No abstract

Objective: The aim of this study was to evaluate the effects of suprabullar pneumatization on the orientation of the frontal sinus outflow structures and its association with the volume of anterior ethmoid sinus. Methods: A retrospective chart review of computed tomography of paranasal sinuses (CTPNS) images was conducted. A total of 370 sides of the CTPNS of 185 patients were analyzed. Results: The course of anterior ethmoidal artery (AEA) along the skull base (p = 0.04) and position of AEA at the second lamella (p = 0.04) was significantly associated with the type of suprabullar pneumatization. The AEA is expected to be lower at the skull base and at a longer distance from the second lamella with the increase in grading of the suprabullar pneumatization. The distance of AEA to the second lamella (p < 0.001) and third lamella (p = 0.04) was significantly different depending on the type of suprabullar pneumatization, which indicates AEA is expected to be at a longer distance from the second lamella and third lamella in higher grade suprabullar pneumatization. The type of suprabullar pneumatization has a significant but weak association with the anterior ethmoid sinus volume (p = 0.04). Conclusions: There is a significant effect of the type of suprabullar pneumatization on the orientation of the surrounding anatomical structures at the frontal recess. The type of suprabullar pneumatization is influenced by the anterior ethmoid sinus volume, which suggests it has a possible role in the frontal drainage pathway.

<p class="abstract">Foreign body nose commonly seen in paediatric age group. In mentally disable patient this may occur and become asymptomatic for many years. We reported mentally disable patient presented with massive epistaxis and history of multiple episodes of foul-smelling discharge from his right nose for the past 20 years. After epistaxis resolved during nasal endoscopy noted impacted rhinolith foreign body in between the septum and the right middle turbinate. Rhinolith successful removed using bent tip of Jobson-Horne probe in otorhinolaryngology, head and neck clinic.</p>

In pregnancy there are changes in regulation of thyroid hormone that can affect hypothalamic pituitary thyroid axis. This goitrogenic stimulation can lead to enlargement of thyroid gland. We present a case of 37-year-old woman gravida 4, para 3 at 27-week gestation, who was referred for management of a huge multinodular goitre with impending upper airway obstruction. Severe pre-eclampsia made airway narrower due to oedema at pharyngeal and glottic region. In case of no life-threatening airway, surgery can be electively performed after delivery as to avoid preterm labour. However, if emergency lower segment caesarean section is needed, preferably it to be done under regional anaesthesia in severe preeclampsia cases. If this fails, general anaesthesia may be required with awake fiberoptic, jet ventilation and bronchoscopy standby in case of difficult intubation due to constricted airway. Our patient underwent emergency lower segment caesarean section under spinal anaesthesia at 31 weeks gestation due to severe pre-eclampsia. Right hemithyroidectomy was done three months postnatal. Obstructive symptoms resolved after operation.International Journal of Human and Health Sciences Vol. 05 No. 04 October’21 Page: 514-518