Allergic rhinitis and its impact on asthma classification correlations.

OBJECTIVE: Allergic rhinitis is inflammation of the nasal mucosa following exposure to allergens. A few studies have investigated how the Allergic Rhinitis and its Impact on Asthma classification correlates with symptom severity and skin prick test results in allergic rhinitis patients. Our objective was to evaluate such a correlation. MATERIALS AND METHODS: The study population consisted of 268 patients who had allergic symptoms and were diagnosed with allergic rhinitis. RESULTS: Analysis of the Allergic Rhinitis and its Impact on Asthma classification with regard to symptom severity revealed that there were statistically significant differences between the groups for nasal symptoms, wheezing, eye itching/watering and eye redness. Symptom frequency and severity increased gradually towards the moderate to severe persistent allergic group. There was a statistically significant difference between the groups for grass pollen and house dust mite allergy. CONCLUSION: The Allergic Rhinitis and its Impact on Asthma classification, which takes symptoms and quality of life into consideration in addition to allergen exposure, is a useful classification system for allergic rhinitis.

Role of magnetic resonance imaging in evaluating sphenoid sinus and internal carotid artery.

OBJECTIVE: This study aimed to determine whether magnetic resonance imaging has a role in the evaluation of the sphenoid sinus and internal carotid artery. In addition, we aimed to establish reference measurements for the minimal distance between the internal carotid arteries. METHOD: The sphenoid sinuses and neighbouring internal carotid arteries of 90 patients were evaluated using sagittal T1-weighted and axial and coronal T2-weighted magnetic resonance images. RESULTS: Sphenoid sinus pneumatisation was categorised as occipitosphenoidal (0 per cent), conchal (3.3 per cent), presellar (14.4 per cent) or sellar (82.2 per cent). The internal carotid artery protruded into the sphenoid sinus in 32.8 per cent, with a septum in 9.4 per cent. The incidence of sellar-type sphenoid sinus pneumatisation was higher in patients with protrusion of the internal carotid artery into the sphenoid sinus (p < 0.001). The incidence of presellar pneumatisation was higher in patients without internal carotid artery protrusion (p < 0.001). The minimal distance between the internal carotid arteries varied between 9.04 and 24.26 mm (mean, 15.94 mm). CONCLUSION: Magnetic resonance imaging can provide useful information about the sphenoid sinus and internal carotid artery, prior to endoscopic sphenoidotomy and trans-sphenoidal hypophysectomy.

A misdiagnosis: duplication of the external auditory canal.

We present imaging and clinical findings of a case with a duplicated external auditory canal, which led to misdiagnosis secondary to lipomatous content on imaging studies prior to surgery. It is a very rare congenital anomaly. This entity is usually misdiagnosed not only clinically but also radiologically. This leads to a delay and failure in diagnosis and treatment. To the best of our knowledge, herein is the first case report of the duplication of the external auditory canal presenting with dominant lipomatous imaging features. In this report, we aim to draw attention to the atypical presentation.

Nasal septal deviation and concha bullosa coexistence: CT evaluation.

PROBLEMS/OBJECTIVES: The discussion of the incidence of sinusitis in patients with nasal septal deviation and concha bullosa has been accompanied by some controversy. In this study, we assess the incidence, in conjunction with concha bullosa and nasal septal deviation, of sinus, ostiomeatal and frontal recess disease on either side in the same patients. METHODOLOGY: We reviewed the CT studies conducted between 2003 and 2005 of the paranasal sinuses of 130 patients. All examinations were performed for the evaluation of a symptom referable to the sinonasal region. Fifty-eight patients had both nasal septal deviation and concha bullosa. We recorded the presence and degree of septal deviation, the direction of septal deviation, and sinus, ostiomeatal and frontal recess disease. RESULTS: Twenty-six patients had deviation to the right. Of these patients, nine had sinusitis on the left and ten had sinusitis on the right. Thirty-two patients had deviation to the left. Of these patients, 14 patients had sinusitis on the left and 17 had sinusitis on the right. No statistical difference was found (p > 0.05). Likewise, no correlation was found with frontal recess or ostiomeatal disease. CONCLUSIONS: The incidence of the coexistence of nasal septal deviation and concha bullosa is high (44.6%). There does not appear to be a statistically significant difference between the laterality of sinus, ostiomeatal and frontal recess disease (p > 0.05). The incidence of sinusitis in severe nasal septal deviation is higher when compared with mild (p = 0.001) and moderate groups (p < 0.001).

Ceruminous gland carcinoma of the external auditory canal presenting as chronic otitis media.

OBJECTIVE: Ceruminous neoplasms of the external ear canal are rare. Classification, clinical behavior, and management of these tumours are controversial. We report a case of carcinoma originating from the ceruminous glands of the external ear canal (EAC), operated based on a diagnosis of chronic otitis media with polyp. CASE REPORT: A 48-year-old man presented with left ear discharge and hearing loss. Clinical examination showed a well-circumscribed polypoid mass limited to the EAC. There was no history of bloody ear discharge or radiological findings of bony erosion suggestive of malignancy. Our preliminary diagnosis was chronic otitis media with polyp formation. Tympanoplasty was performed. Histopathology revealed a ceruminous carcinoma, and an additional operation involving lateral temporal bone dissection was performed, followed by 60 Gy radiation therapy. CONCLUSION: Ceruminous carcinomas should be considered in the differentialdiagnosis of middle and external ear pathologies in cases of soft tissue mass in the EAC.