Endoscopic repair of anterior cranial base has been widely reported. However there is still no uniformity in the technique of endoscopic repair of lateral sphenoid cerebrospinal fluid (CSF) leaks. To highlight the management of CSF leak or encephalocele in the lateral sphenoid recess and relate our experiences. We retrospectively reviewed the medical records of all our patients who underwent an endoscopic repair of CSF leaks in the lateral sphenoid recess during the period from September 2003 to January 2010 at our tertiary hospital. Fifteen cases with CSF leaks/encephalocele that were repaired by the endoscopic approach were included. The majority of our cases were spontaneous leaks. In all our cases we approached the site of defect by an end on approach. All our patients were successfully treated in the first attempt. Endoscopic repair of lateral sphenoid recess has shown better surgical outcome with reduced morbidity.

Multiple reports have demonstrated the efficacy of endoscopic dacryocystorhinostomy (DCR). However the results of the same have varied from centre to centre. Many still regard external DCR as the gold standard. To describe an endoscopic DCR technique which anatomically simulates an external DCR and assess its results. Prospective, nonrandomized and noncomparative interventional case series. Clinical charts of patients with nasolacrimal duct obstruction based on symptomatic, clinical and radiological basis were included in the study. All surgeries were done endonasally using standard operative technique. The modification in the standard technique included creating a wide exposure of the lacrimal sac, incising the sac and the suturing the medial wall of the lacrimal sac with the lateral nasal wall. The same was achieved by using either vascular clips or 5.0 vicryl sutures. Twenty (11 females and 9 males) were included in the study. The average age of the patients was 56.86 years old (range 27-85 years old). The main presenting symptom was epiphora and 1 patient with mucocele. Successful outcome was measured in terms of relief of sympto anatomical patency assessed by sac syringing and nasal endoscopy showing a wide patent lumen. A primary success rate of 95% and ultimate rate of 100% was achieved in the cases with a nasolacrimal duct (NLD) block while an overall success rate of 82.6% was noted when the cases with NLD block and common canalicular block were considered together. Endoscopic DCR can now easily replace external DCR as a standard. It is not only minimally invasive, but has minimal complications and using this technique, we have been able to achieve very high success rates.

Unilateral maxillary swelling is a rare condition, however we being in tertiary care centre did see a large number of these cases. All patients presenting with unilateral maxillary seen during the last 3 years were included in this retrospective study and evaluated concerning histories, diagnostic and therapeutic approaches and achieved outcomes. A total of 31 patients were seen during this period. 27 of these were benign lesions and were subdivided as follows: odontogenic cystic lesions (11/ 27), fibro-osseous lesions (8/27), secondary to extensive allergic fungal sinusitis (5/27) and mucocele (2/27). The remaining five were malignant lesions, two each were squamous cell cancer and adenocarcinoma of the maxillary sinus, and one was rhabdomyosacroma. All patients received treatment with due merit of the underlying etiology. Understanding and recognizing key diagnostic features helps in appropriate management and reducing morbidity.

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