Nasal endoscopic findings in patients with perennial allergic rhinitis.

Nasal endoscopy was carried out in 83 patients with perennial allergic rhinitis to evaluate endonasal anatomic variation and to find the correlation between the symptoms of patients and the endoscopic findings. All of the patients had nasal symptoms, 7.2% of the patients were runner, 7.2% were blocker and 85.6% were both. 86.75% of the patients had allergy-related symptoms, i.e. throat symptoms (73.5%), sinus headache (50.6%), and smell disturbance (10.8%). 95.2% of patients had abnormal endoscopic findings, i.e. deviated nasal septum (72.3%), abnormal middle turbinate (49.4%), narrowing of the entrance into the frontal recess (30.1%), septal spur (25.3%), obstruction of the entrance into the frontal recess (19.3%), nasal polyps (15.7%), mucopurulent discharge (14.5%), inferior turbinate hypertrophy (10.8%), abnormal uncinate process (9.6%), abnormal ethmoid bullae (7.2%), and enlargement of aggar nasi cells (2.4%). There was no significant correlation between each symptom and each endoscopic finding. However, there was a significant correlation between sinus headache and all of the combined abnormal endoscopic findings (P<0.05). These findings suggested that variations in endonasal anatomy was not by itself a pathology or a cause of symptoms. However, a combination of these variations may narrow the cleft of the ostiomeatal unit and cause contact area or stenosis, which predisposed patients to persistent symptoms, recurrent infection or resistance to therapy in patients with perennial allergic rhinitis. The endoscope might be a very useful tool for allergists, immunologists, and rhinologists, who work in the nose to deal with these cases.

A complicated case of arteriovenous malformation of mandible.

A 10-year old boy presented with sever hemorrhage from right lower gum after an attempt to remove a mobile premolar milk tooth. Physical examination and carotid angiography revealed a large arteriovenous malfmation of mandible. The patient had aspiration of blood into the lung, pulmonary oedema and pneumothorax as anaesthetic complications while being anaesthesized for angiography. The initial treatment was embolization of the feeders of this arteriovenous malformation and extraction of all mobile teeth.