ABSTRACT
Nasal polyps are one of the most common inflammatory mass lesions of the nose. Their etiology remainsunclear, but they are known to have associations with allergy, asthma, infection, fungus,cystic fibrosis, andaspirin sensitivity. However, the underlying mechanisms interlinking these pathologic conditions to nasal polypformation remain unclear. In the present cross-sectional study was carried with 100 patients diagnosed withnasal polyposis in the age group of 10-60 years of both the sexes were studied during this period from June 2014to October 2015 in the department of ENT, Kakatiya medical college attached to MGM Hospital, Warangal werefound in large majority age groups of 11 – 30 years, men are most commonly seen affecting than women (men:women are 2:1).Allergic rhinitis is strongly associated with nasal polyposis, most common symptom is nasalobstruction, anosmia and facial pain are also seen.Most of the patients had nasal polyps reaching beyond themiddle turbinate. And also, most of the patients had bilateral ethmoidalopacification on CT scan.only fewshowed sphenoid and frontal opacities.Steroid therapy was useful in 38% of patients.All others required endoscopic sinus surgery. Also, strong genetic factors are implicated in the pathogenesis of nasal polyps, but geneticand molecular alterations required for its development and progression are still unclear
ABSTRACT
Aims: The aim of the study is to compare the effect of Mometasone Fuorate and Levocetrizine in alleviating the symptom triad of Rhinorrhoea, Nasal obstruction and Sneezing in patients of Allergic Rhinitis. Study Design: Prospective cohort study. Place and Duration of Study: Department of Otolaryngology, Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sevagram, between 1st April 2012 to 31st March 2014. Methodology: In this study 50 patients were assessed. The diagnosis was made on the basis of 1) Careful detailed history, 2) Clinical examinations, 3) ARIA Classification was used to classify the patients. Patients received, Group A: Mometasone furoate nasal spray 50 µg in each nostril twice daily for the first 7 days followed by once daily upto 8 weeks, Group B: Levocetrizine 5 mg in the night for 8 weeks. In followup period of 12 weeks Patients receivedGroup A: Mometasone furoate nasal spray 50 µg in each nostril once daily for 12 weeks. Group B: Levocetrizine 5 mg in the night for 12 weeks. Results: In patients with Intermittent Symptoms, 76% of the participants in the group A were found to be relieved of the nasal discharge as compared to 24% in the group B. This difference was found to be statistically significant (P = .0007). 83% of the participants in the group A were found to be relieved of the nasal obstruction as compared to 17% in the group B. This difference was found to be statistically significant (P = .0022). 61.5% of the participants in the group A were found to be relieved of the sneezing as compared to 48.5% in the group B. This difference was not found to be statistically significant (P=0.8017). In patients with Persistent Symptoms, 84.6% of the participants in the group A were found to be relieved of the nasal discharge as compared to 15.4% in the group B. This difference was found to be statistically significant (P = .0124). 100% of the participants in the group A were found to be relieved of the nasal obstruction as compared to 0% in the group B. This difference was found to be statistically significant (P = .0006). 75% of the participants in the group A were found to be relieved of the sneezing as compared to 25% in the group B. This difference was not found to be statistically significant (P = .5647). Conclusion: In this study we conclude that both Mometasone Fuorate and Levocetrizine are potent drugs for the management of allergic rhinitis but because of the local action and a high lipophilicity, longer retainability and induction of apoptosis of eosinophills in the nasal mucosa, patients taking Mometasone Fuorate as medication appreciate better relief in symptoms as compared to Levocetrizine.
ABSTRACT
CSF rhinorrhoea poses a significant challenge even to most astute and experienced surgeons in its accurate localization and management. The diagnosis of CSF leak is ascertained on proper history, neurologic and otorhinolaryngologic examination, laboratory tests and endoscopic findings supplanted by appropriate radiologic studies. The exact visualization and atraumatic surgical technique using endoscope provides better lighting with magnified view, even in lateral recesses giving an edge over other techniques, thus enhancing the surgical outcome.