material and methods: Five patients with different fractures of the frontal sinus were treated surgically. The same management protocol - diagnosis and surgical intervention - was implemented in all cases. Retrospective analysis included assessment of the fracture and the surgical approach, as well as evaluation of long-term outcomes. Results: The most common cause of the fractures was falls, and two complex fractures involved the anterior and posterior walls. External approach, bone fragment removal, endoscopy, and external stabilization were used in all cases. One patient required delayed revision surgery due to a retained metallic foreign body. Follow-up radiological examinations showed that normal healing and cosmetic outcomes were satisfactory in all of the cases. Conclusion: Surgical management of isolated fractures of the frontal sinus anterior wall, involving removal of bone fragments, realignment, and endoscopy, yielded satisfactory functional and cosmetic outcomes without internal or external stabilization. Long-term monitoring and symptom assessment are crucial, especially in cases with penetrating injuries and foreign body risk. [ABSTRACT FROM AUTHOR]

Introduction Despite the high level of patient satisfaction with functional endoscopic sinus surgery (FESS) and the clinical improvement, polyp recurrence is observed in 23% to 87% of patients and requires reoperation.

Background: Epistaxis is a common condition but with diverse etiology dependent on geography, season, climate, and demography. Aims and Objectives: To describe the demographic, clinical, and etiological profile and management strategies of epistaxis cases at a tertiary center in U.P. (west). Materials and Methods: Patients were identified from the emergency and outpatient department, and their demographic and clinical details were noted. Local examination was performed, and necessary investigations were carried out. Management strategies were noted. Duration of hospital stay and mortality, if any, was documented. Descriptive analytics were used. Data were represented as numbers and percentages, mean±standard deviation, and median. Results: A total of 189 epistaxis patients were enrolled in the study. The mean age of patients was 32.89±17.92 (range 1–85 years). The sex ratio (M: F) was 2.71. Majority of patients presented to the emergency department (60.3%) within 1 day (64.6%), had single episode (66.7%), the presence of old clot (72%) and the anterior location of bleeding (91.5%). 119 (63%) cases required admission. Nasal endoscopy and computed tomography scan were performed in 49 (25.9%) and 24 (12.7%) cases, respectively. The most common etiology was trauma (49.2%), followed by idiopathic cause (14.8%), hypertension (12.7%), and others. Nasal packing and cauterization were required in 16.4% and 15.9% of cases, respectively. Surgery was required in 5 (2.6%) cases. A minuscule percentage of cases required blood transfusion. There was no mortality. Conclusion: Epistaxis is a common emergency with males predominating over females. Causes are varied. Most patients can be managed conservatively with favorable outcomes if timely intervention is done.

Introduction Patients with chronic rhinitis suffer from postnasal drip (PND) but this symptom is not well addressed. Nasal endoscopy may aid in identifying PND. Well described endoscopic features of PND are presence of secretions in the posterior nasal cavity, diffuse erythema, and hemorrhagic spots in the nasopharynx, but these have not been formally studied.

Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a disease of real interest for researchers due to its heterogenicity and complex pathophysiological mechanisms. Identification of the factors that ensure success after treatment represents one of the main challenges in CRSwNP research. No consensus in this direction has been reached so far. Biomarkers for poor outcomes have been noted, but nonetheless, their prognostic value has not been extensively investigated, and needs to be sought. We aimed to evaluate the correlation between potential prognostic predictors for recalcitrant disease in patients with CRSwNP. Methods: The study group consisted of CRSwNP patients who underwent surgical treatment and nasal polyp (NP) tissue sampling. The preoperative workup included Lund–Mackay assessment, nasal endoscopy, eosinophil blood count, asthma, and environmental allergy questionnaire. Postoperatively, in subjects with poor outcomes, imagistic osteitis severity was evaluated, and IL-33 expression was measured. Results: IL-33 expression in NP was positively and significantly correlated with postoperative osteitis on CT scans (p = 0.01). Furthermore, high osteitis CT scores were related to high blood eosinophilia (p = 0.01). A positive strong correlation was found between postoperative osteitis and the Lund–Mackay preoperative score (p = 0.01), as well as the nasal endoscopy score (p = 0.01). Conclusions: Our research analyzed the levels of polyp IL-33, relative to blood eosinophilia, overall disease severity score, and osteitis severity, in patients with CRSwNP. These variables are prognostic predictors for poor outcomes and recalcitrant disease. Considering the importance of bone involvement in CRSwNP, this research aims to provide a better insight into the correlations of osteitis with clinical and biological factors. [ABSTRACT FROM AUTHOR]

Objective: To examine the prevalence and nature of nasal endoscopic findings in patients referred for structural nasal obstruction, and analyze how such findings influence the preoperative evaluation or operative plan. Study Design: Cross‐sectional study. Setting: University‐based academic otolaryngology practice. Methods: Nasal endoscopy was performed by a single surgeon and the exam findings were documented. Patient demographics, variables in the patient history, Nasal Obstruction Symptom Evaluation scores, and an Ease‐of‐Breathing Likert Scale were tested for associations with findings on endoscopy. Results: A total of 82 of 346 patients (23.7%) had findings on rigid nasal endoscopy not appreciable on anterior rhinoscopy. Prior nasal surgery (p =.001) and positive allergy testing (p =.013) were significantly associated with findings on nasal endoscopy. Endoscopic findings prompted additional preoperative studies in 50 (14.5%) patients, and a change in the operative plan in 26 (7.5%) patients. Conclusion: In patients referred for surgical management of nasal obstruction, findings on nasal endoscopy otherwise undetected with anterior rhinoscopy are most common in but certainly not limited to those with prior nasal surgery or allergic rhinitis. Routine nasal endoscopy should be considered for all patients being evaluated for nasal airway surgery. These results may benefit future updates of the clinical consensus statements regarding the role of nasal endoscopy in the evaluation of nasal valve compromise and septoplasty. [ABSTRACT FROM AUTHOR]

Objective: To investiga te the therapeutic effect of prednisolone on chronic sinusitis and its influence on olfactory function and nasal mucosa morphology in patients with chronic sinusitis. Methods: 80 patients with chronic sinusitis admitted to our hospital from January 2019 to December 2022 were selected as the research objects. All patients were randomly divided into observation group and control group with 40 patients in each group. The patients in the control group were treated with simple endoscopic surgery, while the patients in the observation group were treated with medloratadine before surgery for one month and then underwent endoscopic surgery. The clinical treatment effects, levels of inflammatory factors before and after treatment, quantitative score of endoscopic nasal mucosa morphology, olfactory function and saccharin test time of the two groups were compared. Results: There was no difference in the total effective rate between the two groups (P>0.05); After treatment, IL-6, IL-1 and TNFα were found in the two groups The levels of inflammatory factors in the observation group were lower than those in the control group (P<0.05); Before treatment, there was no difference between the two groups in the quantitative score of endoscopic nasal mucosa morphology (P>0.05) for patients with rhinorrhea, scab, scar, mucosal edema, polyp, purulent secretion, etc. After treatment, the quantitative score of endoscopic nasal mucosa morphology in patients with rhinorrhea, scab, scar, mucosal edema, polyp, purulent secretion, etc. decreased in the two groups, and the observation group was different with control group (P<0.05); There was no difference in the olfactory recognition threshold and saccharin test time between the two groups before treatment (P>0.05). After treatment, the olfactory recognition threshold and saccharin test time of the two groups decreased, and the observation group were different with control group (P<0.05). Conclusion: Lydesloratadine before endoscopic sinus surgery has a significant clinical effect on chronic sinusitis, and can reduce the level of inflammatory factors in patients after surgery, improve the morphology of nasal mucosa, enhance ciliary motor function and olfactory function, which is worthy of clinical application and promotion. [ABSTRACT FROM AUTHOR]

Background: Epistaxis is a common condition but with diverse etiology dependent on geography, season, climate, and demography. Aims and Objectives: To describe the demographic, clinical, and etiological profile and management strategies of epistaxis cases at a tertiary center in U.P. (west). Materials and Methods: Patients were identified from the emergency and outpatient department, and their demographic and clinical details were noted. Local examination was performed, and necessary investigations were carried out. Management strategies were noted. Duration of hospital stay and mortality, if any, was documented. Descriptive analytics were used. Data were represented as numbers and percentages, mean±standard deviation, and median. Results: A total of 189 epistaxis patients were enrolled in the study. The mean age of patients was 32.89±17.92 (range 1-85 years). The sex ratio (M: F) was 2.71. Majority of patients presented to the emergency department (60.3%) within 1 day (64.6%), had single episode (66.7%), the presence of old clot (72%) and the anterior location of bleeding (91.5%). 119 (63%) cases required admission. Nasal endoscopy and computed tomography scan were performed in 49 (25.9%) and 24 (12.7%) cases, respectively. The most common etiology was trauma (49.2%), followed by idiopathic cause (14.8%), hypertension (12.7%), and others. Nasal packing and cauterization were required in 16.4% and 15.9% of cases, respectively. Surgery was required in 5 (2.6%) cases. A minuscule percentage of cases required blood transfusion. There was no mortality. Conclusion: Epistaxis is a common emergency with males predominating over females. Causes are varied. Most patients can be managed conservatively with favorable outcomes if timely intervention is done. [ABSTRACT FROM AUTHOR]

Copyright of Polish Otorhinolaryngological Review / Polski Przegląd Otorynolaryngologiczny (Index Copernicus) is the property of Index Copernicus International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This review summarizes the challenges and adaptations that have taken place in rhinology and facial plastics in response to the ongoing coronavirus disease-19 pandemic. In particular, the prolonged exposure and manipulation of the nasal and oral cavities portend a high risk of viral transmission. We discuss evidence-based recommendations to mitigate the risk of viral transmission through novel techniques and device implementation as well as increasing conservative management of certain pathologies.

Introduction: The definitive management of complete nasolacrimal duct obstruction from chronic dacryocystitis is surgical. The surgery of choice is dacryocystorhinostomy (DCR), which can be done external or endonasal with or without stenting. We aim to compare the anatomical and functional outcomes of endoscopic endonasal DCR with and without stenting. Materials and Methods: This prospective study was carried out involving 30 patients of either sex randomly divided into two groups of 15 patients each. Group A underwent endoscopic DCR with stenting of the canaliculi, whereas Group B underwent endoscopic DCR without stenting. These patients were followed up at week 1, 6, and 12. The success of surgery in each group was determined by the absence of epiphora (Munk scale grades: 0 and 1), patent ostium on irrigation, positive Jones test, and decrease in the marginal tear film volume as seen on dye disappearance test (grade: 0 and 1) at week 12. Final data were analyzed using SPSS 21 version. Results: About 86.6% success rate was noted in the group where stenting was done (Group A) compared to 100% success in the group without stenting (Group B). This difference was, however, not statistically significant (P = 0.143). Failures in the study were attributed to the closure of rhinostomy ostium at week 12 follow-up. The most common complication noted was postoperative pain around the bridge of nose. Stent-related complications such as conjunctivitis and difficulty in removal of the stent were also noted. Conclusion: In our study, the surgical results of endoscopic endonasal DCR without stenting were better than endoscopic dacryocystorhinostomy with stenting both anatomically as well as functionally.

Introduction: Inverted papilloma is the most common benign tumour of the sinonasal region characterized by a locally destructive growth pattern, a tendency to recur, and a risk of malignant alteration. It grows from the epithelium of the sinonasal mucosa. One of its clinical signs is epistaxis, which is an emergency condition. This case report aims to acquaint Emergency Medicine physicians with inverted papilloma as an emergency condition in some patients. Case report: A 75-year-old woman presented to our Ear, Nose and Throat Emergency Room complaining of repetitive left-sided nose bleeds. Clinically, histopathologically, and using radiology scans, we confirmed the diagnosis of inverted papilloma and the patient was surgically treated. Conclusion: In patients with recurrent nose bleeds, an accurate diagnosis of inverted papilloma is needed for planning surgical treatment to avoid recurrence, local destruction and malignant alteration of the tumour.