The complaint of a nose block is often a complex clinical problem by itself. There is no consensus about the value of objective measurements of nasal patency. However, the perception of nasal airflow ultimately is a subjective sensation and, therefore, difficult to quantify. In this study, we have objectively evaluated 75 patients coming to our institute with the complaint of nose block. The mean area of air blast of both the nasal cavities of each patient was calculated by cold spatula test using modified "Glatzel mirror (GM)," and the subjective sensation of nose block was compared on each visit. We observed that both medical and surgical interventions objectively did improve the area of air blast in both unilateral and bilateral nose block patients. This also correlated with the increase in subjective sensation of relief from nose block in the patients. Thus, we could conclude that in patients with nose block, both medical and surgical interventions improved the area of air blast (p < 0.001), which correlated with the subjective sensation of relief in nose block. Thus, in standard conditions, cold spatula test using modified GM can be used to objectively evaluate the nasal patency.

Allergic rhinitis (AR) refers to an IgE-mediated inflammation following exposure to allergen. Often deemed as a minor inconvenience rather than a disease, AR impairs the QOL. Medical treatment has a beneficial effect. To evaluate the QOL in patients of AR. Patients of AR with ≥ 18 years age, receiving treatment in our department are included. Pre and Post treatment VAS (Visual Analogue Scale) and RSDI (Rhinosinusitis Disability Index) are compared to know the effect of disease and treatment on QOL. The patients of PAR (Persistent Allergic Rhinitis) had a greater impact on QOL. In PAR, a combination of INCS (Intranasal Corticosteroids) + oral antihistaminics result in significant reduction in VAS & RSDI scores. In IAR (Intermittent Allergic Rhinitis), Oral antihistaminics monotherapy was most effective in reducing itching while Oral antihistaminics + 1 week of intranasal decongestant was most effective in reducing sneezing, running nose and nasal blockage. Oral antihistaminics + LTRA (Leukotriene Receptor Antagonist) was most effective in reducing physical RSDI score. Oral antihistaminics + 1 week of intranasal decongestantwas most effective in reducing functional and emotional RSDI score. Functional RSDI scores had improved much higher than emotional and physical scores. All these observations were statistically significant. AR does affect the QOL while pharmacotherapy helps in improving the overall QOL. Oral antihistaminic alone or in combination with local decongestant/LTRA in IAR cases while INCS + oral antihistaminic in PAR cases are significantly effective in controlling symptom scores and QOL.

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<p class="abstract"><strong>Background:</strong> Importance of HRCT before middle ear surgery is proved by many published articles but most of the studies were done without evaluating the accuracy of clinical judgment at the same time.</p><p class="abstract"><strong>Methods:</strong> All the patients of CSOM in whom the middle ear surgery was planned were included in the study. Total number of sample size was 80 patients. Group A: 20 patients in which HRCT temporal bone was indicated as a routine evaluation before middle ear surgeries. Group B: 60 patients in which HRCT temporal bone was not indicated.  </p><p class="abstract"><strong>Results:</strong> Maximum 43.75% (35) patients belong to 21 to 30 yrs. F: M is 1.5:1. Unilateral ear disease is more common (62.5%). 41.8% had mucosal type while 16.25% had squamosal type of COM. 77.5% ears found to have hearing loss. Conductive hearing loss was the most common (43.13%). HRCT in comparison with Intra-op had Kapa value of 1 (Aditus blockage &amp; Tegmen erosion), 0.6 (sinus plate erosions), 0.5 (malleus, Incus, stapes erosions), 0.48 (Ossicular chain status), 0.46 (Scutum erosion), 0.4 (LSC fistula) and 0.3 (fallopian canal erosions. Clinical judgment in comparison with intra-op had kapa value of 1 (stapes erosion), 0.96 (aditus blockage), 0.79 (Incus erosion), 0.78 (malleus erosion) and 0.76 (ossicular chain status).</p><p class="abstract"><strong>Conclusions:</strong> Clinical judgment is as good as or even better than CT in presuming/detecting at least individual ossicular erosions, ossicular chain status, aditus blockage and HRCT temporal bone should be reserved for high risk and complicated cases.</p>

<p class="abstract"><strong>Background:</strong> Role of CT scan in sinonasal disease is proved by many published articles. Most of them are having small sample size, poorly defined protocol of CT reporting and does not mention the window width and window level of the software. We did this study to include these points and tried to have sample size of at least 200.</p><p class="abstract"><strong>Methods:</strong> 231 patients included in the study. After clinical examination CT PNS was done. A strict protocol was maintained for the timing of CT, window settings (to get highest bony definition) and for the reporting of CT.  </p><p class="abstract"><strong>Results:</strong> Few common anatomical variations were agger nasi (61.9%), DNS in 50.6%; concha bullosa (18.6%), paradoxical MT (20.3%), Onodi Cells (21.6%) and Haller cells (11.3%). Most common subtypes amongst some anatomical variations include middle meatal drainage of frontal recess (58.8%), type I frontal cell (7.1%), type I ethmoid roof (48.9%), type I attachment of UP (58.8%) and sellar type of sphenoid pneumatization (68%). CT has 100% sensitivity and specificity in detecting the diseased sinuses correctly. Except from 11.8% cases in which frontal recess drainage could not be assessed, all other anatomical variation were same intra-op as shown by CT. In fungal rhinosinusitis anatomical variations were difficult to detect by CT.</p><p class="abstract"><strong>Conclusions:</strong> This study proves that CT-PNS gives us the detailed and near exact picture of the disease with its extent as well as of existing anatomical variations in non-neoplastic sino-nasal diseases except in FRS cases where in anatomical variations are difficult to analyze.</p>