To analyse the possible factors contributing to spontaneous cerebrospinal fluid (CSF) rhinorrhea and to assess the outcome of Transnasal endoscopic repair at our centre. Retrospective case series of patients with spontaneous CSF rhinorrhea at our institution from Jan 2006 to May 2010. 7 patients were diagnosed with spontaneous CSF rhinorrhea. 5 of the 7 patients were obese, middle aged females managed with Transnasal endoscopic repair with fascia lata auto graft. Successful repair of CSF rhinorrhea was achieved in all the patients with a single endoscopic procedure; no patient required a revision procedure. Spontaneous CSF rhinorrhea is a rare condition seen mostly in middle aged obese females with the anterior part of the cribriform plate being the most common site of leak. HRCT paranasal sinus (1 mm cuts) was an effective modality of investigation in our study with ancillary investigations been CT Cisternography, CSF analysis and MRI for inactive leaks. In the absence of a large breech of the skull base, endoscopic repair of CSF rhinorrhea carries a high success rate with a high safety margin and very low morbidity rate.

To evaluate the treatment of hypertrophy of inferior turbinates in patients diagnosed with allergic/non allergic rhinitis with the use of radiofrequency ablation technique. Ablation with radiofrequency was used in this study on the inferior turbinates of 200 patients diagnosed as allergic/non allergic rhinitis at our institution between January 2006 and December 2009. The results were evaluated subjectively by changes in pre and post operative symptoms, size of inferior turbinate, postoperative pain and assessment of ciliary function. Four patients (2%) at the end of 6 months and 4 patients (2%) at the end of 12 months reported persistent symptom of nasal obstruction. No patient reported nasal discharge, 28 patients (14%) at 6 months, 20 patients (10%) at 24 months reported persistence of sneezing. 8 patients (4%) at 6 months, 4 patients (2%) at 24 months reported persistence of snoring, no patient complained of persistence of hyposmia. 4 patients (2%) at 6 months, no patient at 24 months complained of crusting, no patient complained of bleeding at 6, 24 months. No alteration of ciliary function and anatomy of the inferior turbinate mucosa was noticed. These results suggests that ablation with radiofrequency is an easily applied, efficient and reliable technique in the treatment of hypertrophied inferior turbinate in allergic/non allergic rhinitis patients with no changes in the ciliary function and necrosis/atrophy of inferior turbinate.

Cyanoacrylate use in myringoplasty obtains graft uptake rates of 99% compared with most studies, which report 80% to 90%. This also allows removal of the pack by the seventh day, allowing close follow-up of the graft and less patient discomfort. Importantly, it has not interfered with the formation of the neotympanum or compromised hearing improvement.

Objective: The aim is to review the effectiveness of sialendoscopy in treating various salivary gland disorders related to the duct. Methods: A total of 133 patients who underwent sialendoscopy were included in this study. Data was collected from case records of patients and was analysed. A detailed history examination was taken and the operative findings were analysed. Causes of obstructive sialadenitis were evaluated and treated. Results: A total of 159 glands were subjected to sialendoscopy and pathology was identified in 149 glands. Forty one submandibular glands had calculi and twelve had non-calcular obstruction. Fifteen parotid glands had calculi and 81 had non-calcular obstruction, of which stricture was the most common. Calculi retrieval or dilation of stricture was achieved with a sialendoscope in 112 glands. In 23 patients, the calculi were retrieved by combined approach. In three patients, the calculi were fragmented with intra luminal Holmium laser and the fragments were removed. All these patients had a good relief from their symptoms. Duct perforation was seen in two patients and a false passage was formed in one. Conclusion: Sialendoscopy was a safe and effective procedure for managing ductal pathologies of salivary glands.

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