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.

<p class="abstract"><strong>Background:</strong> Nasal obstruction is the most common complaint in ENT practice. Surgical correction of deviated nasal septum has been performed by a variety of techniques of which sub mucous resection and Septoplasty procedures of surgical correction of nasal septum play a prime role in management of patients of nasal obstruction. Nasal endoscope is very useful tool to visualize posterior part of septum and do the surgery more precisely and with less complication as compare to conventional method. The objectives of the study were to compare the outcomes of conventional and endoscopic septoplasty, to evaluate the advantages, disadvantages and complications of both endoscopic and conventional<strong> </strong>septoplasty</p><p class="abstract"><strong>Methods:</strong> 50 cases (between (Oct. 2014 - March 2016) of deviated nasal septum selected in this prospective study and they were randomly divided equally in 2 groups for endoscopic (A) and conventional (B) septoplasty respectively.  </p><p class="abstract"><strong>Results:</strong> The study included 50 cases. Majority of patients in this study were males 84% (n=42) and 16% (n=18) were female. 46% (n=23) patients had DNS to right side and 54% (n=27) patients had left side, anterior deviation (48%). C and S shaped deviations (14%). Spur was present in 22% (n=11) of cases and 10% (n=5) patients presented with thickening. After completing 2 months of follow up 92% (n=23) of group A and 88% (n=22) of group B were relieved from nasal discharge, while nasal obstruction was absent in 96% (n=24) patients of group A and 80% (n= 20) of group B. 4% cases (n=1) in endoscopic septoplasty was having persistent deviated nasal septum and 16% (n=4) patients of conventional septoplasty belong to this group.</p><p><strong>Conclusions:</strong> Endoscopic septoplasty has an obvious edge over the conventional approach due to better illumination which enables to identify the pathology accurately, excise the deviated part of septum precisely and realignment of the cartilage for best results.</p>

<p class="abstract"><strong>Background:</strong> This study evaluates the outcome of osteopathic manipulation in the patients with globus pharyngeus.</p><p class="abstract"><strong>Methods:</strong> The study comprised of 50 patients with globus pharyngeus. All cases were provided major body diaphragms release namely pelvic diaphragm, abdominal diaphragm, thoracic outlet release, hyoid release, gastroesophageal junction release and sphenoid basilar junction generalized release in some selected cases as per their symptoms. Patients were treated 2 times in a week for 3 weeks.  </p><p class="abstract"><strong>Results:</strong> Results were analyzed on the basis of patient’s satisfaction and improvement in the symptoms on regular basis after 2 wks. Visual analogue score (VAS) and clinical assessment were used to see the quantum of satisfaction and overall symptoms. The mean VAS score of patients receiving OMT (MFR) with PPI was 6.23±0.43 and patient who required psychotherapy along with OMT (MFR) had the VAS score of 3.78±0.17 (p&lt;0.05).</p><p><strong>Conclusions:</strong> The patients required multidisciplinary approach hyoid bone release and other osteopathic manipulations, anti-reflux and antipsychotic treatment. The patients having psychological symptoms requiring antipsychotic drugs were found to be least respondent to the treatment. Patients having associated GERD showed a good response to the treatment and their dependency on drugs decreased following the OMT. The best response was seen in patients having no associated ailment and received OMT (MFR). </p>