The use of different intranasal splints Doyle splints versus Reuter bivalve splints versus no splints in primary septal surgeries: A randomised clinical trial looking at morbidity.

OBJECTIVE: The objective of this study is to compare the morbidity of different types of intranasal splints (Doyle splints and Reuter bivalve splints) with no intranasal splints in primary septal surgeries and concomitant submucosal reduction of the inferior turbinate. DESIGN: Randomised clinical trial SETTING: Single-Center trial at a tertiary care facility PARTICIPANTS: In this randomised clinical trial, 123 consecutive patients underwent primary septoplasty with bilateral submucosal reduction of the inferior turbinate, with no other concurrent procedure. Patients were randomised into three groups: Doyle splints, Reuter bivalve splints and patients with no splints placed. MAIN OUTCOME MEASURES: Following surgery, the patients were seen at three consecutive visits. During each visit, the Visual Analogue Scale score for headache, nasal obstruction, overall pain and bleeding and an endoscopic score for secretions, oedema and synechiae was filled. RESULTS: Patients were randomised into three groups, 42 received Doyle splints, 41 Reuter bivalve splints and 40 had no splints inserted. When comparing the three groups, the first two post-op visits were scheduled significantly earlier in patients with splints (p < .05). The scores from both groups with splints were statistically higher for headache, nasal obstruction and pain, for the first visit only (p < .05). There was no statistical difference between groups when looking at each subset of the endoscopic score, at each visit (p > .05). CONCLUSION: Increased post-operative pain, headaches and nasal obstruction scores were encountered in patients who had splints after surgery. However, endoscopic scores were statistically similar across the three groups with no difference in post-operative endoscopic scores at each visit. and no difference was seen in symptom scores and endoscopic scores between patients with different splints.

Rhinolithiasis: A Misleading Entity.

INTRODUCTION: Rhinolithiasis is a rare entity; it entails a stone located in the nasal cavity. The entity presents with different signs and symptoms that can be easily confused with other more common clinical entities such as chronic rhinosinusitis. However, it can also mimic sinonasal tumors, making its proper diagnosis crucial. MATERIALS AND METHODS: In this article, we present a case series of 15 patients over the past 13 years between 2002 and 2015 who were seen in the clinics at the American University of Beirut Medical Center. We will shed light on the common presenting symptoms, physical examination findings, proper diagnostic modalities, and treatment options. Our data will be compared to the literature. CONCLUSION: Rhinolithiasis could present with a wide spectrum of signs and symptoms and could be overlooked or mistaken for other diagnosis such as sinusitis or malignancy. It could be differentiated from other entities by rigid nasal endoscopy and computed tomography scan. The diagnosis of rhinolithiasis requires a high index of suspicion.

Atypical lipomatous tumors of the face: a controversial issue.

We reviewed the topic of atypical lipomatous tumors including definition, diagnosis and management, with special emphasis on head and neck location and to report on the management of a rare case located in the temporalis muscle. Atypical lipomatous tumors/well-differentiated liposarcomas (ALT/WDLS) are rarely reported in the head and neck. Their behavior dictates a complete resection. Resection with a safety margin is sometimes needed according to the histological characteristics. Tumors located to the masticator space can be accessed through a mucosal approach achieving relative safety to the facial nerve. ALT constitute a group of tumors of a borderline behavior. Their management can be affected by some histological criteria and by their location in the head and neck region where vital structures can be affected.