Rhinosporidiosis is primarily an infection of the nose. Though occasional involvement of other areas in the human body has been reported, it rarely presents as a disseminated disease. We describe two cases of recurrent nasopharyngeal rhinosporidiosis, one of them with cutaneous and pulmonary involvement. The clinical manifestations and the management of both the cases are discussed.

Dysphagia is a common clinical symptom for an ENT surgeon in his clinic, evaluation of which may not be a great challenge. The objective of this article is to report a rare cause of dysphagia which may be difficult to diagnose unless specifically thought of. This is a report of a case of dysphagia secondary to myasthenia gravis seen in a young lady along with tongue fasciculation in an early onset case unlike the ones reported in the literature where the patients are elderly and more often males in the late phase of the disease. At times, dysphagia may be seen secondary to some rare causes and may mislead the doctor. A carefully taken history and methodical clinical examination will avoid unnecessary invasive procedures and delay in the diagnosis.

<p class="abstract"><strong>Background:</strong> The objectives of the study were to document the presentation of laryngeal tuberculosis, response to anti-tubercular treatment and objective evaluation of larynx during and post anti-tubercular treatment.</p><p class="abstract"><strong>Methods:</strong> A before and after treatment study including 15 subjects with laryngeal tuberculosis treated in our tertiary health care centre during a three year study period. Clinical presentation, management, subjective self-assessment of voice and objective assessment of larynx by videostroboscopy at the beginning, at two months and at six months of anti-tubercular treatment were documented.  </p><p class="abstract"><strong>Results:</strong> Two patients had primary laryngeal tuberculosis and thirteen patients had laryngeal tuberculosis associated with pulmonary tuberculosis. Only one patient was immuno-compromised. Most common presenting symptom was hoarseness (93%). Ulcerative lesions were the most common clinical finding (87%) with the vocal cords being the commonest site involved (80%). All patients responded well to anti-tubercular treatment. Videostroboscopy showed an improvement in vocal cord lesions during treatment. Subjective assessment of voice after two months of anti-tubercular treatment showed marked improvement in voice. At completion of treatment, voice was better but all patients had complaints of residual hoarseness.</p><p><strong>Conclusions:</strong> Primary laryngeal tuberculosis is less common in comparison to laryngeal tuberculosis secondary to pulmonary tuberculosis. With early diagnosis, the response to treatment is satisfactory. Videostroboscopy can be used as an effective tool in monitoring vocal cord changes during the follow- up period.</p>

<p class="abstract"><strong>Background:</strong> Rigid endoscopes have revolutionized the diagnosis and management of upper aerodigestive pathologies. Inadequate disinfection and sterilization techniques carry increased risk for cross infection. Hence, they require high level disinfection to effectively reduce the bacterial and fungal contamination of rigid endoscopes. The present study analyses the various techniques of sterilization practised in Mangaluru, Karnataka, at different Otorhinolaryngology clinics.</p><p class="abstract"><strong>Methods:</strong> This prospective descriptive study was done on 30 rigid endoscopes. Swabs were taken from the endoscopes and container, and send for detailed microbiological examination. The different methods practised at various centres were documented.  </p><p class="abstract"><strong>Results:</strong> The various sterilization technique practised was predominantly cetrimide and chlorhexidine solution (savlon) wash, ETO and Formaldehyde. However, among all techniques the microbiological studies revealed no growth.</p><p class="MsoNoSpacing"><strong>Conclusions:</strong> Rigid endoscopes have emerged as the best diagnostic equipment for otorhinolaryngologists. With regard to high level disinfection and sterilization, the endoscope must undergo recommended techniques. In our study the most commonly used techniques was cetrimide and chlorhexidine solution wash and less commonly ETO and Formaldehyde. The use of standard sterilization technique and maintaining the rigid endoscopes in sterile storage container is the key to maintain an organism free environment. The standard technique of prewash with water and soap water, then washing with cetrimide and chlorhexidine solution, then store the endoscope in sterile container is our recommendation. </p>

Sinonasal lymphomas are aggressive locally destructive midfacial necrotizing lesions. Most of them initially diagnosed as lethal midline granulomas, a term which is slowly replaced by sinonasal lymphoma. Here is one such case report of sinonasal T cell lymphoma where there was a difficulty in diagnosis and required an incisional biopsy.