Purpose The allergic phenotype of chronic rhinosinusitis (CRS) and central compartment atopic disease (CCAD) have been described. The CCAD is a radiological phenotype in patients with CRS that presents as a central mucosal disease due to allergy. The subset of patients having chronic rhinosinusitis with nasal polyps (CRSwNP) has not been well characterized. We aim to describe the clinical and radiological characterizations of patients presenting with the allergic phenotype of CRSwNP. Patients and Methods A cross-sectional study at a tertiary hospital was performed. Adult patients diagnosed with CRSwNP who had both allergology and radiological assessments were enrolled. The symptoms of allergic rhinitis, Lund–Kennedy (LK) endoscopic scoring, Lund–Mackay (LM) computed tomography scan of paranasal sinuses (CTPNS) scoring, CCAD features, skin prick test (SPT) and level of specific IgE were assessed. All the patients underwent SPT for house dust mites. Results A total of 38 patients were enrolled. Symptoms, endoscopic and CTPNS scores were higher in the allergy and CCAD groups compared to the nonallergy and nonCCAD groups. The symptom of “need to blow nose” was statistically significant in allergy vs nonallergy ( p =0.01) and CCAD vs nonCCAD ( p =0.02). There were significant differences in the endoscopic scores in both allergy and CCAD (allergy vs nonallergy, p =0.01; CCAD vs nonCCAD, p =0.03), and CT scores in both allergy and CCAD (allergy vs nonallergy, p =0.02; CCAD vs nonCCAD, p =0.02). All patients with CCAD have worse scoring than nonCCAD (LK score, p =0.03; LM score, p =0.02). Patients with allergy have more polypoidal involvement of the middle turbinates (left middle turbinate, p =0.141; right middle turbinate, p =0.074) and CCAD (left middle turbinate, p =0.017; right middle turbinate, p =0.009) than nonallergy and nonCCAD patients. Conclusion Allergic phenotype of CRSwNP has a worse clinical and radiological disease burden. Optimal treatment of allergy is essential for a better outcome.

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Malignant otitis externa is an inflammation of the external auditory canal with preceding osteomyelitis of the temporal bone and the adjacent structures that could be potentially lethal. Malignant otitis externa may present with cranial nerve involvements and massive spread of disease mimicking nasopharyngeal carcinoma or any other malignancies on imaging. Two elderly patients who presented with severe otalgia and significant facial nerve palsy and lower cranial nerve palsies showing extensive spread of disease are reported in this case series. They both had resolution of disease after a prolonged course of antibiotics and cortical mastoidectomy for disease clearance in one of them.

Topical application of mitomycin C is best used as an adjunct in airway surgeries together with combination of other modalities of endoscopic techniques such as excision, balloon dilatation and laser treatment in treating subglottic stenosis. We present a case of a 12-year-old boy who acquired Cotton–Myer grade 3 subglottic stenosis 6 months post endotracheal intubation. The stenotic segment was treated with cautery-assisted excision followed by balloon dilatation and topical application of mitomycin C at the raw area. The patient recovered well with improvement of airway diameter, no more symptoms, no more events of restenosis and without the need for multiple procedures.

A frequently confused symptom that leads to mismanagement is referred pain. It can be of a great diagnostic value if one knows the potential origin of it. There are possibilities for physicians to miss an underlying oral or oropharyngeal pathology if they overlook the presentation and findings that are not familiar or directly organ-related. We present a case of a 75-year-old male diagnosed with a mandibular cyst when he presented with a sudden onset of extreme left-sided neck pain radiating to the left side of face and the post auricular region. Orthopantomography revealed a large cystic lesion extending from the left lower border of the mandible to the ramus. The most common cystic lesions affecting the maxillofacial region are odontogenic cysts.