Nasal obstruction due to deviated nasal septum is a common problem encountered by otolaryngologists. A variety of surgical procedures have been tried in the treatment of the same. This study was conducted to evaluate the outcomes and complications of endoscopic and conventional septoplasty. This is a prospective, randomized study. Fifty patients with symptomatic deviated nasal septum were included in the study, 25 of them underwent conventional septoplasty and the rest underwent endoscopic septoplasty. The difference in the functional outcome of both the surgeries was insignificant. There was a significant difference with respect to complications. Endoscopic septoplasty had better outcome with respect to complications. It is easier to correct posterior deviations and isolated spurs with endoscopic septoplasty. Complications are lesser with endoscopic septoplasty.

Effectiveness of endoscopic posterior nasal neurectomy for the treatment of intractable rhinitis INTRODUCTIONRhinitis is an inflammatory condition affecting the lining of the nose, characterized by nasal congestion, rhinorrhea, itching, sneezing and/or post-nasal discharge 1 . More than 20% of the population is affected by chronic rhinitis [2][3][4] . Depending on whether an allergic etiology is implicated, non-infectious rhinitis can be subdivided into allergic and non-allergic. With 600 million of world's population affected, allergic rhinitis is the most prevalent atopic disorder. The incidence of allergic rhinitis is on steady increase 5 . Various etiological factors have been postulated for chronic rhinitis -these include allergy, occupational exposures, hormonal changes, smoking, xylometazoline abuse, etc. The standard treatment strategy is medical (histamine antagonists, leukotriene receptor antagonists, intranasal corticosteroids, etc.) But many times, these therapies show limited effectiveness and cause substantial burden for treatment cost on the long term. In addition, the symptoms of intractable rhinitis can cause social embarrassment with a profound effect on patients' quality of life.Surgical management can be considered in such patients with intractable rhinitis. Various surgical techniques have been documented including Vidian neurectomy 6 , posterior nasal neurectomy, inferior turbinate reduction, with varying success rates [5][6][7][8] . In view of this, we are studying the effectiveness of posterior nasal neurectomy (PNN) in patients who have intractable rhinitis, refractory to maximum medical therapy. The outcome is assessed with patient's level of satisfac-ABSTRACT BACKGROUND. Chronic rhinitis is a clinical condition affecting more than 20% of the world population. The standard treat-

<p class="abstract"><strong>Background:</strong> Aplasia or agenesis of frontal sinuses is not uncommon in the literature. Previous studies have shown unilateral aplasia varying from 1-10% and bilateral agenesis of frontal sinus in 3-10% of patients. It is critical for the operating surgeon to be well aware of the normal anatomy and the variations while doing procedures like endoscopic sinus surgeries, cranialisation of frontal sinuses, frontal sinus trephination, and during anterior skull base procedures. The aim of this study is to demonstrate the incidence of anatomic variations of frontal sinus among Indian populations<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> We did a cross sectional study on computed tomography (CT) scan of head, nose and paranasal sinuses in 730 patients above the age of 10 years. We excluded pregnant ladies, patients with prior sinus surgeries, sinonasal tumors, nasal polyposis, craniofacial trauma<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">We observed an incidence of 6.2% of unilateral aplasia of frontal sinus (2.2% in males and 4.0% in females, 3.7% right side and 2.5% left side) and 2.5% of bilateral frontal sinus aplasia (0.95% in males and 1.5% in females). </span></p><p class="abstract"><strong>Conclusions:</strong> Frequent occurrence of frontal sinus aplasia highlights the need to gain a thorough knowledge of the normal anatomy and its variations in order to navigate safely through the nose during basic endoscopic sinus or anterior skull base surgeries to avoid complications<span lang="EN-IN">.</span></p>

Introduction Approximately 20% of patients with tracheostomy are discharged from hospital with the tracheostomy  tube in situ. Proper long term care and management of such tracheostomy patients remains as a challenge to care givers. Fracture of metallic tracheostomy tube (TT) with aspiration of the fragment into tracheobronchial airway is a rare complication of  tracheostomy. Case Report Here we are presenting a case of a 42-year-old male patient, presented to the emergency department with complaint of mild respiratory distress following aspiration of fractured metallic TT and a novel method in removing the dislodged fragment. Discussion A detailed review of literature has been included to discuss different aspects of aspiration of fractured fragment of tracheostomy tube and best practice recommendations for proper tracheostomy care. Conclusion Educating the care-giver about care of the tracheostomized patient in general and care of the tracheostomy tube in particular, may help reduce accidental complications.

No abstract