Clinicopathological Correlation of Sinonasal Masses with Pre-operative Computed Tomography Findings

Aim of the Study: The aim of the study was to study the clinical, radiological, and histopathological correlation of sinonasalmasses.Materials and Methods: This was a descriptive study conducted on 72 patients with sinonasal masses at Government T DMedical College, Alappuzha, over a period of 18 months from January 01, 2014, to June 30, 2015.Results: Age group was from 13 to 85 years with a male to female ratio of 1.3:1. Nasal obstruction was the most commonsymptom followed by nasal discharge and headache. Of the 72 cases, 59 belonged to the non-neoplastic group and 13 to theneoplastic group of sinonasal masses. Clinically, nasal polyp was the most common presentation. Sinonasal polyps (65.3%)formed the majority of the non-neoplastic lesions, vascular lesion (6.9%) was the most common benign neoplastic mass, andmalignancy was seen in 6.9% of cases. After clinical examination and computed tomography scan of the nose and paranasalsinuses, patients underwent surgery. Finally, clinical, radiological, and histopathology correlation of all the sinonasal masseswere done. The clinical diagnosis with computed tomography (CT) scan correlation was the same except in three cases andin one case with histopathology. Histopathology and CT scan result correlated well except in three cases. It was found thatthere was a significant association between the clinical, radiological, and histopathological diagnoses (P < 0.05) and that thesemodalities were complementary to each other. It was also possible to classify the lesions as non-neoplastic, neoplastic benign,and malignant using these modalities. This was important because even though initial presentation of these masses was similar,management of each of them varied significantly.Conclusion: Histopathology still remains the gold standard in the diagnosis of sinonasal masses, while CT scan is indispensablein studying the anatomical variants and providing the route map before and during endoscopic sinus surgeries.

Efficacy of Saline Nasal Irrigation in Chronic Rhinosinusitis

Aim of the Study: To test whether daily saline nasal irrigation (SNI) improves sinus symptoms in adult subjects with chronicrhinosinusitis (CRS) and also to study the safety of saline irrigation, incidence of any complication and improvement in qualityof life (QOL) in these patients.Materials and Methods: This was a prospective observational study conducted between two groups of patients at GovernmentT D Medical College, Alappuzha. Patients who satisfied the criteria for diagnosing CRS were included in the study. The firstgroup was given SNI with oral drug therapy, while the second group was put on oral drugs alone. Each subject was given apretested, structured questionnaire. Along with socio-demographic information, the questionnaire also contained queries ofQOL measure, compliance of nasal irrigation and adverse effects following its use.Results: The pre-treatment scores and post-treatment scores were analyzed and the results were statistically significant withP < 0.001 in all. About 77% of the patients in the saline irrigation group were strictly using SNI which meant satisfactory complianceand the improvement in post-treatment scores were statistically highly significant with a P < 0.001. Furthermore, there was astatistically significant difference between the mean pre-test and post-test scores between the two groups with P < 0.001 andt-values of 51.942 using the paired t-test.Conclusion: Chronic rhinsinusitis has a major negative impact on the health care and economy of not only the patients butalso of society. SNI is an effective yet easy method of therapy in alleviating the symptoms of CRS and improving the QOL ofthese chronic sufferers.

Facial Nerve Schwannoma – A Diagnostic and Surgical dilemma: A Case Report

Facial nerve schwannomas are rare facial nerve tumors that can arise anywhere along the course of the nerve where Schwanncells are present. The clinical presentation and symptoms differ not only due to the location of tumor but also due to theneighboring anatomical structures it involves. Delay in diagnosis can increase the morbidity of the condition for the patient.Surgical excision is the definitive treatment and often it can be challenging to the surgeon. Our case demonstrates an unusualpresentation of this relatively uncommon tumor that mimicked cholesteatoma causing lower motor neuron facial palsy whichturned out to be a facial schwannoma later by biopsy

Tumor-Induced Osteomalacia: A Case Study Of A Nasal Tumor

Oncogenous osteomalacia, which is also known as tumor-induced osteomalacia, is a condition where a neoplasm isassociated with systemic bone demineralization and renal phosphaturia. We report a case who presented with a bleedingnasal mass, generalized fatigue, and cramps in her leg. Excision was done, and histopathologically, it was diagnosed tobe a phosphaturic mesenchymal tumor. The cramps disappeared soon after surgery and she is on regular follow-up forthe past 2 years.