Inhaled glucocorticoids are very effective for the management of seasonal and perennial allergic rhinitis. Various glucocorticoids are available for inhalation therapy with varying affinity for the receptors. Inhaled glucocorticoids have very low incidence of systemic side effects at the usual therapeutic doses. In this review we have discussed the pharmacokinetics, pharmacodynamics and adverse effects profile of the commonly available inhaled glucocorticoids.

Endoscopic dacryocystorhinostomy is an established surgery for nasolacrimal duct block. We did a prospective study to evaluate the results and advantages. All the 90 patients underwent endoscopic DCR and 26 patients had septoplasty simultaneously. Postoperative evaluation of patency and relief of symptoms was done up to 6th month. Our study concludes that endoscopic. DCR is a safe, simple procedure with a better success rate and fewer complications along with review of literature.

Twenty patients who presented to the ENT, head and neck department with nasal septal abscess were retrospectively studied.

Retrospective study.

KVG Medical College and Hospital, Sullia.

January 2006 to June 2010 (54 months)

Twenty patients (17 males and 3 females), aged between 7 to 45 years (average age 25.25 years), with nasal septal abscess were studied.

All patients were admitted and posted for emergency incision and drainage under antibiotic cover. In 13 cases the destroyed septal cartilage was repaired with autologous conchal cartilage in the same sitting of incision and drainage. In two cases the same procedure was done in two different sittings.

Sixteen patients were implanted autologous conchal cartilage at time of incision and drainage and most of them doing well at 6 months of follow-up.

Nasal septal abscess promptly treated under antibiotic cover total reconstruction of abscess-induced destruction of nasal septal cartilage with patients own conchal cartilage grafts so far, resulted in normal dorsum of the nose being retained during follow-up.

Aspirates from 50 chronically inflamed maxillary sinuses were processed for aerobic and anaerobic bacteria. Bacterial growth was present in 48 (96%) specimens. There were 110 bacterial isolates (2.2/specimen). Forty of the isolates were aerobic or facultative organisms (0.8/ specimen). The predominant aerobic or facultative organisms were Staphylococcus aureus, coagulase-negative staphylococcus (CNS), S. pneumoniae, E. coli, H. influenzae and P. aeruginosa. Seventy anaerobes were isolated (1.4/specimen), Prevotella spp, Peptostreptococcus spp., Porphyromonas spp. and bacteroides spp. being predominant. These findings illustrate the presence of polymicrobial aerobic-anaerobic flora in patients with chronic maxillary sinusitis.

Chronic rhinosinusitis (CRS) is a very common disorder in ENT practice. There are many modalities available for the treatment and control of symptoms of allergic rhinosinusitis, varying from antihistamines, corticosteroids, mast cell stabilizers in oral and topical formulations.

The present study was planned to see the influence of nasal saline irrigation on symptomatology of chronic rhinosinusitis.

Qualitative study using a questionnaire.

Nasal saline irrigation (NSI) was advised to 53 patients twice a day along with anti-allergic treatment. The control group consists of 47 allergic patients who received only anti-allergic treatment.

The symptom score significantly (p < 0.001) improved in the group 1 patients using nasal saline irrigation along with anti-allergic treatment.

the results of the study suggest that concomitant use of NSI with anti-allergic treatment gives much more satisfactory results than with only anti-allergic treatment in patients with chronic rhinosinusitis.

Endoscopic sinus surgery is recommended when the medical treatment fails. To ensure a successful surgical outcome, one needs to have a good radiological back up in form of axial, coronal and sagittal reconstruction, hypotensive anethesia and powered instruments.

To analyze the results of oral voriconazole following optimum management protocol for invasive sino-orbital aspergillosis.

It was a prospective study wherein all immunocompetent cases with a final histopathological diagnosis of invasive sino-orbital aspergillosis were included from a period between Jan 2007 till Dec 2009. All cases were evaluated clinically and radiologically for the condition and were classified into four groups on clinical and radiological basis. All cases were subjected to endonasal endoscopic biopsy and were subjected as per the optimum management protocol. These were then followed up for a period ranging from 6 months to 3 years clinically, endoscopically and radiologically.

There were 15 cases enrolled for the study. There were 10 males and 5 females with age ranging from 14 to 43 years. The most common sign was proptosis. The cases in each group were subjected to the treatment protocol decided for the group. Residual disease was seen in 2 cases (13.34%) and recurrence was seen in 1 case (6.67%). One patient (6.67%) died of disease in our series.

Invasive sino-orbital aspergillosis is associated with significant morbidity and mortality. In our study, voriconazole was found to drastically improve the outcome of sino-orbital aspergillosis.

We present a case of 53 years old male who developed reddish thickening on sclera and was diagnosed as scleral maltoma after investigations. Primary scleral involvement remains only a theoretical possibility and has never been documented in literature except for one odd case report where orbital lymphoma was misdiagnosed as scleritis but later proved to be of conjunctival origin by histology.1 This case report has been brought up to highlight the technical challenges faced in planning and execution of external radiation therapy in primary scleral lymphoma.

A button battery inserted in the nose of children is an unusual foreign body which is capable of causing extensive tissue damage, resulting from electrical and chemical burns. We report a case of an ignored button battery in the nose of a 4 years old presenting with unilateral discharge and bleeding along with pain in the left nasal cavity. The foreign body was removed using endoscope but it had perforated the septum by the time. We report this case to emphasise the hazards of button battery impaction and the value of early diagnosis and treatment to prevent serious complications.

Osteoma and nasal polyposis are common benign conditions seen by ENT practitioner, however it is very rare that both of them present together. Osteoma is the most common neoplasm of the nose and paranasal sinuses. It is commonly asymptomatic, being an incidental finding 1% of plain sinus radiographs and 3% CT scans of sinus. In an extensive review of english literature, we could not find any case reported having large osteoma with bilateral nasal polyposis. We found only two reported cases of osseous metaplasia in cases of nasal polyps but not ivory osteoma hence bilateral nasal polyposis can radiologically have association with osteoma and should be investigated and treated accordingly.

There has been a single case reported in the Spanish literature though. In current case report, we present a case of patient with bilateral nasal polyposis accompanied with unilateral frontoethmoid osteoma.

Extranasopharyngeal angiofibromas are rare tumors with only 65 cases being reported in the world literature. The most common sites involved are maxillary sinus, ethmoid sinus, sphenoid sinus, nasal septum, middle turbinate, inferior turbinate, cheek, conjunctiva, pterygomaxillary fissure, infratemporal fossa and laryngotracheal tree. We report on a case of 18 years old male patient of extranasopharyngeal angiofibroma of nasal septum.

Bilateral antrochoanal (AC) polyps have been rarely reported in english literature. Here we report the first case of an adolescent male with bilateral AC polyps, cystic fibrosis and diabetes. The case was managed successfully by functional endoscopic sinus surgery (FESS). The patient has been under follow-up for the last six months with no signs of recurrence.

Term Giant Cell Reparative Granuloma (GCRG) a non-neoplastic lesion characterized by a proliferation of granulation tissue containing numerous multinucleated giant cells was introduced by Jaffe in 1953 to describe an apparently reactive intraosseous lesion of the mandible and maxilla following trauma induced intraosseous hemorrhage. It is a disease of the young presenting as a painless swelling in the anterior jaw. It appears on radiology as a unilocular or multilocular radiolucency with a characteristic tendency of resorbing the root tips of adjacent unerupted teeth. A central giant cell granuloma of the maxilla is presented, which was diagnosed in a seventeen-year-old male and surgically treated.

Rare cases of fungal balls of paranasal sinuses in children. No case has been reported in young children so far. However, allergic aspergillosis has been reported in young children.

A case report of 2 cases of fungal balls of paranasal sinuses in children and review of the current literature concerning fungal balls of paranasal sinuses in children are presented.

2 cases of fungal balls in paranasal sinuses were diagnosed in children of 9 and 10 years respectively. Both of them presented with nasal obstruction and eye signs provisional diagnosis was based on CT scan findings. FESS was done and fungal balls were subjected to histopathological examination to rule out invasive fungal sinusitis, fungal staining and culture were done which confirmed the diagnosis of Aspergillosis.

To our knowledge this is the first case report of fungal balls in PNS in children in otolaryngology literature. Both the patients were males with age of 9 and 10 years respectively.

Hemangiopericytomas of the sinonasal cavity are relatively rare tumors. Most of them are essentially benign though malignant potential and metastasis to distant sites has also been reported. Treatment options usually involve external approaches. We hereby discuss the combined endoscopic and transoral approach to these tumors.