To Assess the Effect of Septoplasty on Pulmonary Function Tests: A Prospective Study.

To assess the effect of septoplasty on pulmonary function test (PFT). 50 cases were chosen between the age group 18-50. All cases had nasal obstruction due to nasal septum deviation. Demographic data, detailed clinical examination including anterior and posterior rhinoscopy was performed. PFT values (fvc, fev1, fev1/fvc, fef25%, fef50%, fef75%, fif25%, fif50%, fif75%) were taken pre operatively and 1 month after the surgery by using Helios 401 spirometer. All the data were recorded and spss version 20.0 was used to analyse the data. Among 50 patient, most of the patients were males 78% (n = 39) and the rest were females (n = 11) 22%. The patient were in between 18 and 50 age group. The maximum patient belonged to age group 18-27 years (n = 25) 50% of the total patients. 38% (n = 19) were in the age group of 27-37 years. 12% (n = 6) of the patients were in age group of 37-50. Nasal obstruction was present in all patients (n = 50) followed by sneezing (56%), nasal discharge (42%), and headache (26%). Maximum number of patient had deviation of septum to the left (n = 28) 56% and the rest had to the right (n = 22) 44%. After the surgery there was improvement in PFT values in all types of patient with DNS, but statistical significance was seen in type II in fef25% and fif75% values (p < 0.05). In rest of the patients there was no statistical significant improvement seen. A favorable outcome was seen in PFT values after Septoplasty, thus signifying the effect of deviated nasal septum on lower airway.

Spreader Graft Placement: An Effective Procedure for Alleviation of Internal Nasal Valve Collapse.

PURPOSE: The internal nasal valve (INV) is one of the most commonly involved areas in patients with nasal obstruction, and surgeries such as turbinate reduction and septal recontouring affect the physiology of the nasal valve area. With this concept, a cohort study was conducted to evaluate spreader graft's effectiveness in recontouring INV and relieving nasal obstruction. MATERIALS AND METHODS: A prospective cohort study was performed, including patients with nasal obstruction with INV involvement. To quantify and compare the amount of nasal obstruction, Gertner Metal Plate (GMP) was used, and to assess the relief in associated symptoms, the Sino-Nasal Outcome Test (SNOT-22) was taken into consideration. GMP and SNOT 22 were performed preoperatively and postoperatively at the 1st, 3rd, and 6th months, and the data obtained were analyzed by SPSS 22 software using paired t-tests. The postoperative broadening of the nasal dorsum and patient satisfaction with the surgical outcome were also assessed using the visual analog scale . RESULTS: A total of 38 patients were included, with 28 males and 10 females. The data obtained were analyzed by using paired t-tests. Improvement in GMP assessment showed that t = 10.392305, 13.391485, and 15.985243 at the 1st, 3rd, and 6th months, respectively, with an overall P ≤ .00001 and relief in associated symptoms assessed by SNOT 22 computed t = 12.24228, 15.824486, and 18.046395 at the 1st, 3rd, and 6th month, respectively, with an overall P ≤ .00001. A total of 81.57% of patients did not perceive significant nasal dorsum broadening, and 86.84% of patients were highly satisfied by the surgical outcome based on the visual analog scale. CONCLUSION: We conclude that in patients with nasal obstruction associated with INV involvement, spreader grafting provides rapid relief of nasal obstruction and associated symptoms, does not cause any appreciable broadening, and provides a high degree of patient satisfaction. Hence, it should be preferred over septal recontouring and turbinate reduction.

Pilomatricoma: Forget me not.

Pilomatricoma is a benign skin neoplasia, which is not commonly encountered in general practice. The diagnosis is often made only after histopathology. The present case report is of a 30-year-old woman who presented with swelling in neck, which was diagnosed as pilomatricoma only after excision. The idea of reporting this case is that pilomatricoma is not rare in occurrence but rarely diagnosed because of lack of confirmation of excised swelling and it is imperative that it should be kept in the differential diagnoses of all superficial skin tumors by dermatologists and surgeons.

Acute onset progressive hemiparesis in a case of head and neck injury.

Traumatic carotid artery injury is an increasingly recognized complication of severe blunt head or neck trauma in patients with motor vehicle accidents. A 22-year-old male presented after a high-velocity road traffic accident and sustained head, neck and systemic injuries. Initially the patient was neurologically stable and initial CT scan brain was also apparently normal. Few hours after the injury, the patient developed progressive left hemiparesis. MRI of brain was suggestive of acute infarct involving right internal carotid artery territory. In accordance with the literature and as in present case, it would be emphasized that the patients who develop gross neurological abnormalities after blunt trauma to the head or neck, there should be a high index of suspicion of having sustained injury to the carotid arteries.