Access to the frontal sinus is limited by the anteroposterior depth of the frontal recess. Carolyn’s window, described by Seresirikachorn, Harvey, and colleagues, is a direct-access Draf IIa frontal sinusotomy designed to overcome this limitation. We evaluated its feasibility, safety, and short-term outcomes. A prospective, single-arm cohort study was conducted in adults with frontal sinus pathology—chronic rhinosinusitis (CRS) with or without nasal polyps, or frontal sinus mucocele—that was not treatable with simple endoscopic sinusotomy. All procedures were performed by a single surgeon using Carolyn’s window, and an independent surgeon performed postoperative endoscopic assessments. The primary outcome was complete intraoperative access to the frontal sinus pathology; secondary outcomes were early and late morbidity, neo-ostium patency, and the Sinonasal Outcome Test-22 (SNOT-22). Twenty patients (60
Abstract Background Vertigo and dizziness present frequently in clinical practice and account for more than 8% of medical consultations. Patients present to a wide variety of medical specialties including ER departments, otology, neurology, GP and family medicine. Diagnosing the underlying cause can be challenging due to the numerous possibilities, and physicians are often concerned about missing a serious condition. Main body The aim of this guide is to fill current gaps of knowledge and to provide a workable practice-oriented guide to all specialties that deal with patients presenting with vestibular symptoms. A graduated, practice-oriented approach was followed, with a comprehensive reference list for further information. This guide is intended as a practical narrative overview for frontline clinicians rather than a formally graded, evidence-based clinical guideline; it does not follow a systematic search strategy, predefined eligibility criteria, formal study appraisal, or certainty-of-evidence grading, and recommendations should be interpreted accordingly. Appendices are added to detail each important step to help the reader interpret the results. Conclusion Using this simple yet comprehensive guide should help clinicians of various specialties manage dizzy patients without excessive time loss or waste of resources.
Velopharyngeal insufficiency (VPI) often triggers secondary laryngeal compensations in children due to hyperfunctional phonation habits. This study aimed to investigate the prevalence and clinical characteristics of various vocal fold lesions in children presenting with VPI of different etiologies compared to control groups. A comparative cross-sectional study was conducted. Group I (study Group) included23 children diagnosed with VPI of various etiologies, with the diagnosis confirmed by comprehensive perceptual speech evaluation and flexible nasoendoscopy. Group II (control group) included23 typically developing children with no history of speech, language, or voice disorders. Visual assessment of the vocal folds to detect and characterize any structural lesions was thoroughly performed for all participants in both groups using rigid and flexible nasoendoscopy. Correlation between speech findings and the presence of nodules among cases (n=23). demonstrates a statistically significant association between vocal fold nodules and compensatory speech behaviors. Glottal stops were more frequent in cases with nodules (61.5
Abstract Background Nasal septal deformities represent common anatomical variations of the nasal cavity and may influence sinonasal function. Knowledge of their prevalence and patterns is important for clinical assessment and surgical planning. Materials and methods This cross-sectional observational study included brain computed tomography (CT) images from 398 adult Libyan patients. The study population consisted of 203 males and 195 females aged 18–90 years. Patients were recruited from the eastern, western, and southern regions of Libya. Axial and coronal CT images were reviewed to identify nasal septal anatomical variations. These variations included nasal septal deviation (NSD), nasal septal spur (NSS), and nasal septal pneumatization (NSP). Nasal septal deviation was classified as C-shaped, S-shaped, or septal deviation associated with a nasal septal spur. The prevalence of these anatomical variations was analyzed according to sex, age group, and geographical region. Results Nasal septal deviation (NSD) was the most prevalent anatomical variation, with an overall prevalence of 59.8%. C-shaped NSD and nasal spur associated with septal deviation were the most frequent patterns (27.4% and 25.9%, respectively), whereas S-shaped NSD was less common (6.5%). Other variations, including fused NSS with the middle turbinate, isolated NSS, and NSP, were less frequent, with prevalence of 4%, 4.8%, and 2.5%, respectively. Septal variations were more frequently observed in males than females; however, no statistically significant sex-related differences were detected. C-shaped and S-shaped NSD were more prevalent in older age groups, while NSS associated with septal deviation was more common in younger age groups. Statistically significant regional differences in NSD prevalence were observed among the western (55.1%), eastern (86%), and southern (43%) regions ( p < 0.05). Conclusion Nasal septal anatomical variations are common in the Libyan population, with NSD being the most frequent finding. No significant sex-related differences were observed. Regional differences were identified, whereas age-related associations were limited. Preoperative CT evaluation is valuable for accurate anatomical assessment and surgical planning.
