Nasal obstruction is a subjective complaint in patients with nasal disease. The ability to quantitate the nasal ventilation dysfunction would be useful for making the appropriate choice of nasal disease management. This cross-sectional study comprised of 200 adult subjects. They underwent assessment of relevant symptoms, nasal examination and investigations before undergoing active anterior rhinomanometry (AAR) assessment. A group of 88 normal subjects and 112 patients with nasal disease were included. The mean total nasal air resistance (NAR) was significantly higher in patients with nasal disease (0.33 Pa/cm(3)/s) as compared to normal subjects (0.24 Pa/cm(3)/s). There was no significant difference in total NAR between patients with symptoms of nasal obstruction and those without the symptoms (p = 0.42). It is concluded that AAR is a sensitive but not a specific tool for the detection of abnormalities in NAR and it failed to relate to the symptom of nasal obstruction.
Matched MeSH terms: Nose/physiopathology; Nose Diseases/diagnosis*; Nose Diseases/physiopathology
The frustration and disappointment in managing advanced cancers of the nose and paranasal sinuses are well known. We report a case of a successful treatment of such a tumour in a 37-year-old soldier, using a combination of therapy including surgery, chemotherapy and radiation. Each mode of treatment is discussed.
Matched MeSH terms: Nose Neoplasms/drug therapy; Nose Neoplasms/radiotherapy; Nose Neoplasms/surgery; Nose Neoplasms/therapy*
Rhinoliths result from neglected nasal foreign bodies that gradually increase in size. They are usually discovered incidentally during routine ENT examination or due to the associated symptoms such as nasal obstruction or persistent foul-smelling unilateral nasal discharge. A case of a 14-year-old girl was reported with a year history of the symptom. The foul-smelling nasal discharge noted by her mother was not the main concern to them. She was referred by her primary care physician as she complained of impacted ear wax. However, rhinolith was incidentally found upon routine clinical examination in the ENT clinic and was removed uneventfully.
We report a case of rhinocerebral mucormycosis in a 31 year old immunocompetent female presenting initially like acute rhinosinusitis with nasal stuffiness, severe headache, vomiting who soon developed isolated right lateral rectus palsy. Computed tomography (CT) scan of the Post-Nasal Spaces(PNS) showed an ill defined expansile heterogenous density mass in the sphenoid with extension into the ethmoids, nasal cavity, optic canal, superior orbital fissure, clivus and right temporal lobe with signal void in Magnetic Resonance Imaging (MRI). The debris and polypoid mucosa obtained on nasal endoscopy revealed mucormycosis on histopathologic examination. The patient was managed with urgent surgical debridement and medical management.
The incidence of rhinolith is by far very low compared to the nasal foreign bodies, especially in adult. Foreign body (FB) in the nostril will lead to unilateral nasal symptom which can start with nasal obstruction or discomfort. In younger children, they may miss to report the problem to the parents but, later on, the FB will manifest itself with unilateral nasal discharge, which at most of the time fouls smells. We report a case of a healthy adult female who presented with unilateral foul smelly nasal discharge which later was diagnosed as rhinolith, with rubber-tip pencil eraser as the nidus of calcification.
Presently, the quality assurance of agarwood oil is performed by sensory panels which has significant drawbacks in terms of objectivity and repeatability. In this paper, it is shown how an electronic nose (e-nose) may be successfully utilised for the classification of agarwood oil. Hierarchical Cluster Analysis (HCA) and Principal Component Analysis (PCA), were used to classify different types of oil. The HCA produced a dendrogram showing the separation of e-nose data into three different groups of oils. The PCA scatter plot revealed a distinct separation between the three groups. An Artificial Neural Network (ANN) was used for a better prediction of unknown samples.
Basal cell carcinoma (BCC) is an indolent, slow-growing malignant skin tumour. Approximately 70% of the tumours occur in the head and neck region. The nose is a common site for malignant skin tumours, such as basal cell carcinoma and squamous cell carcinoma because it is exposed to the sun. Excision of the BCC will leave the nose with a soft tissue defect which requires reconstruction. This report illustrates a case of BCC of nose whereby a wide excision and reconstruction was performed with a paramedian forehead flap.
Malignant melanocytic melanoma is a rare sinonasal malignancy. We present a case report of an elderly lady who presented with epistaxis and intranasal polyps. Computed tomography revealed soft tissue mass in the oropharynx, nasopharynx, left ethmoid and entire maxillary sinus. The mass was removed via endoscopic medial maxillectomy. Histopathology examination revealed sinonasal melanocytic malignant melanoma. At present 17 months postoperatively she is symptom free with no recurrence and under regular follow up.
The interalar width of the nose and the intercanine distance were measured in 266 Malay subjects (111 males and 155 females) randomly selected from the students of the School of Medical Sciences. University Sains Malaysia in Kota Bharu, Malaysia. The mean interalar width of the nose in male subjects was 39.8 +/- 2.3 mm (range 34-45 mm) and in female subjects 36.2 mm +/- 2.2 mm (range 30-41 mm). There is a statistically significant difference (t = 12.9: p < 0.05) in the nasal width between male and female Malay subjects. This agrees with the findings of other similar studies that males have wider noses than females. The mean maxillary intercanine distance in male subjects was 36.7 = 2.6 mm (range 30-42 mm) and in female subjects 36.2 = 2.3 mm (range 30-42 mm). The anterior maxillary arch is significantly wider in Malay subjects compared to Chinese from Singapore (Keng 1986) as p < 0.05 and to Caucasians (Sawiris 1977) as p < 0.05. There is a significant correlation (r = 0.312; p < 0.05) between the nasal width and the intercanine distance in female subjects but not in male subjects.
A single nostril associated with alobar holoprosencephaly is a rare congenital lesion. This paper reports two female term neonates with holoprosencephaly. The first neonate asphyxiated at birth had a single nostril, hypotelorism, posterior cleft palate, inferonasal coloboma of the iris and disc and persistent tunica vasculosa lentis. The other neonate had cleft lip and palate and recurrent convulsions. Both neonates had gross motor and developmental delay. Cranial sonography and CT scan showed features consistent with alobar holoprosencephaly. Karyotyping for the first neonate and her family members was normal. Both of them were treated conservatively and supervised.
Sinonasal teratocarcinosarcoma is very unusual malignant neoplasm histologically consisting of an epithelial element and one or more mesenchymal components. This is a report of teratocarcinosarcoma, in a 74-year-old male, involving the right nasal cavity and ethmoids with intracranial extension. The tumour was totally resected via the craniofacial approach and the patient was given post-operative chemotherapy. Extensive tumour necrosis, rapid growth and local destruction are the prominent features of this tumour. The clinical presentation, pathological features and clinical course of this rare malignancy are discussed with a review of the literature.
A case of the Hutchinson-Gilford progeria syndrome (HGPS) in Malaysia is described. A brief discussion of this rare condition and its differential diagnosis follows.
Yaws is an infectious, non-venereal disease of the tropical countries, which is caused by Treponema pertenue. Gangosa and goundou were seen commonly in cases of yaws in Africa, particularly in the early part of this century. After successful WHO mass treatment campaigns, these conditions are rarely seen now. A case of yaws with gangosa, goundou, and a nasopharyngeal carcinoma is presented here for its rarity.
Matched MeSH terms: Nose Deformities, Acquired/etiology*
A tooth in the nasal cavity is an uncommon phenomenon. The exact mechanism is unclear, and patients may present with non-specific nasal symptoms. We encountered a 24-year-old patient with history of cleft palate repair, presenting to us with unilateral nasal discharge not improving with conventional medications. Rigid nasal endoscopy revealed a rhinolith-like foreign body at the floor of the left nasal cavity. Removal of the rhinolith was done under general anesthesia, and it turned out to be an intranasal tooth. Intranasal tooth is often misdiagnosed due to its non-specific symptoms. Detailed dental and oropharyngeal examination as well as imaging studies are essential in diagnosing an intranasal tooth. Early surgical removal is the mainstay of treatment in order to prevent further complications. Patients with unilateral nasal symptoms not responding to conventional treatment require proper ear, nose, and throat (ENT) evaluation to rule out other pathology.
This study was designed to develop language-specific stimuli for the assessment of resonance and to obtain nasalance scores using the newly developed speech stimuli in Mandarin. Gender and age influences on nasalance scores for each of the stimulus were also examined. Participants recruited were typically developing Mandarin-speaking ethnic Chinese children aged 6;00-7;11 growing up in Malaysia. Perceptual ratings of nasality were made based on the GOS.SP.ASS.'98 (revised) for children while nasalance scores were recorded for each stimulus using the Nasometer II (Model 6400). Fifty Mandarin-speaking children (24 males and 26 females) were recruited. None of the participants were perceived with abnormal nasality on the three stimuli. The mean nasalance scores for the Mandarin stimuli were 16.08% (SD = 2.57, 95% CI = 15.35-16.81) for the Oral passage, 25.20% (SD = 3.63, 95% CI = 24.17-26.23) for the Oral-Nasal passage and 55.44% (SD = 4.17, 95% CI = 54.25-56.63) for the Nasal passage. No significant age- and gender-related differences were observed for all the three stimuli. This is the first set of Mandarin stimuli and nasalance norms for Mandarin-speaking children in Malaysia. The influence of phonetic content on nasalance is supported. Findings call for language-specific normative nasalance data and careful selection of stimuli for the assessment of resonance.
The uniquely enlarged noses of male proboscis monkeys are prominent adornments, and a sexually selected male trait. A recent study showed significant correlations among nose, body, and testis sizes and clear associations between nose size and the number of females in a male's harem. However, to date, the analyses of other common male traits, i.e., canines, are lacking. Whereas male nose size had a positive correlation with body size, we unexpectedly found a negative correlation between body and canine sizes. We explain this by an interaction between sexual and natural selection. Larger noses in males may interfere with the use of canines, thereby reducing their effectiveness as weapons. Additionally, longer canines are opposed by natural selection because the larger gape it imposes upon its bearer reduces foraging efficiency, particularly in folivores. This unique case of decoupling of body and canine size reveals that large canines carry an ecological cost.