Background The nasal valves constitute the majority of the nasal cavity's resistance. Any reducti... more Background The nasal valves constitute the majority of the nasal cavity's resistance. Any reduction in this already narrow area can cause a significant reduction in the nasal airflow. In this present study, the aim was to do an endoscopic assessment of the internal nasal valve (INV) in patients with various nasal septal deviations, with or without external nasal deformity. We measured endoscopically the INV in various nasal deformities and derived its association with the INV on anterior rhinoscopy and endoscopic assessment. Method We included 75 patients in the study who were analyzed for angle and grade of the INV by anterior rhinoscopic examination and Hopkins rod zero-degree nasal endoscope (Karl Storz SE & Co., Tuttlingen, Germany). Nasal septal deviations were also studied with respect to the Mladina classification. Correlation between various nasal septal deviations with the INV was done. Since studies addressing the classification of INV are not available in the literature, for the purpose of simplification of observation of INV angle, (normal range 9-15 degrees), subjective stratification was made in the study, i.e. below 9, 9-15, and more than 15 degrees for the sake of knowing the underlying cause and its relationship. Result An anterior rhinoscopic examination was performed on 75 patients. INV Grade 1 was the most common, with 18 patients of (69.2%), 15 patients of DNS with caudal dislocation (55.6%), five patients of DNS with spur (38.5%), and four patients of DNS with external nasal deformity (50%). The next frequently observed Grade of INV on anterior rhinoscopy examination was Grade 2, in 11 patients of DNS with caudal dislocation (40.7%), four patients of DNS with spur (30.8%), and three patients of DNS with external deformity (37.5%), which was statistically significant in our study. In the majority of patients with all types of nasal septal deviations with or without external nasal deformity, INV (angle) of less than 9 degrees was noted, which was statistically significant. A linear relationship, ie., Grade 0 INV in Type I, Grade 1 INV in types II, III, IV, and V, and Grade 2 in Type VII was observed. Our study is on par with the literature questioning the dogma of the normal angle of INV being 9-15 degrees. Conclusion We were able to establish a positive and complimentary role of anterior rhinoscopic and endoscopic assessment of INV. The proposed novel classification of the angle of INV by endoscopic assessment gives a better insight into the association of INV with various nasal septal deformities with or without external nasal septal deviation.
Nasal obstruction is a common presenting symptom for both primary care physicians and otolaryngol... more Nasal obstruction is a common presenting symptom for both primary care physicians and otolaryngologists, and it can be caused by various anatomic, physiologic, and pathophysiologic factors. Structural nasal obstruction may result from a Deviated Nasal Septum (DNS), Internal Nasal Valve (INV) obstruction, External Nasal Valve (ENV) obstruction, inferior turbinate hypertrophy, Nasal Septal Swell Body (NSB) etc. Combined causes occasionally go unnoticed, and postoperative symptom relief may not always be satisfactory. Revision surgeries in cases where septoplasty fails due to misdiagnosed multicausative factors can increase the complexity of the procedure, further affecting its success. In this review, our objective is to examine the significance of the NSB and the INV, which are often overlooked nasal structures, in improving the outcomes of septoplasty. Upon reviewing the findings, it can be confirmed that diagnosing these overlooked structures has led to improved outcomes in septopl...
Background The nasal valves constitute the majority of the nasal cavity's resistance. Any reducti... more Background The nasal valves constitute the majority of the nasal cavity's resistance. Any reduction in this already narrow area can cause a significant reduction in the nasal airflow. In this present study, the aim was to do an endoscopic assessment of the internal nasal valve (INV) in patients with various nasal septal deviations, with or without external nasal deformity. We measured endoscopically the INV in various nasal deformities and derived its association with the INV on anterior rhinoscopy and endoscopic assessment. Method We included 75 patients in the study who were analyzed for angle and grade of the INV by anterior rhinoscopic examination and Hopkins rod zero-degree nasal endoscope (Karl Storz SE & Co., Tuttlingen, Germany). Nasal septal deviations were also studied with respect to the Mladina classification. Correlation between various nasal septal deviations with the INV was done. Since studies addressing the classification of INV are not available in the literature, for the purpose of simplification of observation of INV angle, (normal range 9-15 degrees), subjective stratification was made in the study, i.e. below 9, 9-15, and more than 15 degrees for the sake of knowing the underlying cause and its relationship. Result An anterior rhinoscopic examination was performed on 75 patients. INV Grade 1 was the most common, with 18 patients of (69.2%), 15 patients of DNS with caudal dislocation (55.6%), five patients of DNS with spur (38.5%), and four patients of DNS with external nasal deformity (50%). The next frequently observed Grade of INV on anterior rhinoscopy examination was Grade 2, in 11 patients of DNS with caudal dislocation (40.7%), four patients of DNS with spur (30.8%), and three patients of DNS with external deformity (37.5%), which was statistically significant in our study. In the majority of patients with all types of nasal septal deviations with or without external nasal deformity, INV (angle) of less than 9 degrees was noted, which was statistically significant. A linear relationship, ie., Grade 0 INV in Type I, Grade 1 INV in types II, III, IV, and V, and Grade 2 in Type VII was observed. Our study is on par with the literature questioning the dogma of the normal angle of INV being 9-15 degrees. Conclusion We were able to establish a positive and complimentary role of anterior rhinoscopic and endoscopic assessment of INV. The proposed novel classification of the angle of INV by endoscopic assessment gives a better insight into the association of INV with various nasal septal deformities with or without external nasal septal deviation.
Mucoceles of the paranasal sinuses are epithelium-lined cystic masses that develop when the sinus... more Mucoceles of the paranasal sinuses are epithelium-lined cystic masses that develop when the sinus ostia get obstructed. They most frequently occur in the frontal and ethmoid sinuses. The paranasal sinus mucoceles' proximity to the orbit and skull base renders the patient at risk for substantial morbidity. Mucoceles have reactive bone growth, bleeding, fibrosis, and granulation tissue, which are histological traits of respiratory mucosa. The conventional therapy is surgical excision, with endoscopic procedures becoming more popular. A 60-year-old female patient reported to the ENT outpatient clinic complaining of swelling over the medial aspect of her left eye that had begun slowly and progressed over a year. Although there were no neurological, ocular, nasal, or facial symptoms clinically, radiological and cytological examinations aided us in arriving at the definitive diagnosis. The patient in this scenario had an infected mucocele and left medial canthal swelling with no visual impairment, which made it challenging to reach an accurate diagnosis. However, radiological evaluation and cytological examination focused on establishing a definitive diagnosis.
Journal of Pharmaceutical Research International, 2021
Background/Rationale: The human nose is structurally complex and this complexity results in nasal... more Background/Rationale: The human nose is structurally complex and this complexity results in nasal shape and shape variations. Midline deformities such as hump nose, saddle nose, tip deformities and lateral nasal deformities such as crooked nose, deviated nose, alar depression are common forms of deformity affecting the external nose. Internal nasal valve (INV) is a key anatomical landmark of nasal cavity. Any obstructions in this region have tremendous effects on inspiratory and expiratory currents. This study aims to assess the nasal septal deviation and external nasal deformities and correlate the severity of sino nasal symptoms. Methods: This Prospective observational study will include total 50 patients with nasal septal deviation. Patients will undertake Sino Nasal Test -22 questionnaire. Investigations like Diagnostic nasal endoscopy with 30 degree nasal endoscope, X-ray PNS Water’s view and complete blood count including absolute eosinophilic count will be carried out. Data w...
Intracranial consequences from chronic otitis media can be dreadful. Meningitis is the most frequ... more Intracranial consequences from chronic otitis media can be dreadful. Meningitis is the most frequent complication followed by a cerebral abscess. In this pre-antibiotic era, otogenic brain abscess is rare, but it poses one of the life-threatening complications of otitis media. In recent years, brain abscess was noticed almost only in patients of chronic Otitis media with cholesteatoma. A case of a 36-year-old non-diabetic male patient with an otogenic cerebellar abscess, who presented with no cerebellar signs and unique intraoperative ossicular chain status was successfully managed by a combined approach of otolaryngology and neurosurgery, is presented in this report.
Background The nasal valves constitute the majority of the nasal cavity's resistance. Any reducti... more Background The nasal valves constitute the majority of the nasal cavity's resistance. Any reduction in this already narrow area can cause a significant reduction in the nasal airflow. In this present study, the aim was to do an endoscopic assessment of the internal nasal valve (INV) in patients with various nasal septal deviations, with or without external nasal deformity. We measured endoscopically the INV in various nasal deformities and derived its association with the INV on anterior rhinoscopy and endoscopic assessment. Method We included 75 patients in the study who were analyzed for angle and grade of the INV by anterior rhinoscopic examination and Hopkins rod zero-degree nasal endoscope (Karl Storz SE & Co., Tuttlingen, Germany). Nasal septal deviations were also studied with respect to the Mladina classification. Correlation between various nasal septal deviations with the INV was done. Since studies addressing the classification of INV are not available in the literature, for the purpose of simplification of observation of INV angle, (normal range 9-15 degrees), subjective stratification was made in the study, i.e. below 9, 9-15, and more than 15 degrees for the sake of knowing the underlying cause and its relationship. Result An anterior rhinoscopic examination was performed on 75 patients. INV Grade 1 was the most common, with 18 patients of (69.2%), 15 patients of DNS with caudal dislocation (55.6%), five patients of DNS with spur (38.5%), and four patients of DNS with external nasal deformity (50%). The next frequently observed Grade of INV on anterior rhinoscopy examination was Grade 2, in 11 patients of DNS with caudal dislocation (40.7%), four patients of DNS with spur (30.8%), and three patients of DNS with external deformity (37.5%), which was statistically significant in our study. In the majority of patients with all types of nasal septal deviations with or without external nasal deformity, INV (angle) of less than 9 degrees was noted, which was statistically significant. A linear relationship, ie., Grade 0 INV in Type I, Grade 1 INV in types II, III, IV, and V, and Grade 2 in Type VII was observed. Our study is on par with the literature questioning the dogma of the normal angle of INV being 9-15 degrees. Conclusion We were able to establish a positive and complimentary role of anterior rhinoscopic and endoscopic assessment of INV. The proposed novel classification of the angle of INV by endoscopic assessment gives a better insight into the association of INV with various nasal septal deformities with or without external nasal septal deviation.
Nasal obstruction is a common presenting symptom for both primary care physicians and otolaryngol... more Nasal obstruction is a common presenting symptom for both primary care physicians and otolaryngologists, and it can be caused by various anatomic, physiologic, and pathophysiologic factors. Structural nasal obstruction may result from a Deviated Nasal Septum (DNS), Internal Nasal Valve (INV) obstruction, External Nasal Valve (ENV) obstruction, inferior turbinate hypertrophy, Nasal Septal Swell Body (NSB) etc. Combined causes occasionally go unnoticed, and postoperative symptom relief may not always be satisfactory. Revision surgeries in cases where septoplasty fails due to misdiagnosed multicausative factors can increase the complexity of the procedure, further affecting its success. In this review, our objective is to examine the significance of the NSB and the INV, which are often overlooked nasal structures, in improving the outcomes of septoplasty. Upon reviewing the findings, it can be confirmed that diagnosing these overlooked structures has led to improved outcomes in septopl...
Background The nasal valves constitute the majority of the nasal cavity's resistance. Any reducti... more Background The nasal valves constitute the majority of the nasal cavity's resistance. Any reduction in this already narrow area can cause a significant reduction in the nasal airflow. In this present study, the aim was to do an endoscopic assessment of the internal nasal valve (INV) in patients with various nasal septal deviations, with or without external nasal deformity. We measured endoscopically the INV in various nasal deformities and derived its association with the INV on anterior rhinoscopy and endoscopic assessment. Method We included 75 patients in the study who were analyzed for angle and grade of the INV by anterior rhinoscopic examination and Hopkins rod zero-degree nasal endoscope (Karl Storz SE & Co., Tuttlingen, Germany). Nasal septal deviations were also studied with respect to the Mladina classification. Correlation between various nasal septal deviations with the INV was done. Since studies addressing the classification of INV are not available in the literature, for the purpose of simplification of observation of INV angle, (normal range 9-15 degrees), subjective stratification was made in the study, i.e. below 9, 9-15, and more than 15 degrees for the sake of knowing the underlying cause and its relationship. Result An anterior rhinoscopic examination was performed on 75 patients. INV Grade 1 was the most common, with 18 patients of (69.2%), 15 patients of DNS with caudal dislocation (55.6%), five patients of DNS with spur (38.5%), and four patients of DNS with external nasal deformity (50%). The next frequently observed Grade of INV on anterior rhinoscopy examination was Grade 2, in 11 patients of DNS with caudal dislocation (40.7%), four patients of DNS with spur (30.8%), and three patients of DNS with external deformity (37.5%), which was statistically significant in our study. In the majority of patients with all types of nasal septal deviations with or without external nasal deformity, INV (angle) of less than 9 degrees was noted, which was statistically significant. A linear relationship, ie., Grade 0 INV in Type I, Grade 1 INV in types II, III, IV, and V, and Grade 2 in Type VII was observed. Our study is on par with the literature questioning the dogma of the normal angle of INV being 9-15 degrees. Conclusion We were able to establish a positive and complimentary role of anterior rhinoscopic and endoscopic assessment of INV. The proposed novel classification of the angle of INV by endoscopic assessment gives a better insight into the association of INV with various nasal septal deformities with or without external nasal septal deviation.
Mucoceles of the paranasal sinuses are epithelium-lined cystic masses that develop when the sinus... more Mucoceles of the paranasal sinuses are epithelium-lined cystic masses that develop when the sinus ostia get obstructed. They most frequently occur in the frontal and ethmoid sinuses. The paranasal sinus mucoceles' proximity to the orbit and skull base renders the patient at risk for substantial morbidity. Mucoceles have reactive bone growth, bleeding, fibrosis, and granulation tissue, which are histological traits of respiratory mucosa. The conventional therapy is surgical excision, with endoscopic procedures becoming more popular. A 60-year-old female patient reported to the ENT outpatient clinic complaining of swelling over the medial aspect of her left eye that had begun slowly and progressed over a year. Although there were no neurological, ocular, nasal, or facial symptoms clinically, radiological and cytological examinations aided us in arriving at the definitive diagnosis. The patient in this scenario had an infected mucocele and left medial canthal swelling with no visual impairment, which made it challenging to reach an accurate diagnosis. However, radiological evaluation and cytological examination focused on establishing a definitive diagnosis.
Journal of Pharmaceutical Research International, 2021
Background/Rationale: The human nose is structurally complex and this complexity results in nasal... more Background/Rationale: The human nose is structurally complex and this complexity results in nasal shape and shape variations. Midline deformities such as hump nose, saddle nose, tip deformities and lateral nasal deformities such as crooked nose, deviated nose, alar depression are common forms of deformity affecting the external nose. Internal nasal valve (INV) is a key anatomical landmark of nasal cavity. Any obstructions in this region have tremendous effects on inspiratory and expiratory currents. This study aims to assess the nasal septal deviation and external nasal deformities and correlate the severity of sino nasal symptoms. Methods: This Prospective observational study will include total 50 patients with nasal septal deviation. Patients will undertake Sino Nasal Test -22 questionnaire. Investigations like Diagnostic nasal endoscopy with 30 degree nasal endoscope, X-ray PNS Water’s view and complete blood count including absolute eosinophilic count will be carried out. Data w...
Intracranial consequences from chronic otitis media can be dreadful. Meningitis is the most frequ... more Intracranial consequences from chronic otitis media can be dreadful. Meningitis is the most frequent complication followed by a cerebral abscess. In this pre-antibiotic era, otogenic brain abscess is rare, but it poses one of the life-threatening complications of otitis media. In recent years, brain abscess was noticed almost only in patients of chronic Otitis media with cholesteatoma. A case of a 36-year-old non-diabetic male patient with an otogenic cerebellar abscess, who presented with no cerebellar signs and unique intraoperative ossicular chain status was successfully managed by a combined approach of otolaryngology and neurosurgery, is presented in this report.
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