Role of Bilateral Inferior Turbinoplasty as an Adjunct to Septoplasty in Improving Nasal Obstruction and Subjective Performance in Patients With Deviated Nasal Septum Associated With Allergic Rhinitis: An Interventional, Prospective Study.

BACKGROUND: Patients with nasal obstruction due to deviated nasal septum (DNS) often have allergic rhinitis (AR) as contributing factor. When optimal medical therapy for AR fails, septoplasty alone may not adequately treat nasal obstruction. Therefore, with bilateral inferior turbinate hypertrophy representing long-standing AR, adding bilateral inferior turbinoplasty (BIT) to septoplasty might be beneficial. OBJECTIVE: To assess whether septoplasty with/without BIT alleviates nasal obstruction in the above patient cohort and whether adding BIT to septoplasty brings significant benefit. METHODOLOGY: In this interventional, prospective study, patients with nasal obstruction due to DNS and persistent, moderate-severe AR refractory to optimal medication were randomly allocated into group A (septoplasty alone) and group B (septoplasty with BIT). Nasal Obstruction and Symptom Evaluation (NOSE) score, along with Subjective Performance parameters (days-off/month; number of outdoor visits/month; overall satisfaction score [OSS]) were used to assess the symptom and quality of life, respectively, at follow-up. RESULTS: Each group had 40 age/sex-matched patients. Friedman test, and subsequent pair-wise comparison within groups without Bonferroni correction, revealed that septoplasty with/without BIT elicited significant reduction in NOSE scores and in the Subjective Performance parameters (days-off/month; number of outdoor visits/month) at 3 and 6 months. Wilcoxon Signed Rank test revealed that the OSS within groups also improved significantly with time. Further, comparison between groups revealed significant improvement in NOSE scores at all levels of follow-up when BIT was included. However, there were no significant differences between groups in the Subjective Performance parameters at any level of follow-up. Improvement in OSS between groups was significant only at 3 months but not subsequently. CONCLUSION: Septoplasty with/without BIT is helpful in treating patients with DNS and refractory AR. However, although adding BIT brings significant benefit in decreasing nasal obstruction, it does not significantly improve the Subjective Performance parameters during follow-up, except for OSS at the third month.

Diffuse Idiopathic Skeletal Hyperostosis Involving Cervical and Lumbar Spine Presenting with Dysphagia: A Case Report.

INTRODUCTION: Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a very rare cause of dysphagia when it occurs in the cervical spine. It can also affect the lumbar region where it causes deformity. CASE REPORT: In this article, a rare case of Diffuse Idiopathic Skeletal Hyperostosis involving both the cervical and lumbar spine, presenting with dysphagia and spinal stiffness leading to a stooping posture, is reported. CONCLUSION: Cases of simultaneous involvement of cervical and lumbar vertebrae by Diffuse Idiopathic Skeletal Hyperostosis, presenting with symptoms of both area involvement, are rarely reported in the English literature. When investigating a case of dysphagia, a high level of suspicion is required to diagnose such a condition.