Background Laryngopharyngeal reflux symptoms assessed with the reflux symptom index can overlap with non-allergic rhinitis symptoms. This study aims to explore the association between the reflux symptom index and nasal symptoms in non-allergic rhinitis patients. Methods A cross-sectional study was conducted on consecutive adults with non-allergic rhinitis. The reflux symptom index (score of more than 13 = laryngopharyngeal reflux) and nasal symptoms (categorised as mild (total score of 0–3), moderate (4–7) or severe (8–12)) were assessed. Results The study included 227 participants (aged 58.64 ± 12.39 years, 59.5 per cent female). The reflux symptom index scores increased with total nasal symptom scores (mild vs moderate vs severe, 8.61 ± 6.27 vs 12.94 ± 7.4 vs 16.40 ± 8.10; p < 0.01). Logistic regression indicated that laryngopharyngeal reflux is more likely in patients with severe nose block (odds ratio 5.47 (95 per cent confidence interval = 2.16–13.87); p < 0.01). Conclusion Laryngopharyngeal reflux symptoms are associated with nasal symptom severity, and nasal symptoms should be primarily treated. Those with predominant nose block and laryngopharyngeal reflux symptoms are more likely to have laryngopharyngeal reflux.

Malaysia Introduction : Cosmetic and functional outcome is the two important indicator for evaluation of success in septorhinoplasty surgery. In our study we evaluated the functional outcome objectively and subjectively. I was a prospective single blinded interventional study held in Otorhinolaryngology Clinic, Universiti Kebangsaan Malaysia Medical Centre UKMMC Materials and Methods: Rhinomanometry and two questionnaires Nasal Obstruction Symptoms Evaluation NOSE scale and Health-Related Quality of Life Questionnaires HRQOL in Rhino Surgery were used to assess the objective and subjective functional outcome of septorhinoplasty respectively. All measurements were taken preoperatively and months postoperatively Results: From the total of patients recruited in this study, majority had no history of trauma. Twisted nose was the most common external nose abnormality followed by crooked and saddle nose. All patients had internal valve insufficiency. There were significant improvement of the total and of all the parameters in the NOSE scale post septorhinoplasty p<.. Furthermore, there were significant improvement in total and in all parameters in HRQOL score post septorhinoplasty p<.. There were improvements in the rhinomanometry data bilaterally during inspiration and expiration, but were not statistically significant p>.. Significant correlations were noted in the improvement between the two subjective assessments NOSE scale and HRQOL score. However, there was no significant correlation in the improvement between the subjective NOSE scale and HRQOL score with objective rhinomanometry score assessments. Conclusions: Septorhinoplasty improves the nasal airflow and quality of life of patients with nasal obstruction Office-based rhinologic surgery in our clinic

Esthesioneuroblastoma is a rare malignant neoplasm of oflactory neuroepithelium and usually located at the olfactory cleft at superior nasal cavity. Ectopic localization of esthesioneuroblastoma is even rarer and usually posed with a diagnostic dilemma and delay in the diagnosis and management, We report a rare case of ectopic esthesioneuroblastoma of the sphenoclivus with the presentation of intermittent unilateral epistaxis, intermittent intractable headache without anosmia. Nasal endoscopy findings showed a pulsatile mass at the anterior face of the sphenoid sinus with extension posteriorly towards the clivus region and occupying the floor of the sphenoid sinus. Endonasal transclival endoscopic excision of tumour was performed which involved otorhinolaryngology surgeon and neurosurgeon with intraoperative navigation imaging and frozen section. The histopathological findings was esthesioneuroblastoma. Due to its rarity and unusual presentation, the diagnosis of ectopic esthesioneuroblastoma is difficult and can be misdiagnosed with the other type of malignancy. Therefore, the histopathological result is important in confirming the type of tumour and can lead to the next step of management.

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Adenoid cystic carcinoma is difficult to treat. Sinonasal tract tumours can be resected via endoscopic endonasal resection or endoscopic assisted craniofacial resection, but prolonged follow up is advisable. Radiotherapy is an important adjuvant treatment.

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Though a common symptom, epistaxis should never be overlooked as the implications may be consequential. Nasal leech infestation represents an unusual etiology of recurrent epistaxis. The leeches release enzymes to anaesthetize the attachment site to facilitate the feeding process. Given the inconspicuous area of infestation and the absence of pain, there is often a delayed treatment. A detailed history taking and physical examination remain paramount in the assessment of recurrent epistaxis.