Print ISSN: 0027-1446

Online ISSN: 2309-6217

Main Subjects : Otolargngology

Endoscopic Findings in Adults with Nasal Obstruction: A case series study

Hassan Myasar Abdulwahid; Anmar Abdula Jassim; Islam Ghanim Mahmood; Raghdan Mohammed Dawood

Annals of the College of Medicine, Mosul, 2021, Volume 43, Issue 2, Pages 123-131
DOI: 10.33899/mmed.2021.130671.1098

Background: The obstruction of the nasal is known as the most distinct disturbing complain of nasal disease and nasal sinus. The nasal obstruction could either be found unilateral (in one nasal cavity), bilateral (in both cavities), intermittent, progressive or persistent. The rhino-scopy  (anterior and posterior) provides limited information when compared to nasal endoscopy. In certain cases, the structure which lies under the sight line and the posterior rhino-scopy is not possible. Furthermore, the early diagnosis of many unpleasant lesions will be very difficult unless using nasal endoscopy.
Objectives: This study was designed to identify the real & precise causes of nasal obstruction in adults &  properly evaluate the condition of nasal cavity ,post nasal space and nasal mucosa by direct vision through nasal endoscopy. and evaluate the value of naso endoscopy in diagnosis of the cause of nasal obstruction.
Methods: This study was conducted to analyze noses related to 75 patients with nasal obstruction who underwent clinical and endoscopic nasal examination for the period from May 2014 to April 2015 in Mosul namely; Al-jumhoori Teaching hospital.
Results: This case series study included 75 patients complaining from nasal obstruction The study include 43 male patients (57.3%), and 32 female patients (42.6%) with a M:F ratio of (1.3:1). The patients’ ages ranged between 15-70 years of age whose mean age was 42.5 years. endoscopic findings for adults patients with nasal obstruction in our study were: congested nasal mucosa 40 (53.3%) patients, septal deviation 26 (34.6%) patients, inferior turbinate hypertrophy 18 (24.0%) patients, pale swollen mucosa with watery nasal secretion 14 (18.6%) patients, bilateral nasal polyposis 10 (13.3%), post nasal drip 10 (13.3%), crustation 8 (10.6%), mucopurulent discharge from middle meatus  & congested mucosa 7 patients (9.3%), adenoid hypertrophy 5 patients (6.6%), no abnormal findings 4 patients (5.3%), bluish tinged  mucosa with watery nasal secretion 3 patients (4.0%).
Conclusion: Nasal endoscopy includes evaluating the passages of the nasal cavity and the nasal sinus, and post nasal space using a magnified high-quality view and serves as an objective diagnostic tool in the evaluating of nasal mucosa, sinonasal anatomy, nasal cavity, and post nasal space pathology.
In this study, nasal endoscopy is recommended in cases where patients complain of obstruction in the nasal specifically when anterior and posterior rhino-scopic examinations do not succeed in diagnosing causes of nasal obstruction

Review of Different Methods of Uncinectomy in Endoscopic Sinus Surgery

Haitham Alnori

Annals of the College of Medicine, Mosul, 2021, Volume 43, Issue 1, Pages 70-75
DOI: 10.33899/mmed.2021.129601.1079

Uncinectomy is a safe procedure in experienced hands whatever technique is used. It is usually the first step in endoscopic sinus surgery and the first surgical maneuver the new rhinologist has to learn. The most familiar two methods of doing uncinectomy are the classic method, introduced by Stammberger in 1986, and Wormald’s swing-door technique in 1998. The swing-door technique appears to be associated with a slightly higher risk of injury to the lacrimal duct. Simultaneously, failure to identify maxillary ostium and orbital penetration are both more common in the classic method.
This study aims to review the different methods of doing uncinectomy during endoscopic sinus surgery and compare the most standard techniques regarding their efficiency and safety.

Endoscopic Dacryocystorhinostomy: A Case Series Study from Mosul City

Islam Ghanim Mahmood; Professor Ali Abdulmuttalib Mohammed; Hassan Myasar Abdulwahid

Annals of the College of Medicine, Mosul, 2021, Volume 43, Issue 1, Pages 81-86
DOI: 10.33899/mmed.2021.129046.1064

Background: Dacryocystorhinosty is a technique applied to patients who complain of excessive tearing (epiphora) and demonstrate obstruction of the lacrimal outflow system.
Objectives: The present study aims at studying the outcome and complications
of endoscopic dacryocystorhinostomy EnDCR.
Methods: This case series study was conducted to analyze 70 eyes related to 66 patients with epiphora and recurrent attacks of dacryocystitis who underwent EnDCR for the period from January 2018 to June 2019. Surgeries were done in 2 hospitals in Mosul namely; Al-jumhoory Teaching hospital and Al-Rabee Private hospital.
Results: This case series study included 70 eyes of 66 patients (62 unilateral and 4 bilateral cases) complaining from epiphora excessive tearing and/or chronic dacryocystitis. There was 45 females (68.2%) and 21 males (31.8%) with F:M ratio of 2.1:1. The patients, ages ranged between 4-74 years of age with a mean age of 39 ± 18.31. The success rate of endoscopic dacryocystorhinostomy EnDCR in the present study was 97.15 % depending on clinical improvement of epiphora , endoscopic assessment for patency of the new ostium and passage of tears aided by pressing over the medial canthus. Hemorrhage was the most common complication and there was no serious orbital complication in our study neither during surgery nor in the follow up period.
Conclusion: Endoscopic dacryocystorhinostomy EnDCR carries very good success rate with relatively not critical and low complication rate. Moreover, it has the advantage of overlooking unnecessary scar, the ability to operate both sides simultaneously and revising the operation in case of failure of surgery.