Veerasigamani Narendrakumar

Pragathi ENT & Endocrine Clinic, Chennai, India.

Maxillary sinus was first described by Nathaniel Highmore (1613–1685), a British physician and anatomist [1]. Maxillary sinuses are embryologically the first to develop, starting at around tenth week, and are almost always present at the time of birth [2]. The growth patterns of the maxillary sinus indeed undergo significant changes during childhoo...

Anatomical variations in the maxillary sinus pneumatisation are limited unlike the ethmoids. We present rare variations of the maxillary sinus along its floor other than septations and includes wide pneumatisation of alveolar and palatal recess with cell formation. An intra-maxillary cell that opens into the maxillary infundibulum well within the s...

The field of otorhinolaryngology is made challenging by the complex and unique anatomy of head and neck region. Successfully navigating this area with surgical finesse remains an enigma. 100 Complications of Otorhinolaryngology & Skull Base Surgery provides a broad overview of various complications encountered in ENT and skull base surgeries, their...

Pilomatrixoma, also known as pilomatricoma, is a rare benign appendageal neoplasm of the hair follicle matrix. It usually presents as a superficial, firm mass, commonly found in the head and neck region which may pose a diagnostic challenge as it may resemble other common benign lesions. Pilomatricoma remains to be misdiagnosed and is usually not c...

Introduction: Endoscopic Denker’s approach involves complete exposure of the anterior, inferior and lateral walls of the maxillary sinus providing access to both infratemporal and pterygopalatine fossa. Open approaches to maxillary sinus may lead to a high chance of cranial nerve dysfunction, trismus and wound healing issues. Surgical methods diffe...

In the present era, Hemostasis in Endoscopic nasal and sinus surgeries are challenging even with appropriate use of instrumentation and surgical skills. This can be addressed with appropriate local anaesthesia and nerve blocks. Expertise in performing surgery under local anaesthesia can be acquired over years of surgical training. The objective of...

To study the Computerized Tomography (CT) Paranasal Sinus findings in patients with acute bacterial sinusitis and the clinical symptom associated with it. 120 patients were examined over 2 years with coronal CT images of paranasal sinus with clinical symptoms of acute sinusitis of 2 weeks duration from the onset. Patients with symptoms of more than...

Aim The study intents to compare the hemostatic and hemodynamic effects of topical application versus intranasal injection of adrenaline during endoscopic sinus surgery (ESS) under general anesthesia (GA). Materials and Methods This is a tertiary hospital-based, 1-year prospective observational study in fifty adults, within the age group of 18–70...

Aim, To evaluate the treatment outcomes of endoscopic prelacrimal approach in managing various maxillary sinus pathologies, analyzing the associated adverse events and post treatment quality of life and also to compare surgical outcomes of prelacrimal approach with middle meatal antrostomy approach to remove various maxillary sinus pathologies. Ma...

Background Endoscopic ear surgery is a game changer in the field of otology. Training in endoscopic skills is essential for ENT residents, and is especially important during the coronavirus disease 2019 lockdown period. In such difficult times, ENT residents and surgeons can undergo hands-on training using a papaya petiole, even within their homes....

Background Despite advances in surgical technique, postoperative hemorrhage remains a common cause of morbidity and mortality for patients following tonsillectomy. Attempts to reduce the morbidity of tonsillectomy have included changes to the surgical techniques and perioperative medications to reduce the risk of bleeding. Here, we did a decade stu...

The management of inverted papilloma involving frontal sinus and supraorbital ethmoidal cells is still challenging even for the well-trained rhinologists. These cases sometimes require an external approach, but now with the technique of endoscopic orbital transposition many such cases are handled effectively endonasally. Here in our case report, we...

Cribriform plate is the commonest site of Cere-brospinal fluid (CSF) leak, its fragility and juxtaposition of arachnoid's investment to the bone, where the olfactory nerve pierces the skull, is a vulnerable site for CSF leak. Endoscopic transnasal approach has been the main stay for CSF leak repair over the past 2 decades. The technique and surgica...

Background: Eventhough various treatment modalities are available for auricular pseudocyst, the location and pathogenesis ushered newer concepts. Aim: To assess the effect of steroid injection after aspiration of pseudocyst and reaspiration of injected steroid after stipulated time duration. Methodology: During the four years study period we ass...

Endoscopic Sinus Surgery is evolving day by day, there is a constant need for improvisation in terms of instrumentation with clear bloodless surgical field and good postoperative results. The applications of Dr. Ahila’s Conchal Crusher for managing Concha bullosa in Functional Endoscopic Sinus Surgery (FESS) Surgery are presented. The creation/inno...

65 year old female presented with complaints of Right sided nasal obstruction of 1 year duration, intermittent nasal discharge for the past 6 months, without much significant improvement in medical management. Computerized tomography of paranasal sinuses revealed presence of supra maxillary cell (SMC) which was infected, along with sphenoid sinus (...

Abstract Introduction: Orbital infection has spread beyond the orbital septum leads to orbital cellulitis. The distinctive features of orbital cellulitis are proptosis and limitation of ocular movements. Additional useful signs are chemosis of bulbar conjunctiva, reduced visual acuity, afferent pupillary defect, and toxic systemic symptoms. Prompt...

p class="abstract">Lymphangiomatous polyps are rare tumours present in head and neck. Squamous papilloma accounts for majority of benign lesions, whereas vascular tumours are rarely reported. Tonsillar lymphangiomatous polyp is an uncommon hamartomatous lesion that generally arise from tonsillar surface. We present a case of young adolescent female...

p class="abstract">Nasolabial cysts are rare, nonodontogenic soft tissue developmental cysts occur in the maxillary lip and nasal alar regions. Patients usually presents with an asymptomatic soft swelling with obliteration of the nasolabial fold. Due to it's origin from entrapped epithelium in an embryonic fusion plane developmentally, this cyst is...

The presence of the thyroid gland outside its compartment is defined as ectopic thyroid. It is an abnormal embryological development. When present in the base of the tongue, it is lingual thyroid. We report this case of incidental lingual thyroid during routine clinical examination and highlight the importance of endoscopic examination in otorhinol...

The uvula is a downward projection of the posterior margin of the soft palate, which is formed by the musculus uvulae muscle. An elongated uvula can be associated with various problems such a chronic cough, difficulty in speech, upper airway obstruction or irritation. Here we present a case report of a patient with a long uvula causing difficulty i...

Background: Obstructive sleep apnea is the most common form of sleep-disordered breathing. However, obstructive sleep apnea has been associated with much more insidious conditions, including hypertension, diabetes, heart disease, stroke, and daytime somnolence can lead to a dramatically increased risk of motor vehicle accidents. Methods: This study...

Blunt trauma to orbit can lead to orbital blow out fracture. Computerized tomography of paranasal sinuses plays the main role in diagnosing it. Repairing the defect and restoring the orbital contents is a challenging task for the surgeon. Endoscopic endonasal approach in reduction of blow out fracture provides good cosmetic outcomes and grossly min...

BACKGROUND Chronic Suppurative Otitis Media (CSOM) is the chronic inflammation of the middle ear cleft mucosa, which is characterised by irreversible changes in it with a history of ear discharge for more than 3 months through a permanent tympanic membrane defect. Chronic suppurative otitis media is of two types tubotympanic (mucosal) and atticoant...

Background: The distance between the anterior wall of the maxillary sinus and the nasolacrimal duct shows a large individual variation. Methodology: To evaluate the feasibility of accessing the maxillary sinus through a prelacrimal window access (PLWA), a series of 100 paranasal CT scans from adult patients was analysed retrospectively. The distanc...

Objective: The aim of the study is to evaluate the age, sex, site of lesion, histopathological diagnosis, and recurrence rate of the maxillectomy patients. Materials and methods: A retrospective study was done in 42 patients, who underwent maxillectomy for malignant growth of the nose and paranasal sinuses from 2006 to 2015 at our center. Results:...

A variety of anatomical variation of paranasal sinus and nasal turbinates exist, as its development is a complex and long standing process. Computerized Tomography (CT) of the paranasal sinuses is a very valuable tool in diagnosing these variations. Preoperatively defining the anatomical variations of the intranasal structures is essential in perfo...

Background: The distance between the anterior wall of the maxillary sinus and the nasolacrimal duct shows a large individual variation. Methodology: To evaluate the feasibility of accessing the maxillary sinus through a prelacrimal window access (PLWA), a series of 100 paranasal CT scans from adult patients was analysed retrospectively. The dist...

Introduction: Chronic Rhino Sinusitis (CRS) is one of the most prevalent chronic illnesses across the globe, affecting persons of all ages. It is an inflammatory process that involves the paranasal sinuses with symptoms lasting longer than 12 weeks. Aim: To establish the significance of blood eosinophil (count) levels in CRS with nasal polyps and t...

The giant cell tumor (GCT) or osteoclastoma is considered to be a locally aggressive benign tumor. The GCTs of the cranium represent only 1% of all GCTs and preferentially affect the sphe- noid and temporal bones. We report a case of an 18-year-old male who presented with headache and diplopia. Radiological investigation shows a destructive midline...

Aims To study the anatomical variations of osteomeatal complex and the importance of preoperative computed tomography (CT) in patients with chronic sinusitis undergoing functional endoscopic sinus surgery. We studied the different variations and their frequency of occurrence. Materials and methods A total of 100 patients undergoing endoscopic sinu...

Allergic rhinitis and vasomotor rhinitis are effectively treated by vidian neurectomy but it is presently seldom used because of its high incidence of complications like dry eye, cheek and gums, numbness and eye movement disturbances. This emergence the endoscopic posterior nasal neurectomy for rhinorrhea patients, in which resection of the postgan...

Orbital fractures can cause facial disfigurement and disturbs vision. Medial orbital wall fractures are diagnosed with frequent use of computed tomography (CT) scans in the diagnosis of orbital trauma. Orbital reconstruction plays a challenging role for the surgeons as it comes in a multitude of different forms. We report a case of 45-year male wit...

Perrault syndrome is a rare disease comprising pure gonadal dysgenesis (46 XX) and sensorineural hearing loss in females and deafness alone in affected males. It is an autosomal recessive disorder. Over the years many additional features like marfanoid habitus and central nervous system findings have also been reported. Herein we report a case of s...

Lip cancer is the most frequent malignant neoplasm of the oral cavity. Lower lip is the most common site. Defects larger than one-fourth of total upper lip length require reconstruction by established techniques or multiple procedures. Nasolabial rotation flaps based on the upper lateral lip subunit for superficial and large defects of the upper la...

Auditory neuropathy is a hearing disorder in which sound enters into the inner ear normally but the transmission of signals from the inner ear to auditory cortex is impaired due to the poor brain development. We report a case of 7 year male child presented with hard of hearing, deformed both external ears and inability to speak since birth. On exam...