Nasal mucociliary clearance is a primary physiological defense mechanism of upper as well as lower respiratory tract, and thus maintains the state of health of the respiratory tract. Any disturbance in number or movement of cilia and change in character or amount of mucus production leads to an altered nasal mucociliary clearance. The present study was undertaken to study the effect of aging on nasal mucociliary clearance.

Nasal mucociliary clearance time was assessed in 240 normal subjects, 120 males and 120 females, which were divided in six groups, each comprising of one decade starting from 11 to 20 years. The mean nasal mucociliary clearance time ranged 7.34 to 14.48 minutes in males and 7.36 to 15.38 minutes in females in different groups (A-F). There was no statistical difference between males and females in each group (p > 0.05). The nasal mucociliary clearance time was not found to be increased till 5th decade (p = 0.05). However, the nasal mucociliary clearance time was found to be increased in 6th and 7th decades (group E&F) significantly (p 0.001), which was more marked in group F. This may explain the increased susceptibility of elderly to sinusitis chronic bronchitis, deep lung infections and increased incidence of pneumonia.

Successful outcome of endoscopic sinus surgery depends on complete visualization of the operative field and intraoperative control of bleeding. Major disadvantage of general anesthesia is the increased bleeding encountered, which can interfere with optimum visualization of the intranasal anatomy unless hypotensive methods are used.

To study the different anesthetic techniques in relation to their impact on blood loss and duration of surgery. The role of propofol was also evaluated.

Department of Anesthesia and ENT, Head and Neck Surgery, KVG Medical College and Hospital, Sullia, Karnataka, India.

213 cases of endoscopic sinus surgeries done for nasal polyposis, sinusitis, dacryocystitis and septorhinoplasties under local and general anesthesia were evaluated between June 2009 and August 2010.

A good operative field was seen with propofol anesthesia compared to halothane anesthesia. The problems of fogging and frequent suctioning were lesser with propofol hypotensive anesthesia.

Hypotensive anesthesia using propofol infusion is the anesthesia of choice for extensive nasal polyposis. Propofol when used both for induction as well as maintenance of general anesthesia in endoscopic sinus surgeries significantly reduces the blood loss, thereby improving the visibility of the endonasal structures and minimizes the chance of complications related to endoscopic sinus surgery.

Plaster of Paris (POP), thermoplastic splints and self-adhesive padded aluminium splints are the most common splinting methods used after reduction of fractured nasal bones and rhinoplasty. All these methods have their proponents but may have one or more disadvantages in the way of being cumbersome, time-consuming, bulky, conspicuous and expensive.

A retrospective study at KVG Medical College and Hospital, department of ENT and head and neck surgery.

94 cases of splinting done for nasal bone fractures and rhinoplasties were included in our study. POP and adhesive aluminium splints were used to stabilize the nasal framework.

Eleven cases of nondislocated nasal fractures and 10 cases of internal augmentation rhinoplasties were stabilized by aluminium nasal splints. 69 cases of displaced nasal fractures and 4 cases of external rhinoplasties were stabilized by POP splints.

POP splints give the best stabilization for nasal bone fractures as well as for rhinoplasties but are bulky and conspicuous. Aluminium nasal splints are not bulky and conspicuous but cannot be used for fractures with lacerations and external rhinoplasties.

Sphenoid sinus lesions can present with a multitude of symptoms/signs including ophthalmic disturbances.

We describe a total of five patients, of which two had mucoceles and rest three had fungal infection. Ophthalmic symptoms/signs were the ones we were really interested in. We also present one case which had isolated sphenoid fungal sinus. We also give details of their presentation, investigations and treatment. Possible ocular manifestations of mucoceles and the diagnostic imaging techniques used are discussed. The treatment of mucoceles is reviewed. It is stressed that a team approach involving the ophthalmologist, otolaryngologist and radiologist is essential for accurate diagnosis and management.

Invasive sinus aspergillosis infection has been reported with increasing frequency in the last decade, especially, in immunocompromised patients with chronic invasive sinus aspergillosis (CISA). The gold standard for treatment has been wide surgical debridement, intravenous administration of antifungal agents, such as amphotericin B, but the prognosis remains poor. Newer antifungal agents are being tried but no standard treatment option with new antifungal agents has yet been established for chronic invasive fungal sinusitis. Therefore, we undertook this study to evaluate the efficacy of voriconazole in patients of chronic invasive sinus aspergillosis.

This study is a prospective randomized unblinded study with primary aim of evaluating the feasibility and effectivity of voriconazole in patients of chronic invasive sinus aspergillosis with intraorbital or intracranial extension, and secondarily to compare voriconazole with amphotericin B therapy in patients with chronic invasive sinus aspergillosis.

Thirty-three patients who fulfilled the eligibility criteria were included in this study. There were 18 patients enrolled in group I who received amphotericin therapy and 15 patients in group II who received voriconazole therapy. Out of 33 patients, 9 patients had complete response, 10 had partial response, in eight patients disease became stable and there were seven failures. Overall 50% patients had a successful outcome in group I, whereas 60% had a successful outcome in group II receiving oral voriconazole. On comparing only in extradural group, 5/10 had a successful outcome in group I receiving amphotericin B, whereas 8/12 (66.7%) had a successful outcome in group 2 receiving voriconazole. There was significant difference between adverse reactions of the two drugs, with amphotericin B having a significant renal and cardiotoxicity as compared to voriconazole; though patients on voriconazole developed skin rashes which were transient and disappeared on completion of the therapy.

The present series demonstrates that oral voriconazole can be the primary line of therapy in chronic invasive sinus aspergillosis in carefully monitored immunocompetent cases. Multicentric, randomized studies are required to define disease definition, duration and successful outcome.

Invasive sinus aspergillosis infection has been reported with increasing frequency in the last decade, especially, in immunocompromised patients with chronic invasive sinus aspergillosis (CISA). The gold standard for treatment has been wide surgical debridement, intravenous administration of antifungal agents, such as amphotericin B, but the prognosis remains poor. Newer antifungal agents are being tried but no standard treatment option with new antifungal agents has yet been established for chronic invasive fungal sinusitis. Therefore, we undertook this study to evaluate the efficacy of voriconazole in patients of chronic invasive sinus aspergillosis.

This study is a prospective randomized unblinded study with primary aim of evaluating the feasibility and effectivity of voriconazole in patients of chronic invasive sinus aspergillosis with intraorbital or intracranial extension, and secondarily to compare voriconazole with amphotericin B therapy in patients with chronic invasive sinus aspergillosis.

Thirty-three patients who fulfilled the eligibility criteria were included in this study. There were 18 patients enrolled in group I who received amphotericin therapy and 15 patients in group II who received voriconazole therapy. Out of 33 patients, 9 patients had complete response, 10 had partial response, in eight patients disease became stable and there were seven failures. Overall 50% patients had a successful outcome in group I, whereas 60% had a successful outcome in group II receiving oral voriconazole. On comparing only in extradural group, 5/10 had a successful outcome in group I receiving amphotericin B, whereas 8/12 (66.7%) had a successful outcome in group 2 receiving voriconazole. There was significant difference between adverse reactions of the two drugs, with amphotericin B having a significant renal and cardiotoxicity as compared to voriconazole; though patients on voriconazole developed skin rashes which were transient and disappeared on completion of the therapy.

The present series demonstrates that oral voriconazole can be the primary line of therapy in chronic invasive sinus aspergillosis in carefully monitored immunocompetent cases. Multicentric, randomized studies are required to define disease definition, duration and successful outcome.

Tuberculosis of nose, nasopharynx and paranasal sinus is extremely rare even in countries with a high incidence of pulmonary disease. We present two cases of primary nasal tuberculosis managed in last three years in our department with 2500 to 3000 patient visits per month. One case simulated basal cell carcinoma while other case was an ATT defaulter. Both the cases were managed on RNTCP guidelines. Nasal tuberculosis needs high level of suspicion and is diagnosed with laboratory support.

Contrast enhanced computed tomography (CECT), Magnetic resonance imaging (MRI).

Nasogastric tubes are commonly used in hospitals for both feeding and/or decompression of the upper gastrointestinal tract. We present a case of a forgotten nasogastric tube coincidentally found, four years after difficult removal, lodged in the nose and nasopharynx. We also describe the problems of knotted nasogastric tubes and different methods of removal.

Leech infestations are known as hirudiniasis.1 Leeches are blood-sucking hermaphroditic parasites that vary in color and range in length from a few millimeters to half a meter. They enter the human body through drinking water, and localize on the mucosa of the upper aerodigestive tract.2 In this paper, we present a case with one month history of intermittent epistaxis and nasal obstruction. The cause was found to be a leech in the nose by means of endoscopic examination. We used an easy method to remove the parasite.

Adenomatoid odontogenic tumor (AOT) is an uncommon tumor of odontogenic origin, constituting only 3% of all odontogenic tumors. AOT is characterized histologically by the formation of duct-like structures with amyloid-like deposits.

An 18-year-old male presented with right chek swelling. CT scan revealed well-defined expansile heterogeneous mass with central hypodensity. Patient underwent excision of the mass by Caldwell-luc approach and histopathologically the diagnosis adenomatoid odontogenic tumor was made. Since it is a benign tumor, the treatment should consist of enucleation and curettage.

Rhinophyma is a rare disease which causes disfiguring soft tissue hypertrophy of the nose. Various medical and surgical treatment modalities have been proposed and tried with varying degree of success. We report a case where we adopted excision of the rhinophymatous tissue and reconstructed with the local nasolabial flap. The result was cosmetically good enough and the procedure technically simple.

The antrochoanal polyp or Killian's polyp is a benign, solitary lesion that affects mainly children and young adults. It is unilateral in occurrence though a few cases of bilateral antrochoanal polyps have also been reported.

We report a unilateral antrochoanal polyp extending to the opposite side, a presentation not mentioned in literature till date.