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Examination Of Nose And Paranasal Sinuses

HISTORY

Symptoms: (a) Nasal Discharge- Duration-
Continuous/ Intermittent
Unilateral/ Bilateral
Watery/ Purulent/ Blood stained
oul-smelling/ Non- foul smelling
Associated- Headache/ Sneezing
(b) Nasal Obstruction- Duration-
Diurnal variation-
Intermittent/ Continuous
Unilateral/ Bilateral
Associated- Headache/ Nasal
Discharge/ Foul smell
(c) Headache - Duration-
Continuous/ Intermittent
Shooting/ Dull throbbing/ Heaviness
Radiating
Mild/ Severe
Localized/ Generalized
Diurnal variation
Aggravating/Relieving Factors-
Associated Sneezing/ Nasal
Obstruction/ Nasal discharge
(d) Sneezing - Duration –
Aggravating/ Relieving factors-
Frequency of episodes
Associated Nasal discharge/
Headache
(e) Epistaxis - Duration -
Frequency of episodes-
Quantity of blood loss in each
episode
Unilateral/ Bilateral
Spontaneous/ Traumatic
Aggravating/ Relieving Factors
Similar Family history-
Bleeding from other sites
Any treatment taken-
(f) Others - Change of smell/ Loss of smell
Nasal intonation of voice
Crusting in nose
Fever-
Lacrimation-
Diplopia/ Other visual disturbances
Otalgia/ Otorrhoea
Swelling of Face-
Trauma
Nose picking
Allergy
Bleeding tendencies in self/ family
Drug intake
Cough
Personal history: (a) Alcoholism
(b) Smoking
(c) Snuff abuse
(d) Occupation in chrome/ metal industry
Family History : (a) Bleeding disorders
(b) Allergy
(c) Asthma
Past History : (a) Drug intake
(b) Similar complaints in past/ Treatment for the same
(c) Surgeries
(d) Tuberculosis- On treatment/ Treated
(e) Diabetes Mellitus- on treatment- Oral Hypoglycemics/Insulin Controlled
(f) Hypertension- Controlled/ On treatment
(g) Exanthematous fevers
Examination of External Nose:
(a) Inspection:
  • Nasal bridge deformity- Saddle Nose/ Hump deformity
  • Swelling
  • Ulcers
  • Sinuses
  • Growths on skin
  • Scars
  • Broadening of nose
  • Inflammation/ cellulites
(b) Palpation:
  • Crepitations
  • Tenderness
Anterior Rhinoscopy:
  • Nasal Mucosa- Pink and Moist/ Pale
  • Inferior turbinate-
  • Middle turbinate-
  • Nasal septum-
  • Inferior meatus-
  • Middle meatus-
  • Nasal floor-
  • Nasal vestibule-
Spatula Test:
Probe test:
Posterior Rhinoscopy:
  • Posterior margin of bony septum
  • Posterior end of inferior, middle and superior turbinate
  • Posterior nares/ choanae
  • ET openings
  • Fossa of Rosenmuller
  • Roof of Nasopharynx
  • Adenoids
  • Nasal surface of soft palate and uvula
Inspection and palpation of paranasal sinuses:
  • Maxillary
  • Frontal
  • Anterior Ethmoidal Sinuses
INVESTIGATIONS
DIAGNOSTIC NASAL ENDOSCOPY:
First Pass:

Second Pass:

Third Pass:

CT SCAN (NOSE AND PARANASAL SINUSES):

DIAGNOSTIC BIOPSY & HPE:

FROZEN SECTION:

BLOOD INVESTIGATIONS:

OTHER INVESTIGATIONS:

DIAGNOSIS:

SURGERY PLANNED:

SURGERY EXECUTED:

INTRAOPERATIVE FINDINGS:

POSTOPERATIVE PERIOD/ COMPLICATIONS:

COURSE OF STAY IN HOSPITAL:

ADVICE:

FOLLOW-UP:

 
 
Otology Master Class
From the Organizing desk

Dear friends,

MESIARC CME is here again. We have always strived to bring you the best in Otology, over the past 10 years, Our live surgery workshops, have focused on cutting edge surgery, detailed teaching, scientific deliberations of the highest order and top class video coverage from one of the most advanced otological theatre suites in the world this time, we are focusing on the enigma of budding otologists - cholesteatoma and Otosclerosis. Two very diverse conditions, but requiring surgical expertise of the highest order to deliver good results. The two-day surgical workshops will feature both myself and a luminary in Otology, Dr. Ashesh Bhumker from Thane, Mumbai and we would be demonstrating in detail the finer aspects of surgical techniques that can be adapted by a keen otologist to sustain good results over time.

We have lined up an array of diverse cases- and the techniques that we intend to demonstrate include minimal access stapedotomy, Laser stapes surgery, stapes surgery with stapes head amputation for tendon preservation, bone obliteration technique for cholesteatoma, a variety of grafting techniques, intact canal wall tympanoplasty for limited cholesteatoma and a series of revision surgeries.

Do send in your registrations early as we have to limit attendance to 70 seats. A smaller crowd is ideal for active discussions which is something so characteristic of MESIARC CME programs and we do not want to deviate from that agenda.


Yours truly,

Manoj MP  
Organizing chairman

Otology in Perspective Live Surgery 2015
From the Organizing desk

Mesiarc brings you a unique live surgical workshop- a demonstration of both endoscopic and microscopic otologic skills.

Otologic surgery is special for its intricate anatomy, extreme precision and attention to detail. Traditionally done with the operating microscope, and now in some centers across the world with the endoscope, the repetoire of the art is widening.

Confusion persists. Advocates of endoscopic work claim that the microscope is passe, and traditional surgeons laugh off the ability of the one handed

The truth lies somewhere in between; there are specific conditions that require either of both of the techniques. Dogmatism, they say, is the end of science.

Mesiarc brings you a unique live surgical workshop- a demonstration of both endoscopic and microscopic otologic skills.

MESIARC has always stood for dissipation of knowledge and the live surgical workshops are not pubilicity events, nor are they grandiose. We have just one agenda- to educate.

This workshop with a difference aims to demonstrate both endoscopic and microsopic skills in otologic surgery, while attempting to define which is more suitable for what. Do come and enjoy!


Yours truly,

Manoj MP  
Organizing chairman

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