scholarly journals Adenoid Hypertrophy with Deviated Nasal Septum in Young Adults

2021 ◽  
Vol 10 (36) ◽  
pp. 3199-3201
Author(s):  
Shweta Anand ◽  
Mahesh Virupakshi Kattimani
Keyword(s):  
Young Adults ◽  
Nasal Septum ◽  
Case Series ◽  
Endoscopic Examination ◽  
Adenoid Hypertrophy ◽  
Medical Sciences ◽  
Deviated Nasal Septum ◽  
Waldeyer’S Ring ◽  
Adenoid Tissue ◽  
Vertical Height

Adenoid hypertrophy is a common cause of nasal obstruction in children but relatively uncommon in adults, however adenoid hypertrophy in young adults is thought to be a persistence of untreated adenoid hypertrophy of childhood. This case series also notes that adenoid hypertrophy can be associated with deviated nasal septum. Coblation assisted endoscopic adenoidectomy usually has good result in adenoid clearance. Hence, routine endoscopic examination of nasopharynx helps in early diagnosis of adenoid hypertrophy and subsequent better management in young adults with complaints of nasal blockage. Nasopharyngeal vegetations were earlier described by Wilhelm Meyer in 1870 as forming part of Waldeyer’s ring of lymphoid tissue and he coined the term ‘adenoid’ to describe the same. In younger children, it has been thought that the adenoids may have an important role in development of an immunological memory. Physiologically it has been considered that hypertrophy of adenoid tissue occurs during 6 - 10 years and tend to regress and atrophy at 16 years. Grading of adenoid hypertrophy as described by Clemens et al. is as follows.1  Grade I: adenoid tissue filling 1/3rd. of the vertical height of choana.  Grade II: adenoid tissue filling up to 2/3rd of the vertical height of choana.  Grade III: from 2/3rd to nearly all but not completely filling the choana.  Grade IV: complete choanal obstruction We present three cases of adenoid hypertrophy with deviated nasal septums in adults who visited ENT outpatient department (OPD) at National Institute of Medical Sciences, Jaipur during COVID era of January 2021 to April 2021.

Which diagnostic method should be used in which age interval in the diagnosis of adenoid hypertrophy?

2018 ◽  
Vol 7 (3) ◽  
pp. 50-54
Author(s):  
Kamil Hakan Kaya ◽  
Zeki Tolga Bilece ◽  
Harun Acıpayam ◽  
Hasan Koçak ◽  
Hüseyin Avni Ulusoy ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Age Groups ◽  
Endoscopic Examination ◽  
Adenoid Hypertrophy ◽  
Study Materials ◽  
Adenoid Tissue ◽  
Group 4 ◽  
Group 3 ◽  
Group 2

Aim: This study aims to determine the age interval for which the flexible nasopharyngoscopy (FNP) and lateral nasopharyngeal X-ray radiography (LNX) used in the diagnosis of adenoid hypertrophy more effectively in a pediatric population. Study Design: Prospective Cohort Study. Materials and Methods: 281 pediatric patients (1 to 15 years old) who were admitted to our ENT outpatient clinic with the complaints of nasal obstruction, snoring, sleep apnea through April 2016 and February 2017 and who were examined with FNP with the pre-diagnosis of adenoid hypertrophy were included in our study. All FNP examinations were evaluated by a single physician. The degree of choanal obstruction was recorded as percentage (%) with the help of the adenoid tissue image. The patients were divided into four groups according to the quality of the endoscopic examination performed during FNP examination; optimal assessment (group-1), assisted optimal assessment (group-2), assisted suboptimal assessment (group-3), and inability to assess despite assistance (group-4). LNX was performed for the re-evaluation of adenoid tissue in the patients in Group-3 and 4. Statistical analysis was performed among the groups according to the ages of the patients. Results: Optimal images were obtained with FNP in the patients aged between 1 and 2 years and 8-15 years and the expected images were obtained for choanal obstruction. However, no image could be obtained with FNP for assessment of choanal obstruction in more than 30% of patients between the ages of 3 and 8 years (31.2% and 33.3%, respectively), also in more than 50% of the patients who were 4,5,6 and 7 years old (60.6%, 56.7%, 55.8%, 66 , 6%, respectively). For this reason, their degrees of choanal obstruction were determined with LNX. Conclusion: For the optimal assessment of adenoid hypertrophy, we suggest that using LNX for the pediatric patients who are 4, 5, 6 and 7 years old and using FNP for the other age groups are more appropriate methods respectively in order not to disturb the polyclinic process of physician and for patient compliance.

scholarly journals Association of external nose deformity in individuals with nasal septal deviation

2019 ◽  
Vol 5 (5) ◽  
pp. 1372
Author(s):  
Ravi Kishore Hubballi ◽  
Shruthi Manohar Koujalagi
Keyword(s):  
Nasal Septum ◽  
Type I ◽  
Type Ii ◽  
Medical Sciences ◽  
Deviated Nasal Septum ◽  
Type Iv ◽  
External Nose ◽  
Facial Midline ◽  
Nose Deformity ◽  
Type V

<p class="abstract"><strong>Background:</strong> Deviated nasal septum presents a challenge as often functional problems as well as aesthetic deformities must be addressed. Deviated nasal septum can be a result of varying pathologies and etiologies. Classifying the nasal deviation enables the surgeon to choose the appropriate operative intervention. This study is intended to know the association of external nose deformity in patients with deviated nasal septum.</p><p class="abstract"><strong>Methods:</strong> 100 patients were attending to the Department of ENT, Vijayanagara Institute of Medical Sciences, Ballari with deviated nasal septum, septal dislocation, septal spur and external nose deformity. Deviated nasal septum was classified as per the classification proposed by Mladina. External nose deformity was classified into 5 types proposed by Yong Jo Jang’s classification depending on the orientation of 2 horizontal units (bony pyramid and cartilaginous subunits) with respect to facial midline.  </p><p class="abstract"><strong>Results:</strong> Out of 100 patients with deviated nasal septum, external nose deformity was present in 61% of the patients. Significant association was present between the deviated nasal septum and external nose deformity (p=0.01).</p><p><strong>Conclusions:</strong> Type II (33%) deviated nasal septum was most common followed by Type VII (31%). Among the external nose deformity, Type I was most common followed by Type V. Type II deviated nasal septum was associated most commonly with Type V external nose deformity, Type VII deviated nasal septum with Type I external nose deformity and Type IV deviated nasal septum with Type I/II external nose deformity in equal frequency.</p>

scholarly journals Adenoid hypertrophy existence in adulthood- a truth revealed

2014 ◽  
Vol 03 (01) ◽  
pp. 12-16
Author(s):  
Atul M Bage ◽  
Anand Karthikeyan D. ◽  
Nutan N Bage
Keyword(s):  
Nasal Obstruction ◽  
Strong Association ◽  
Endoscopic Examination ◽  
P Value ◽  
Adenoid Hypertrophy ◽  
Macroscopic Appearance ◽  
True Incidence ◽  
Presenting Symptoms ◽  
Waldeyer’S Ring ◽  
Adenoidal Tissue

Abstract Background and aims: The adenoids (nasopharyngeal tonsils) are part of Waldeyer’s ring of lymphoid tissue. Endoscopic examination of the nasopharynx increasingly recognized that adenoidal tissue in adults is not an uncommon finding. The aims of this study were to determine prevalence of adult adenoid tissue and the possible reasons behind it. Methods: A retrospective study of 1,100 adult patients, who had routine nasal endoscopic examination for nasal obstruction and related pathologies, was undertaken. 84 cases with incidental hypertrophied adenoid were reviewed to determine the probable cause, presenting symptoms, clinical suspicion and final histological diagnosis. Results: The age of patients ranged from 18 years to 77 years. Median age was 32 years. 59 (70.24%) of adenoid hypertrophy patients were smokers and only 25 (29.76%) were nonsmokers suggesting strong association between smoking and adult adenoid hypertrophy with odds ratio=5.3251, χ2value of 54.23 and an extremely significant p value. All the 84 cases were confirmed histopathologically as Reactive adenoid hyperplasia and no signs of malignancy in any of them. Conclusions: The true incidence of adenoidal hypertrophy in adults is unknown. Adenoidal tissue in adults, if present, must always be biopsied or removed irrespective of their macroscopic appearance. The result underlines the importance of considering adenoid hypertrophy as a cause or contributing factor in nasal obstruction and related pathologies in adults. It also supports the theory that it represents a long-standing inflammatory process rather than being a novel clinical entity.

scholarly journals Peak nasal inspiratory flow: a comparative study in our day to day practice

2018 ◽  
Vol 4 (5) ◽  
pp. 1293
Author(s):  
Vijay Kumar ◽  
Harshvradhan . ◽  
Kranti Bhavana ◽  
Bhartendu Bharti
Keyword(s):  
Allergic Rhinitis ◽  
Nasal Septum ◽  
Normal Subjects ◽  
Neck Surgery ◽  
Inspiratory Flow ◽  
Response To Treatment ◽  
Medical Sciences ◽  
Deviated Nasal Septum ◽  
Monitoring Treatment ◽  
Peak Nasal Inspiratory Flow

<p class="abstract"><strong>Background:</strong> The peak nasal inspiratory flow is an objective measurement of nasal airway obstruction. It also helps in assessing response to treatment regardless of etiology. With this background this study was undertaken to establish diagnosis and monitoring treatment efficacy of PNIF in patients of allergic rhinitis and deviated nasal septum.</p><p class="abstract"><strong>Methods:</strong> This prospective observational study involved 150 subjects who were selected among the patients attending the outpatient department of ENT and Head-Neck surgery, All India Institute of Medical Sciences, Patna. Thorough history was taken of all patients followed by general systemic and ENT examination. Each subject was asked to complete a SNOT 20 questionnaire. SPSS software was used for data analysis.  </p><p class="abstract"><strong>Results:</strong> Out of total 150 subjects, 50 had deviated nasal septum (DNS), 50 had allergic rhinitis and 50 were normal subjects. Normal subjects had mean PNIF value 80 liter per minute with a range of minimum to maximum; 60 L/min to 150 L/min. Patients with symptomatic deviated nasal septum (DNS) had mean PNIF value 50 L/min with a range 20–80 L/min. Patients with symptomatic allergic rhinitis had mean PNIF value 65 L/min with a range of minimum 40 L/min to maximum 90 L/min.</p><p class="abstract"><strong>Conclusions:</strong> On OPD basis, measurements of PNIF using Youlten peak flow meter can easily suggest anatomical &amp; pathological variations in the nose and nasal cavity and can correlated well with patient’s symptoms and severity.</p>

scholarly journals Is Septoplasty Necessary When Using the Endoscopic Endonasal Transsphenoidal Approach for a Deviated Nasal Septum?

2018 ◽  
Vol 79 (06) ◽  
pp. 569-573
Author(s):  
Do Hyun Kim ◽  
Yong-Kil Hong ◽  
Sin-Soo Jeun ◽  
Jae-Sung Park ◽  
Soo Whan Kim ◽  
...  
Keyword(s):  
Nasal Cavity ◽  
Nasal Septum ◽  
Middle Turbinate ◽  
Case Series ◽  
Septal Cartilage ◽  
Transsphenoidal Approach ◽  
Deviated Nasal Septum ◽  
Endoscopic Endonasal ◽  
Significant Difference ◽  
Group B

Objective This article describes the role played by endoscopic endonasal transsphenoidal approach (EETSA) to the sphenoidal process of the septal cartilage of a deviated nasal septum. Design Case series with chart review. Setting Tertiary referral center. Participants Between 2009 and 2016, 177 patients with skull base tumors who underwent EETSA were included. Main Outcome Measures In 8 cases, the conventional two nostrils–four hands technique was employed (group A). In 16 cases, we placed a right-side conventional nasoseptal flap and a left-side modified nasoseptal rescue flap (group B), and in 153 cases, bilateral modified nasoseptal rescue flaps (group C). The number of septoplasty-required cases and the change of nasal cavity area differences reflecting septal deviation were measured. Results Septoplasty during EETSA was performed in two cases: one from group B and one from group C. There was no significant difference in the ratio of septoplasty-required cases among the three groups (p = 0.127). Between pre- and postoperative nasal cavity, the cross-sectional area difference at the anterior end of the middle turbinate level significantly decreased (p = 0.045). Also, the angle of deviation at the level of ostiomeatal unit significantly decreased after EETSA (p < 0.001). Conclusion Separation of a deviated complex surrounding the sphenoidal process of the septal cartilage is the key to relieving a deviated nasal septum. EETSA combined with the two nostrils–four hands technique allows posterior septectomy (including removal of this deviated complex) to be performed. Thus, EETSA may commence without preceding septoplasty even in cases with severe nasal septum deviations.

scholarly journals The benefits of endoscopic look after curettage adenoidectomy

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Mosaad Abdel-Aziz ◽  
Ahmed Nassar ◽  
Refaat Nashed ◽  
Moatz Elsherbeeny ◽  
Omar Sabry
Keyword(s):  
Prospective Study ◽  
Endoscopic Examination ◽  
Nasal Endoscopy ◽  
Adenoid Hypertrophy ◽  
Adenoid Tissue ◽  
Incomplete Removal ◽  
One Year

Abstract Background Conventional curettage adenoidectomy (CCA) has a risk of incomplete removal of all adenoid tissue, and digital nasopharyngeal palpation is not enough to assess adenoid removal. The aim of this study was to evaluate the benefits of trans-oral endoscopic look of the nasopharynx (ELN) after CCA. Results This prospective study included 1900 children with adenoid hypertrophy. CCA was used for treatment, followed by ELN. Bleeding points and/or adenoid tissue remnants were recorded and managed. One year postoperatively, nasal endoscopy was performed to detect adenoid regrowth. ELN showed bleeding points in 17 patients (0.9%) and residual adenoid tissue remnants in 855 patients (45%). Intraoperatively, the lesions were cauterized and ablated under visualization. However, adenoid regrowths were detected in 263 (42%) out of 627 children (33%) who were subjected to endoscopic examination after 1 year of adenoid removal. Conclusions Trans-oral endoscopic look of the nasopharynx after CCA is a beneficial method in detection of adenoid remnants and bleeding points. Also, it could decrease symptomatic adenoid regrowth postoperatively.

Comparative Study between Endoscopic Aided Septoplasty with Two Handed Technique using Endoholder and Conventional Septoplasty

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Apar Pokharel ◽  
Naganawalachullu Jaya Prakash Mayya ◽  
Nabin Gautam
Keyword(s):  
Comparative Study ◽  
Nasal Septum ◽  
Deviated Nasal Septum ◽  
Endoscopic Septoplasty ◽  
Septal Surgery ◽  
Significant Difference ◽  
Common Causes ◽  
Prospective Comparative Study ◽  
Evolutionary Step ◽  
One Year

Introduction: Deviated nasal septum is one of the most common causes for the nasal obstruction. The objective of this study is to compare the surgical outcomes in patients undergoing conventional septoplasty and endoscopic septoplasty in the management of deviated nasal septum. Methods:  Prospective comparative study was conducted on 60 patients who presented to the Department of ENT, College of Medical sciences, during a period of one year. The severity of the symptoms was subjectively assessed using NOSE score and objectively assessed using modified Gertner plate. Results: There was significant improvement in functional outcome like NOSE Score and area over the Gertner plate among patients who underwent endoscopic septoplasty. Significant difference in incidence of post-operative nasal synechae and haemorrhage was seen in conventional group compared to endoscopic group. Conclusions: Endoscopic surgery is an evolutionary step towards solving the problems related to deviated nasal septum. It is safe, effective and conservative, alternative to conventional septal surgery.

scholarly journals Morphological and histopathological study of hypertrophied inferior nasal turbinate in Egyptian patients: in clinical perspective

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Ashraf Ali El-Demerdash ◽  
Essam Abdel Wanees Beheiry ◽  
Sherif Maher El-Aini ◽  
Asmaa Shams El-Dein Mohamed ◽  
Ahmed Mohamed Ibrahim Khattab
Keyword(s):  
Layer Thickness ◽  
Nasal Septum ◽  
Inferior Turbinate ◽  
Military Hospital ◽  
Deviated Nasal Septum ◽  
Nasal Turbinate ◽  
Egyptian Patients ◽  
Mucosal Layer ◽  
Group A ◽  
Group B

Abstract Background The inferior nasal turbinates have important role in the maintenance of nasal breathing function by providing the nasal valve mechanism necessary for the regulation of air flow through the nose. Hypertrophied inferior nasal turbinates are the second most common cause of chronic nasal obstruction. Our aim of this study is to evaluate the morphological and histopathological features of hypertrophied inferior nasal turbinate in Egyptian patients. Methods Our descriptive comparative study was carried on 30 patients presented with hypertrophied inferior nasal turbinate by clinical and radiological assessment. Patients are divided into two groups according to CT scan and endoscopic examination as group A for patients with deviated nasal septum with compensatory hypertrophied inferior nasal turbinate and group B for patients with hypertrophied inferior nasal turbinate due to allergic rhinosinusitis. Both groups underwent the same operation which partial controlled posterior inferior turbinectomy. During the period from June 2018 till May 2019, patients were selected from out-patient’s clinic of Otorhinolaryngology Department at Menoufia University Hospital and Shebin El-Kom Teaching Hospital, and Military Hospital. Results By histopathological examination of the specimens, we found out that the bony layer thickness was more prominent in group A and the mucosal layer thickness was more prominent in group B. The prominent inflammatory cells were lymphocytes in group A and eosinophils plus mast cells in group B. Conclusion The bony layer thickness should be excised during the surgical treatment of cases presented with deviated nasal septum with hypertrophied inferior turbinate where in cases of allergic rhinitis with hypertrophied inferior turbinate, the mucosal layer is enough to be excised.

scholarly journals Efficiency of modified Goldman’s technique in open pediatric septoplasty

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Omar Sabry ◽  
Hazem Dewidar ◽  
Mosaad abdel Aziz ◽  
Amr Elemam ◽  
Ahmed Nassar
Keyword(s):  
Nasal Septum ◽  
Pediatric Population ◽  
Septal Deviation ◽  
Nasal Resistance ◽  
Deviated Nasal Septum ◽  
Assessment Protocol ◽  
Nose Scale ◽  
Detailed Assessment

Abstract Background Performing nasal surgery on children has been the subject of controversy among surgeons. Specifically, the indications for and timing of septoplasty in children have been debated for the last several decades. In this study, we access the efficacy of the modified Goldman’s technique in dealing with caudal septal deviation in pediatric population suffering from severe nasal obstruction and its effect on nasal functions postoperatively. In this study, 30 pediatric patients suffering from deviated nasal septum who are candidate for septoplasty were included and underwent open septoplasty using modified Goldman’s technique. They were subjected to detailed assessment protocol preoperatively including NOSE scale, anterior rhinomanometry, and CT scans. Follow-up assessment was done at second week postoperative including anterior rhinoscopy and nasal endoscopy and 3 months postoperative including NOSE scale and anterior rhinomanometry. Results There was a statistically significant decrease of the NOSE scale severity to none in 90% of cases. Three months postoperative, all of the patients performed postoperative anterior active rhinomanometry with statistically significant decrease in the postoperative total nasal resistance values with inspiratory values ranging from 0.1 to 0.5 Pa/cm3/s with mean of 0.26 Pa/cm3/s and expiratory nasal resistance values ranging from 0.1 to 0.6 Pa/cm3/s with mean of 0.31 Pa/cm3/s. Conclusions Open septoplasty in children using the modified Goldman’s technique has enabled accurate and conservative approach for correction of nasal septal deviation especially those located in the caudal septal region. The technique also offers a significant reduction of the nasal symptoms postoperatively with marked improvement of the nasal resistance and quality of life in severe cases of deviated nasal septum.

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