Higher incidence of headache in patients with intermittent mucosal contact points between the septum and lateral nasal wall.

INTRODUCTION: The nasal mucosal contact points between the two opposing mucosal surfaces leading to the headache had been a point of debate for many years; the intermittent and fixed contact points and their relationship with headache have never been investigated before. We have studied the relationship of headache with a different type of contact points in our study. OBJECTIVES: The aim of our study was to study two different types of mucosal contact point between the lateral nasal wall and the nasal septum and to study their relationship with symptom of headache.There have been many papers published related to the mucosal contact points in the nose and their relationship with headache, most of the published data did not find any relation between the headache and the mucosal contact points. We conducted a retrospective study of 116 patients with deviated nasal septum and contact point with the lateral nasal wall. METHODS: A retrospective study done at a tertiary institute Included 116 CT scan of paranasal sinuses showing the deviated nasal septum with mucosal contact points, 64 CT scan showed severe deviated nasal septum with fixed contact points between the septum and the inferior turbinate, other 52 scans showed the intermittent mucosal contact point, that is, septum is coming in contact with inferior turbinate only when turbinate is enlarged. RESULTS: Thirteen patients out of 64 patients (20.31%) had a headache in the fixed contact point group as compared to 20 out of 52 (38.46%) patients in the intermittent mucosal contact points group; post-surgery, the 17/20 patients improved in the intermittent mucosal contact points group as compared to 5/13 in fixed contact points group. CONCLUSIONS: We conclude that the overall incidence of headache associated with mucosal contact points is low but the higher association is seen in the intermittent contact group. LEVEL OF EVIDENCE: 4.

Nasal-alar invasive cutaneous aspergillosis in a patient with anaplastic astrocytoma: A case report.

Invasive aspergillosis is commonly encountered in immunosuppressed patients either primarily through direct inoculation or secondary from blood dissemination. This report describes a case of 53 years old immunocompromised female patient who was diagnosed with frontotemporal anaplastic astrocytoma and developed nasal skin lesion turned to be invasive cutaneous aspergillosis.

Synthesis and DSSC application of BODIPY decorated triazole bridged and benzene nucleus cored conjugated dendrimers.

Conjugated dendrimers decorated with 5,5-difluoro-10-(4-(prop-2-ynyloxy)phenyl)-5H-dipyrrolo[1,2-c:1',2'-f][1,3,2]diazaborinin-4-ium-5-uide, usually known as boron dipyrromethene (BODIPY), have been synthesized and their application as photosensitizer in dye sensitized solar cells (DSSCs) has been evaluated. Third generation triazole bridged BODIPY dendrimers show higher light energy harvesting efficiency of 2.5% better than the first and second generation dendrimers, when used as a dye material in solar cells. The current intensity increases with an increase in the generation of the dendrimer as revealed by cyclic voltammetry. Fluorescence decay analysis shows that the relaxation times τ 1 and τ 2 increase as the dendrimer generation increases, however τ 2 for the third generation dendrimer decreases because of fluorescence quenching due to molecular crowding.

Angiofibroma Originating outside the Nasopharynx: A Management Dilemma.

Background. Angiofibroma is a benign tumor, consisting of fibrous tissue with varying degrees of vascularity, characterized by proliferation of stellate and spindle cells around the blood vessels. It most commonly arises from the nasopharynx, although it may rarely arise in extranasopharyngeal sites. Case Report. A 46-year-old male presented with left side nasal obstruction and epistaxis for one month. Clinical nasal examination revealed left sided polypoidal mass arising from the vestibular region of the lateral nasal wall. Results. CT scan and MRI showed highly vascular soft tissue mass occupying the anterior part of the left nostril. Preoperative selective embolization followed by transnasal excision was performed. Histopathological examination confirmed the diagnoses of nasal vestibular angiofibroma. Conclusion. Extranasopharyngeal angiofibroma is a very rare pathology. It should be kept in mind as a differential diagnosis with any unilateral nasal vestibular mass causing nasal obstruction and epistaxis. A biopsy without further investigation can cause life threatening bleeding in the patient.

Nasal Type Extranodal Natural Killer/T (NK/T) Cell Lymphoma Presenting as Periorbital Cellulitis: A Case Report.

BACKGROUND Extranodal lymphoma of the paranasal sinuses is a rare clinical entity seen in only 5-8% of extranodal lymphomas of the head and neck. Nasal natural killer/T cell lymphoma (Nasal NKTCL), which is a subtype of peripheral T cell lymphoma, constitutes about 1.4% of all lymphomas. NKTCL is usually diagnosed at a late stage because it presents with nonspecific symptoms in the early stages. CASE REPORT We report the case of a 25-year-old male patient who presented with periorbital swelling treated as fungal sinusitis but proven to have NKTCL. We review the literature and discuss the clinical manifestations of the disease, its relation to EBV virus, the histological and radiological characteristics, the prognostic indicators, and treatment options. This case report shows physicians that NKTCL lymphoma can present as periorbital cellulitis, although few similar cases are found in the literature. CONCLUSIONS NKTCL is a destructive midline tumor that should be kept in mind as a differential diagnosis of paranasal sinus lesions to help in early diagnosis, which can improve the prognosis.

Recurrent Post Tonsillectomy Secondary Hemorrhage in Patients with Factor XIII Deficiency: A Case Series and Review of Literature.

BACKGROUND Post-tonsillectomy hemorrhage (PTH) has been reported in the literature as a serious complication after tonsillectomy that has high morbidity and can be life threatening. In cases of recurrent secondary PTH, one should consider coagulopathies as the hidden pathology. Factor XIII deficiency is very rare, suggested to be present 1 in 2 million people. Patients with undiagnosed factor XIII deficiency with secondary PTH are extremely rare.  CASE REPORT We report on the cases of six patients (four adults and two children) who presented with recurrent attacks of secondary PTH. CONCLUSIONS Recurrent, severe PTH could be related to undiagnosed hematological disorders.

Tympanoplasty in adhesive otitis media: A descriptive study.

OBJECTIVES/HYPOTHESIS: There is no consensus among clinicians regarding the best treatment strategy for adhesive otitis media (AdOM). It is common practice to only intervene in the presence of recurrent infections or significant conductive hearing loss. In an attempt to provide evidence regarding the efficacy and safety of surgical intervention, we have analyzed the long-term outcome of tympanoplasty for AdOM . STUDY DESIGN: Prospective study. METHODS: From January 2013 to April 2014, 57 patients with AdOM (60 ears) who fit our criteria for tympanoplasty were recruited and underwent tympanoplasty using tragal cartilage combined with transtympanic ventilation tube and cortical mastoidectomy. Otorrhea control, graft uptake, hearing level changes, and complications were evaluated within a 3-year period of follow-up. RESULTS: Otorrhea was controlled in 94% of the ears. Tympanic membrane healing was achieved in all ears except one ear, which had myringitis. Overall there was significant improvement in hearing. Whereas the mean preoperative air-bone gap (ABG) was 30.4 ± 4.0 dB, postoperative mean ABG was 8.6 ± 6.9 dB at 1 year. Closure of ABG to within 20 dB was achieved in 46 ears (83.6%). One ear showed a drop in bone conduction level by 25 dB. No iatrogenic cholesteatoma was detected in any of the cases. CONCLUSION: This study demonstrated that tympanoplasty has favorable outcomes in AdOM . Risks of iatrogenic sensorineural hearing loss or cholesteatoma formation are negligible. LEVEL OF EVIDENCE: 4. Laryngoscope, 126:2804-2810, 2016.

Oropharyngeal trauma mimicking a first branchial cleft anomaly.

We present a unique and challenging case of a remnant foreign body that presented to us in a child disguised as a strongly suspected congenital branchial cleft anomaly. This case entailed oropharyngeal trauma, with a delayed presentation as a retroauricular cyst accompanied by otorrhea that mimicked the classic presentation of an infected first branchial cleft anomaly. During surgical excision of the presumed branchial anomaly, a large wooden stick was found in the tract. The diagnostic and therapeutic obstacles in the management of such cases are highlighted. In addition to exploring the existing literature, we retrospectively analyzed a plausible explanation of the findings of this case. Laryngoscope, 126:E224-E226, 2016.