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Abstract Introduction Choanal polyps are benign lesions arising from the sinonasal mucosa, extending through the choana into the nasopharynx. Though polyps arising from the maxillary sinus and extending to the choana are common, polyps arising from the sphenoid sinus ostium, posterior part of middle turbinate, and inferior and middle meatus are quite uncommon. Objective To document the site of origin of choanal polyps arising from unusual sites; their clinical, radiological, and histopathological characteristics, as well as diagnostic challenges and management. Methods This retrospective, single-center study included 14 patients aged 16 to 75-years-old with choanal polyps. After obtaining informed consent, their clinical, radiological and surgical details and histopathology reports were reviewed. Patients were followed for at least 6 months after surgery. Results The predominant symptoms were unilateral nasal obstruction (n = 9), snoring, rhinorrhea, and epistaxis. Though anterior rhinoscopy was unremarkable, a mass could be visualized during posterior rhinoscopy in the nasopharynx in 11 patients, and a mass could be directly visualized in the oropharynx in 2 patients. After diagnostic by nasal endoscopy, these polyps were noted to arise from the posterior aspect of the middle meatus (n = 6), middle turbinate (n = 3), posterior septum (n = 3), sphenoid sinus ostium (n = 1), and inferior meatus (n = 1). All patients were managed surgically. The histopathological examination revealed inflammatory polyp (n = 12), actinomycosis (n = 1), and rhinosporidiosis (n = 1). Patients were followed up for 6 to 22 months. We observed no complications or recurrence. Conclusion Diagnostic nasal endoscopy should be performed in all patients presenting with nasal obstruction, to rule out choanal polyps arising from unusual sites. Complete polyp removal and appropriate treatment based on histopathology prevents recurrence.
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Background: Rhinosporidiosis is a chronic granulomatous disease caused by aquatic parasite Rhinosporidium seeberi belonging to group of fish parasite Mesomycetozoa. It commonly affects nose and nasopharynx. It is one of the endemic disease is in India. Materials and Methods: This is a prospective study of distribution pattern and management of 12 cases of rhinosporidiosis in our institute(GIMSR)from the region of Visakhapatnam, Vizianagaram and Srikakulam districts of Andhra Pradesh, India. This is also to study the pattern of involvement according to age, sex, site, laterality, and their management. It emphasizes the importance of excision under local anaesthesia once the stalk of the lesion is identified. Results: Our study of 12 patients were shown slightly male preponderance, around the age of 11–20 years, with a clear cut history of having a bath in contaminated pools and rivers . Nasal obstruction & epistaxis are the predominant symptoms. The majority of cases had been excised endoscopically under local anaesthesia with less bleeding and minimal recurrence rate. It also reveals the importance of general anesthesia when the lesions involving posterior aspect of nasal cavity, nasopharynx to prevent aspiration in to lungs and in children who don’t cooperate for local anaesthesia. Conclusion: Endoscopic identification of stalk is mandatory before excising the lesion under local anaesthesia. The bleeding is less when excision done with diathermy cautery.
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@#Being a rare clinical entity, discal cyst presents indistinguishably from other causes of lower back pain and radiculopathy. It is an extremely rare pathology with unclear pathogenesis, indeterminate natural history with no consensus on the ideal management of the condition. We report a rare case of discal cyst in a patient who presented to our centre with localised low back pain and subsequently left sided radicular pain. With the aid of MRI and with clear surgical indication we proceeded with endoscopic removal of the cyst and intraoperatively confirmed its origin from the adjacent disc. The patient had immediate relief of his symptoms and no postoperative complications. We recommend that endoscopic surgery can be an effective alternative to conventional open surgery for discal cyst of the lumbar spine.
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Neurilemmoma is characteristically an encapsulated benign tumor originating from the neural sheath of peripheral, autonomic, and cranial nerves. Whereas between 25% and 45% of all such lesions occur in the region of the head and neck, only 4% of them are found in the nose and paranasal sinuses. Recently, we experienced a case of isolated neuilemmoma of the nasal septum in a 33-year-old female patient who complained of nasal obstruction and postnasal drip over 1 year. The tumor mass was successfully removed by transnasal endoscopic excision under general anesthesia. The patient had an uneventful course with no signs of recurrence. We present our review of the clinicopathologic features, radiologic findings and the value of endoscopy in treatment of this tumor.