Nasal polyposis are common presentations in patients of chronic rhinosinusitis and are considered to be associated with more severe forms of disease with poor treatment outcome. The presentation and treatment outcome after endoscopic sinus surgery in patients of chronic rhinosinusitis and nasal polyposis have been analysed in this study. A prospective analysis of 90 patients of chronic rhinosinusitis who were classified into two groups depending on presence and absence of nasal polyps was performed in the study. The two groups were evaluated using subjective (patient complaints) and objective (computed tomography scan and endoscopy scores) criteria. Preoperative data were compared with data obtained 12 months post endoscopic sinus surgery. The study included 38 patients of chronic rhinosinusitis and 52 patients of nasal polyps. The patients of nasal polyp group presented with increased severity of symptoms of nasal blockage, nasal discharge and reduced sense of smell as compared to the chronic rhinosinusitis group who had significantly higher presentation of headache and facial pain. The preoperative CT scan revealed significantly higher bilateral disease with increased involvement of multiple sinuses in nasal polyp group. Post endoscopic sinus surgery both the groups showed significant improvement in their symptoms with the nasal polyp group demonstrating reduction in improvement on 1 year follow up. In our study we have found the patients with chronic rhinosinusitis and nasal polyp have varied severity of symptoms with the nasal polyp group having higher nasal symptoms and increased severity as compared to chronic rhinosinusitis group. Though the universal rationale of management by adequate drainage and ventilation of sinus is similar in both groups, there is a reduction in both objective and subjective scores during 1 year follow up in the nasal polyp group.

Antrolith of the paranasal sinuses are rare entity which are usually asymptomatic, caused by calcification of a nidus and are detected incidentally on radiological examinations. We report a case which presented to us with features of pansinusitis six months after endoscopic sinus surgery. Radiological examination revealed a discrete bony density in the maxillary sinus blocking the ostiomeatal complex. The bony mass was removed endoscopically from the maxillary sinus with drainage of discharge and debris from the sinuses. Histopathological examination revealed an antrolith with bony nidus and calcium deposited around it. We present the imaging and review the present world literature on this rare complication of endoscopic sinus surgery.

Tumors originating in the parapharyngeal space are rare and are fascinating to the surgeon in view of the anatomical complexity of the area, varied histological type of tumors encountered and the impressive size which some of these tumors attain before becoming clinically evident. We report a rare case of schwannoma arising from the cervical sympathetic chain presenting as a mass in the parapharyngeal space.

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Improving quality of postoperative surgical care in head and neck surgery requires reporting of complications. Clavien-Dindo classification system can be used in grading complications related to head and neck surgery and to assess interobserver variability in grading complex complication scenarios. Data was collected from 242 patients who underwent Head and Neck Surgery from 2015 to 2018 at Dept. of ENT and Head and Neck Surgery at a tertiary care hospital. 177 patients had complications were graded based on Clavien-Dindo classification system, into a 5-scale classification system. Interobserver reliability scores for the complication grading scenarios were found to be statistically significant. Construct validity was confirmed as the length of stay in the hospital was statistically related to complication grade (P = 0.032) Reporting of complications is critical to quality improvement in surgical practice. The Clavien-Dindo complication grading scale system was found to be a useful tool for grading head and neck surgery complications.

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Consanguinity has been considered as one of the risk factors predisposing to the development of congenital hearing loss. Effect of consanguinity on cochlear morphology has been subject of speculation, though many studies have provided insight into functional aspect of cochlea. This study was conducted to know the effect of consanguinity on cochlear morphology, if any. A prospective, observational study, including prelingually deaf children with bilateral profound sensorineural hearing loss who are registered as candidates for cochlear implantation at a tertiary care centre, was conducted. Seven children born out of consanguineous marriages and having bilateral congenital sensorineural hearing loss were imaged for their inner ears by MRI and various cochlear measurements were compared with that of seven control children born out of non-consanguineous marriages and who had congenital bilateral sensorineural hearing deafness. No statistically significant differences were noticed in the measurements of mean cochlear length, cross sectional diameter of cochlea at apex, middle turn and at basal turns; between children born of consanguineous and non-consanguineous marriages. Study revealed normal cochlear morphology in all the children born out of consanguineous marriages. Consanguinity, as a risk factor for development of sensorineural hearing loss, may not result in gross structural anomaly of cochlea. The genetic testing of these patients need not be extensive and can be limited to selective screening of genes responsible for functioning of cochlea rather than its anatomical development.