Common Cause Of Nasal Obstruction Research Articles

Effectiveness of Adenoidectomy as a Standalone Procedure in Improving the Quality of Life of Children with Obstructive Sleep Apnea.

Adenoid hypertrophy (AH) and its sequel like nasal obstruction, obstructive sleep apnoea (OSA), recurrent rhinitis and middle ear disorders are common diseases of pediatric age group, forming the major bulk of pediatric outpatient visits. The recommended approach to treating OSA in children is through adenotonsillectomy. Adenoidectomy is the surgical procedure of removal of hypertrophied adenoid tissues, which is the most common surgery performed by Ear, Nose, and Throat (ENT) surgeons. Given that adenoidectomy alone might lead to reduced instances of adverse outcomes, decreased risk of complications, and lower expenses, our objective was to explore the viability and suitability of adenoidectomy as a standalone treatment for pediatric OSA and to learn the significant effect of adenoidectomy on the quality of life (QOL) of children. Multicentric prospective study conducted in Department of ENT, Head and Neck Oncosurgery, Smita Memorial Hospital, Thodupuzha & Department of ENT, Head and Neck surgery, MCS Hospital, Muvattupuzha, Kerala, India from June 2022 to June 2023. Children between the age group of 5-10 years, who underwent adenoidectomy during the study period, satisfying the inclusion criteria were subjected for the study. Adenoidectomy was done for them using endoscope assisted coblation technique. Postoperative improvement in symptoms and change in quality of life were analyzed using obstructive sleep disorders-6 (OSD-6) questionnaire at the end of 3 months follow up. The surgeon observed a statistically significant improvement in all domains of OSD-6; and there by improvement in QOL in all patients, who underwent adenoidectomy in a course of three months. Adenoid hypertrophy is the most common cause of nasal obstruction in pediatric population and is creating a significant negative impact on the quality of life of children. Adenoidectomy is a safe and simple procedure which can provide significant improvement in quality of life of kids. Adenoidectomy in isolation could be a valid and recommended surgical choice for selected population of children displaying symptoms of pediatric OSA.

Correlation between tympanometric findings and adenoid hypertrophy among children without hearing loss in tertiary care hospital

Adenoid hyperplasia is a common cause of nasal obstruction in children. Chronic infection and hypertrophy result in mouth breathing, snoring, sleep apnoea, hyponasality, sinusitis, and otitis media with effusion (OME). Some children with adenoid hypertrophy have OME in spite of having no complaints of hearing loss. Untreated OME may adversely affect the speech and intellectual development of the child.Aim To determine whether there is a correlation between tympanometric findings and various radiological and endoscopic grades of adenoid hypertrophy.To propose a combination of radiological and/or endoscopic assessment of adenoids and tympanometry as a screening program in patients with suspicion of adenoid hypertrophy.Materials and methods One hundred children, presenting with one or more complaints of upper airway obstruction (UAO), suggestive of adenoid hypertrophy, without a history of hearing loss, to the OPD, were chosen for the study. X-ray nasopharynx soft tissue lateral view was done for all patients. Rigid diagnostic nasal endoscopy with 0° endoscope was conducted in only children who were cooperative and with parental consent. Tympanometry was carried out for all patients and plotted on tympanograms.Results In our study, the mean age of children is 9.43 ± 2.430 years with gender distribution being 57% males and 43% females. The majority of children tend to present with nasal obstruction (100%), mouth breathing (83%), and snoring (56%). On both radiological and endoscopic evaluation of adenoids and correlation with tympanogram, a significantly higher number of patients with Grade 1 adenoids have a type A curve, while a significantly higher number of grade 3 adenoids patients have a type B curve and type C is significantly more prevalent in grade 2 and grade 4 adenoids (p < 0.05).Conclusion In our study, adenoid size as measured from both adenoid X-ray and adenoid endoscopy, showed a significant association with the presence of middle ear effusion and also with eustachian tube dysfunction. This helps in early detection, prior to the development of hearing loss, making it easy to plan early intervention, and curbing the possibility of aggravation of the condition and occurrence of complications.

Septoplasty- Does It Change the Quality of Life in Patients Having Nasal Obstruction?

Introduction: Deviated nasal septum (DNS) is one of the most common causes of nasal obstruction. However, there are several other etiologies which cause difficulty in nasal breathing. The definitive treatment of symptomatic DNS is septoplasty. The efficacy of septoplasty remains controversial as there are no solid tools for clinical evaluation of patients for establishment of reliable statistical data. Our aim was to evaluate patients who have undergone septoplasty for symptomatic DNS, by following them up with the NOSE questionnaire for predicting the surgical efficacy of septoplasty. Materials and Methods: This was a prospective observational study, conducted over 1 year. 50 cases of either sex of 18-65 years, having symptomatic DNS not relieved by medical management, and corrected by isolated septoplasty were included. The primary outcome was measured by the NOSE questionnaire, applied before surgery, and 6th week and 12th week after the procedure from which the 12th week nasal score was taken into consideration. Results: The paired T test done among the variables showed a clear significance, proving the efficacy of the NOSE score in predicting the symptom reducing efficiency of septoplasty Conclusion: The NOSE score can be used as a regular quality scoring system in analysing the outcomes of septoplasty.

Postseptoplasty Quality of Life among Patients in Aseer Region, Saudi Arabia

Background: Deviated nasal septum is among the most common causes of nasal obstruction (NO) in adults. The efficacy of septoplasty for the treatment of septal deviation and the predictors of satisfactory surgical outcomes remains controversial. A significant improvement in the preoperative NO symptom evaluation score was noted after 3 months. Septoplasty resulted in a significant improvement in the disease-specific quality of life (QOL). Aim: The aim was to examine the postseptoplasty QoL and symptoms in patients in Aseer region, Saudi Arabia. Methodology: A descriptive follow-up study was conducted to assess postseptoplasty QoL in patients who underwent surgery from 2020 to 2022. Patients with psychological, behavioral, and severe chronic health problems were excluded. Information on demographic data and postsurgical symptoms was collected. QoL was assessed using the Sino-Nasal Outcome Test 20 questionnaire. Results: A total of 246 patients who underwent septoplasty were included. Patients' age ranged from 19 to 55 years, with a mean age of 33.6 years. Furthermore, 148 (60.2%) patients were men and 104 (42.3%) were aged &gt; 40 years. In terms of rhinological symptoms, 87.8% of the patients reported their need to blow nose, 82.9% had sneezing, 72.8% had a runny nose, 69.6% complained of thick nasal discharge, and 69.1% had postsurgical discharge. Furthermore, 43.5%, 43.9%, 41.1%, 40.7%, 32.9%, and 30.9% of the patients experienced NO, headache, oral breathing, sinusitis, smell disturbance, and snoring, respectively. Conclusions and Recommendations: A clinically significant improvement was noted in olfactory and rhinological symptoms after septoplasty and thus QoL. Psychological and otorhinological functions showed more improvement than rhinological functions.

Surgical Outcomes of Endoscopic Versus Conventional Septoplasty.

The most common cause of nasal obstruction is a deviated nasal septum. It causes breathing difficulties and may eventually also cause sinusitis, epistaxis, sleep disturbances and snoring. The traditional surgeries of the nasal septum improve the nasal airway but do not fulfil the essential criteria in most instances. Endoscopic septoplasty is a fast-developing concept and gaining popularity as it provides a direct targeted approach to the septal anatomic deformity allowing a minimally invasive procedure under excellent visualization. The aim of this study is to compare the post-operative morbidity among conventional and endoscopic septoplasty. The present prospective study was conducted on 50 patients having deviated nasal septum. Patients were randomly divided into two groups of 25 each. Out of 50 patients, in 25 patients (Group A) Conventional septoplasty was done, whereas in other 25 patients (Group B) endoscopic septoplasty was done. The patients were followed up post-operatively at 2weeks, 4weeks and 8weeks. Study Design: comparative study. The mean of operating time (min) in Group A was 60.47 ± 8.16 which was significantly higher as compared to Group B (39.7 ± 6.73). (p value < .0001). The Mean of blood loss (mL) was significantly higher in Group A (88.67 ± 8.77) as compared to Group B. (54.6 ± 7.18). (p value < .0001). Post-operative NOSE score at one month was 7.33 ± 1.5 in group A which was significantly higher as compared to Group B (5 ± 1.41). (p value = 0.0007) whereas post-operative NOSE score at 3months in Group A was 6.53 ± 1.25 which was significantly higher as compared to Group B (4.4 ± 1.78). Proportion of post-operative complications was comparable in Group A and Group B (No complication 80% vs. 92% respectively). According to the present study, both the conventional and endoscopic septoplasty procedures were effective in relieving nasal obstruction in the patients. Endoscopic septoplasty showed significantly better result than conventional septoplasty in terms of time taken for surgery, blood loss during the surgery, post-operative complications and in terms of quality of life as assessed by NOSE Score.

Evaluation of endoscopic septoplasty outcomes using nasal obstruction symptom evaluation scale

Inroduction: Nasal obstruction is the most common complaint in an average ENT practice, and a deviated nasal septum is the most common cause of nasal obstruction. The deformities of the septum are usually congenital, developmental, traumatic, or iatrogenic in nature with traumatic and iatrogenic being the most common. The aim of the study was to evaluate patient-based outcomes on subjective-based opinion in patients undergoing endoscopic septoplasty. Methods: This study was conducted in a tertiary care hospital setting in western Maharashtra. This was a prospective observational study.The present study was conducted on 50 patients who presented with signs and symptoms attributed to septal deviation who underwent endoscopic septoplasty and followed up in the department of otorhinolaryngology, head and neck surgery, tertiary care hospital, Mumbai, Maharashtra.The results of our study were analyzed on SPSS Software using “Paired t-test”. Results: On the statistical analysis of the Nasal Obstruction Symptom Evaluation score of patients (n = 50) at baseline and at postoperative 3- and 6-month follow-up, mean + standard deviation was 61.2 ± 11.18, 9.1 ± 5.32, and 8.1 ± 4.51, respectively, with P < 0.0001 preoperative and 3-month postoperative follow-up which is highly significant and P > 0.05 for 3- and 6-month follow-up and hence insignificant. Conclusion: Endoscopic septoplasty results in significant improvement in disease-specific quality of life with high patient satisfaction.

Inferior Turbinate Hypertrophy: A Comparison of Surgical Techniques.

Introduction Nasal obstruction is one of the most frequently reported symptoms in clinical practice. The second most common causeof nasal obstruction is inferior turbinate hypertrophy, a nasal pathology for which surgical treatmentis often required. This study aims to determine the most effective surgical method in patients with inferior turbinate hypertrophy (ITH). Materials and methods The studywas performed from September 2018 to October 2019 in the Otolaryngology-Head and Neck Surgery Department of the Evangelismos Hospital of Athens.The study population comprised 205 patients that underwent surgery and were monitored in the hospital.Radiofrequency ablation (RFA) was the method used in 73 patients, 68 patients were treated with the microdebrider-assisted turbinoplasty (MAT), and the remaining 64 patients were operated on using electrocautery (EC). Following surgery,postoperative complications were assessed and quantified. Results Overall, 205 patients underwent surgery. The first group (n=73) was operated on using radiofrequency ablation and had a complication rate of 30.1%. Out of 73patients, 51 recovered without complications. The remaining 22 had complications, consisting of 16patients with bleeding and six with postnasal drip. The second group (n=68) was treated using the microdebrider method. The complication rate was 26.5%, where 50 patients did not present with any symptoms post-operativelyand 18 exhibited symptoms. Specifically, postnasal drip was more prevalent with this method as all 18 patients showed postnasal drip as their complication. The third group (n=64) was treated with electrocautery. Patients in this group had the most complications (n=24),16 were attributed to postnasal drip and eight to infections, treated promptly with oral antibiotics. The complication rate using this method was 37.5%. Conclusion In our study, the microdebrider-assisted turbinoplasty offered the lowest complication rate, followed by radiofrequency ablation and electrocautery. However, all three methods managed to alleviate the nasal obstruction and treat inferior turbinate hypertrophy. More research is needed as a lack of consensus remains regarding the optimal surgical technique for lower turbinate hypertrophy.

Comparison of Conventional Surgical Turbinoplasty Versus Microdebrider Assisted Turbinoplasty in Cases of Inferior Turbinate Hypertrophy

Objective: To compare the conventional surgical turbinoplasty versus microdebrider assisted turbinoplasty in cases of inferior turbinate hypertrophy. Design of the Study: It was a cross-sectional survey. Place and Duration of Study: This study was carried at the Department of ENT Nishtar Medical University and Hospital, Multan from January 2022 to June 2022. Patients and Methods: Patients with hypertrophy of the inferior turbinates, the most common cause of nasal obstruction, were split into two groups of 30. The size of the inferior turbinates was classified as Grade I if they took up less than a third of the nasal cavity, Grade II if they took up more than a third but less than half, and Grade III if they took up more than half. Each group had either a standard partial inferior turbinectomy or a turbinoplasty with the help of a microdebrider. Visual evaluation was used to categorise blood loss during and after surgery. Patients were checked on at 1, 2, 4, and 6 months after surgery. Relief from symptoms and the occurrence of problems such crusting and synechiae formation were evaluated. Results of the Study: Both groups showed comparable significant improvements in nasal blockage. Most patients in the CPIT group experienced intraoperative blood loss of grade II (66.66%) or grade III (10%). When the packs were taken off, 60% of patients experienced grade I blood loss, 36.66% experienced grade II blood loss, and 3% experienced grade III blood loss after surgery. Most patients (46%) and surgeons (40%) in the MAT group experienced grade II or higher intraoperative blood loss. The majority of patients' postoperative blood loss was classified as grade I. Six months later, 6.66 percent of the CPIT group had acquired crusting, and 6.66 percent had developed synechiae. Those that received MAT did not have these problems. Practical implication: The choice of surgical procedure is up to the surgeon's attitude and experience due to the lack of agreement regarding their efficacy. That’s why we compared the effectiveness of these treatment methods for turbinate reduction in order to provide evidence to evaluate the results of the several surgical techniques in local population. Conclusion: According to the findings, both surgical approaches are effective in addressing nasal blockage. Complications are less likely to occur with microdebrider-assisted inferior turbinoplasty since the mucosa and nasal physiology are preserved. Keywords: Microdebrider assisted inferior turbinoplasty, Hypertrophied inferior turbinate, Conventional partial inferior turbinectomy,

Otolaryngologists' radiological assessment of nasal septum deviation symptomatology.

Nasal Septal Deviation (NSD) is one of the most common causes of nasal obstruction. This study aims to further examine the clinical utility of imaging assessment in the workup and management of symptomatic nasal septal deviation, across all levels of medical training. Cross-sectional survey. CT scans of 10 confirmed NSD patients and 36 healthy controls (HC) were mixed and emailed through anonymous REDCap surveys to otolaryngologists in the US. The HC had no reported sinonasal obstruction symptoms-NOSE (NSD: 62.2 ± 12.5; HC: 5.69 ± 5.99, p < 0.05); SNOT-22 (NSD: 31.4 ± 14.5; HC: 9.72 ± 10.76, p < 0.05).The images consisted of a coronal slice at each subject's most deviated location. Participants were instructed to choose the patients suspected to present with symptoms of sinonasal obstruction. 88 otolaryngologists responded to the survey. 18 were excluded due to incomplete responses. On average, they identified 64.2 ± 29.8% of symptomatic NSD subjects correctly, but misidentified 54.6 ± 34.6% of HC as symptomatic. Their decisions were strongly correlated to degree of NSD (r = 0.69, p < 0.05). There exists a significant degree of NSD among HC (38.7 ± 17.2%), which does not significantly differ from symptomatic subjects (51.0 + 18.7%, p = 0.09). Residents and fellows performed similarly, with responses correlated between levels of training (r = 0.84-0.96, p < 0.05). The incorporation of a substantial number of otolaryngologists, large patient sample, and blind mixing with HC gives us greater insight to the relative contribution of the extent of septal deviation to symptoms of nasal obstruction. Although NSD is a common factor contributing to nasal obstruction, the results of this study suggest that it is difficult to reliably infer obstructive symptoms based on degree of NSD on CT. Three.

Effectiveness of Septoplasty in Releiving Nasal Obstruction in Patients with Deviated Nasal Septum

Background: Nasal obstruction has many causes and can range from mild feeling unwell to a life-threatening condition. Deviated nasal septum is the most common cause of nasal obstruction, which mostly occur due to trauma. Septoplasty is a corrective surgical procedure to straighten the nasal septum.Objective: To evaluate the effectiveness of septoplasty in relieving nasal obstruction in patients presenting with deviated nasal septum.Materials and Methods: This prospective case series study was conducted at Khyber Teaching Hospital Peshawar (a tertiary healthcare center of Pakistan) from January 2019 to June 2019. Data regarding age, gender, duration of symptoms and effectiveness of septoplasty was gathered. Results: The mean age of our patients was 30. 62% patients were male and 38% patients were female. Mean duration was of symptoms was 2 years. Septoplasty was effective in 80% patients and was not effective in 20% patients. No significant relationship was identified with age, gender and duration of symptoms.Conclusion: Our study concludes that septoplasty was effective in 80% patients in relieving nasal obstruction in patients presenting with deviated nasal septum.Key Words: Septoplasty, Nasal obstruction, deviated nasal septum.

Surgical outcome of septorhinoplasty using spreader graft in patients with nasal obstruction: An institutional study

Nasal obstruction is one of the most common complaints of patients in the ENT OPD. The most common causes of nasal obstruction include septal deviation, turbinate hypertrophy, nasal masses and nasal valve narrowing. The nasal valve pathology is often overlooked and attributed wrongly to other factors such as adeviated septum or hypertrophy of turbinates even at the level of tertiary facility [1]. The under addressed problem of internal nasal valve remains a diagnostic and surgical challenge.

Office based inferior turbinate coblation treatment: a randomized controlled trial on effectiveness and tolerability of medicinal honey

Background: When conservative treatment for nasal obstruction fails, surgery is often applied. Inferior Turbinate Hypertrophy (ITH) is a common cause of nasal obstruction, which can be treated by means of radiofrequency coblation. This technique can be administered under local anesthesia (office based coblation; OBC) and if expedient combined with a lateralization (out-fracture) of the inferior turbinate (IT). Ointment based on medical grade honey, is known to have wound healing characteristics. Methodology: Single center, single blinded randomized controlled trial. Fifty-five subjects received bilateral OBC of the IT. Subjects were randomized to postoperative care with either nasal saline irrigations (NSI) or NSI combined with ointment based on honey (NSI+STB). Subjects weekly reported subjectively overall nasal burden, -crusting, -pain, loss of smell by means of VAS-scores and nasal obstruction by means of the NL-NOSE scale. Results: No significant differences between the NSI and NSI+STB groups, though the latter showed less pain. Concerning the study group as a whole, mean nasal burden score and nasal obstruction significantly decreased from 63.4 to 16.0 and 65.3 to 22.0, respectively. Nasal crusting, -pain, and loss of smell largely resolved 3-4 weeks postoperatively and were only mild. Concomitant lateralization showed a tendency to quicker resolution of the nasal obstruction. Conclusions: OBC is a safe, well tolerated and effective treatment for nasal obstruction caused by ITH. Concerning multiple end-points, we found no evidence of a beneficial effect of ointment based on honey as addition to NSI in postoperative care, except a clear tendency in less crusting and pain.

English

Adenoid hypertrophy is a common cause of nasal obstruction in children but relatively uncommon in adults, however adenoid hypertrophy in young adults is thought to be a persistence of untreated adenoid hypertrophy of childhood. This case series also notes that adenoid hypertrophy can be associated with deviated nasal septum. Coblation assisted endoscopic adenoidectomy usually has good result in adenoid clearance. Hence, routine endoscopic examination of nasopharynx helps in early diagnosis of adenoid hypertrophy and subsequent better management in young adults with complaints of nasal blockage. Nasopharyngeal vegetations were earlier described by Wilhelm Meyer in 1870 as forming part of Waldeyer’s ring of lymphoid tissue and he coined the term ‘adenoid’ to describe the same. In younger children, it has been thought that the adenoids may have an important role in development of an immunological memory. Physiologically it has been considered that hypertrophy of adenoid tissue occurs during 6 - 10 years and tend to regress and atrophy at 16 years. Grading of adenoid hypertrophy as described by Clemens et al. is as follows.1  Grade I: adenoid tissue filling 1/3rd. of the vertical height of choana.  Grade II: adenoid tissue filling up to 2/3rd of the vertical height of choana.  Grade III: from 2/3rd to nearly all but not completely filling the choana.  Grade IV: complete choanal obstruction We present three cases of adenoid hypertrophy with deviated nasal septums in adults who visited ENT outpatient department (OPD) at National Institute of Medical Sciences, Jaipur during COVID era of January 2021 to April 2021.

Homeopathic management of adenoids: A review

:Nasopharyngeal tonsil commonly called “Adenoids”. "Adenoid" meaning "glandular", "gland-like", or "lymphatic". Hypertrophy of the lymphoid tissues in the throat (the adenoids) is the most common cause of nasal obstruction in children. The mouth is always open because upper airway congestion/narrowing has made patients obligatory mouth breathers. Persistent mouth breathing seen in children due to nasal obstruction can lead to malocclusion. The most common symptoms are habitual mouth breathing and snoring. The most dangerous symptom is sleep apnea due to obstruction. Homoeopathic medicines treat them effectively. These remedies aim to control the infection and inflammation in the initial phase and eliminate the risk of reoccurrence by improving the immunity in the later phase.

COMPARATIVE STUDY ON IMPROVEMENT OF NASAL SYMPTOMS FOLLOWING SEPTOPLASTY WITH PARTIAL INFERIOR TURBINECTOMY VS SEPTOPLASTY ALONE IN ADULTS WITH DEVIATED NASAL SEPTUM

BACKGROUND: Nasal obstruction is a common presenting symptom which otolaryngologists encounter in daily clinical practice. One of the most common cause of nasal obstruction is deviated nasal septum(DNS). DNS to one side is associated with overgrowth of inferior turbinate on the contralateral side. Septoplasty alone or septoplasty with inferior turbinate reduction is the mode of treatment but that depends upon the decision of the operative surgeon. In this study we aim to collect data and come to a conclusion as to which surgery is benecial for the patients. AIMS AND OBJECTIVES: (1) To compare the symptomatic improvement of nasal symptoms following septoplasty with partial inferior turbinectomy versus septoplasty alone by NOSE Scale. (2) To corroborate the subjective ndings of NOSE Scale by rhinomanometry and nasal endoscopy. METHODOLOGY: A prospective and comparative study was done on 60 patients over a period of 1 year in a tertiary care centre. Patients were alternatively divided into two surgical groups Group A- septoplasty with partial inferior turbinectomy and Group B- septoplasty alone. Nasal Obstruction Symptom Evaluation(NOSE) was used for subjective evaluation of nasal symptoms. Rhinomanometry was used as a tool for objective evaluation of symptoms. Data was analysed using tables, graph and percentage and test of signicance. Post operative improvement RESULTS: following both group A septoplasty with partial inferior turbinectomy and group B Septoplasty alone was signicant at post op 1,3 and 6 months respectively. When both groups were compared those undergoing partial inferior turbinectomy with septoplasty had highly signicant results by NOSE scale as well as rhinomanometry and endoscopy. This study showed tha CONCLUSION: t hypertrophied turbinate need to be addressed in chronic cases of nasal obstruction with deviated nasal symptom with contralateral turbinate hypertrophy. Thus we can conclude that partial inferior turbinectomy should be done in addition to septoplasty as it is a highly effective modality for treatment of nasal obstruction in patients of nasal obstruction in patients with deviated nasal septum.

Microdebrider-Assisted Turbinoplasty and Submucosal Diathermy for Inferior Turbinate Hypertrophy: A Randomized Clinical Trial

ABSTRACT &#x0D; Background: Nasal obstruction is a common presenting problem which can lead to symptoms like sleep disturbances, mouth breathing, oral cavity dryness. Hypertrophied inferior turbinate is a common cause of nasal obstruction. Microdebrider assisted turbinoplasty and submucosal diathermy are widely used methods for patients who fail to respond to medical therapy to relieve obstruction. The aim of the study was to compare two methods in terms of relief of nasal obstruction, reduction in sneezing and post-operative complications.&#x0D; Material &amp; Methods: This randomized clinical trial was conducted at ENT Department, Benazir Bhutto Hospital Rawalpindi, Pakistan for one year from 01-03-2018 to 28-02-2019. One hundred and twenty patients were randomized to into either MAT and SMD groups each with 60 patients. Nasal obstruction symptom evaluation score system (NOSE) was used to access relieve from obstruction and sneezing. SPSS 22, online chai square and fisher exact test calculators were used to analyze the data.&#x0D; Results:&#x0D; Two groups were comparable for age and gender. After 3 months of treatment, all patients in MAT group and 51 patients in SMD group were completely relieved from obstruction. At two weeks follow up 37(61.57%) patients in MAT group had grade 0 obstruction compared with 14 (23.33%) in SMD group and this difference was significant (p value .000). at one month follow up 55 (91.67%) patients in MAT while 46 (76.67%) had completely relieved obstruction and this difference was significant ( p value .024). Not all patients showed reduction in sneezing in both groups. 37 patients in MAT and 25 patients in SMD group had completely relieved from sneezing at third month follow up with MAT group showing significantly more patients with sneezing reduced at one month follow up. Crust formation was most seen complication in both groups, more with SMD group at two weeks follow up which responded to treatment alkaline nasal douches and crust removal.&#x0D; &#x0D; Conclusion:&#x0D; MAT gives better in terms of nasal obstruction relieved, reduction in sneezing and less complications than SMD procedure.&#x0D; KEYWORDS: Microdebrider; Diathermy; Turbinates; Nasal obstruction&#x0D;

Ectopic pituitary adenoma: a rare and unexpected diagnosis, clinical presentation and review of the literature

&lt;p&gt;Nasal obstruction can be caused by many causes. Most common cause of nasal obstruction is deviated nasal septum followed by nasal masses. Nasal masses can be polyps, tumors or foreign bodies. We are presenting a case of ectopic pituitary tumor as a as cause of nasal obstruction along. Ectopioc pituitary tumors are rare tumors and can present in nasal cavity causing nasal symptoms. They can cause unilateral or even bilateral nasal obstruction depending on their spread in nasopharynx and nose and should be kept in mind while treating a case of nasal masses.&lt;/p&gt;

Adenoid Hypertrophy and Endoscopic Adenoidectomy in Adults: Our Experience.

Adenoid tissue is considered as first line immunological defence mechanism in childhood. Adenoid hypertrophy in children is a common cause of nasal obstruction. It usually gets atrophied by puberty. Adenoid hypertrophy persisting in adults is a cause of nasal obstruction. A randomized prospective study was conducted on adult patients aged above 20years of age presenting with bilateral nasal obstruction at a tertiary care hospital, for duration of 20months from January 2018 to August 2019.The differential diagnosis of adenoid hypertrophy was evaluated and role of endoscopic adenoidectomy was studied. The various associated causes of adenoid hypertrophy in adults showed previous history of adeno-tonsillectomy, allergy, deviated nasal septum and smoking. In all cases endoscopic assisted adenoidectomy was performed. Post adenoidectomy patients were asymptomatic in 21 cases, partial improvement in 6 cases and failure in 3 cases. Enlarged adenoid in adults should be considered in the differential diagnosis of cases suffering from bilateral nasal obstruction, or presenting as a nasopharyngeal mass with aural problems. Endoscopic adenoidectomy is safe and reliable. The nasal endoscope aids in removal of adenoid completely with good haemostasis, without any injury to Eustachian tube.

A comparative study of endoscopic versus conventional septoplasty

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Deviated nasal septum is one of the common causes of nasal obstruction. Correction of deviated nasal septum has been performed by a variety of techniques of which Septoplasty is the most popular one. With the advent of endoscopes and their successful use in endoscopic sinus surgery endoscopes have been tried in septoplasty for better visualization of posterior part of septum and do the surgery more precisely and with less complication as compare to conventional method. The objectives of the study were to compare the outcomes of conventional and endoscopic septoplasty, to evaluate the advantages, disadvantages and complications of both endoscopic and conventional septoplasty.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; It was a prospective observational study conducted on 50 patients with deviated nasal septum, who presented to ENT department of SPMC, Bikaner, patients were randomly divided equally in two groups for conventional and endoscopic septoplasty respectively. Data collected on a prestructured proforma and results analysed. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The study included 50 cases. Postoperatively significant relief from the symptoms of nasal obstruction (82%) in group A and (96%) group B, was seen. In objective assessment at the end of 3 months of surgery, patient had persistent posterior deviation 24% in group A and 3% in group B, spur 12% in group A and 0% in group B.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Endoscopic septoplasty has an obvious edge over the conventional approach due to better illumination which enables to identify the pathology accurately, excise the deviated part of septum precisely and realignment of the cartilage for best results.&lt;/p&gt;

Comparison Between Radiological Versus Endoscopic Assessment of Adenoid Tissue in Patients of Chronic Adenoiditis.

The adenoids are a common cause for morbidity in pre-school and school going children. Adenoid hypertrophy is common cause of nasal obstruction in pediatric population. The assessment of the size of palatine tonsil hypertrophy is quiet easy to perform, however, measuring the size of nasopharyngeal tonsil and establishing its connection with the given symptoms is more difficult. This is basically due to the location of a tonsil in the nasopharyngeal cavity. Since the cavity is inaccessible directly and cannot be examined visually, many direct and indirect methods of adenoid size evaluation have been developed. The objective of this study is to compare the diagnostic efficacy of both X-ray soft tissue nasopharynx lateral view and nasoendoscopy in evaluation of adenoid size in patients having chronic adenoiditis. Our study included 50 children in age group of 3-14years who had signs and symptoms of adenoiditis clinically. After comparing X-ray and endoscopic findings we found that there was good agreement between X-ray and endoscopic method. Sensitivity of X-ray was 79.41% and specificity of 75% whereas sensitivity of nasoendoscopy was 87.10% and specificity was 63.16%. Nasal endoscopy is good screening method and more accurate method to assess the size of adenoids in patients of chronic adenoiditis.