OBJECTIVE

To determine if the prelacrimal window approach is feasible in a Filipino population by measuring the distance between the anterior maxillary wall and lacrimal duct in paranasal sinus CT scans, classifying them into prelacrimal window approach levels of difficulty.

METHODS

Design: Retrospective Review of Records

Setting: Tertiary Private University Hospital

Participants: PNS CT scans of Filipino patients 18 years old or above

RESULTS

A total of 169 PNS CT scans were reviewed, measuring the right and left sides for a total of 338 sides. The mean prelacrimal window distance for males was 5.70mm (±1.79), while for females it was 4.94 (±1.75), with a combined mean distance of 5.32mm. Ten percent (10%) of CT scans (34) were classified as Type 1; 73.7% (249) were classified as Type 2, and 16.3% (55) were classified as Type 3.

CONCLUSION

The prelacrimal window approach may be anatomically feasible in the Filipino population studied, with 90% of the PNS CT scan sides reviewed falling into the Type 2; and Type 3 categories, opening more potential avenues in the management of anterior maxillary lesions in the Philippines.

Human ; Maxillary Sinus ; Paranasal Sinus Neoplasms

OBJECTIVE

To discuss a rare case of ectopic intranasal eruption of a tooth presenting as chronic rhinosinusitis focusing on the cause of the delayed diagnosis and emphasizing the role of otorhinolaryngologists in the management of this disease entity.

METHODS

Design: Case Report

Setting: Tertiary Government Training Hospital

Patient: One

RESULTS

A 25-year-old, partially edentulous woman initially presented with a four-year history of foul-smelling right nasal discharge accompanied by nasal congestion, nasal pain, and epistaxis. Several general physicians prescribed unrecalled antibiotics and pain medications which provided only temporary relief of the symptoms. Due to the persistence of the foul-smelling discharge which was recalcitrant to medications, culture and sensitivity testing at our institution revealed moderate growth of pseudomonas aeruginosa and computed tomography scans of the paranasal sinuses showed a right intranasal tooth, thickening of the inferior turbinate and septal deviation to the right. Following endoscopic removal of the intranasal tooth and septoplasty, there was resolution of symptoms and no complications.

CONCLUSION

Ectopic intranasal eruption of tooth has not yet been reported in the Philippines. Delays in diagnosing and starting proper management can lead to morbidity and serious complications such as development of antibiotic resistance. A high index of suspicion by an ENT-HNS physician with thorough nasal physical examination could have aided in the early diagnosis and management of the intranasal tooth.

Human ; Bacteria ; Female ; Adult: 25-44 Yrs Old ; Pseudomonas Aeruginosa ; Tooth

Objective: To assess the quality of care of telemedicine consultation during the COVID-19 pandemic at the Jose R. Reyes Memorial Medical Center in 2022. : Methods Design: Cross-Sectional Study Setting: Tertiary Government Training Hospital Participants: 210 patients Results: Majority of the respondents were female, less than 40 years of age, unemployed, consulted for the first time, lived < 25km distance from the hospital, consulted because of an ear problem, consulted without symptoms suggestive of COVID-19 and had higher outcomes of face-to-face consultation. The overall satisfaction with teleconsultation was good with majority of patients satisfied and very satisfied with teleconsultation (4.29±1.083). Occupational status, technical problems encountered in the teleconsultation, and those who were bothered by the absence of clinical examination were associated with the perceived quality of care of the ENT teleconsultation (p < .05). Among the population who were satisfied to ENT teleconsultation, 82 (43%) were from the working population (OR 2.2 [1.1-4.7]), 158 (95%) were satisfied with quality of response (OR 23.7 [9.4-59.8]) and 154 (93%) were satisfied with image quality (OR 16.9 [7.3-39.0]). Conclusion Teleconsultation for ENT has proven useful in terms of satisfying the urgent concerns of patients in a pandemic setting.
Telemedicine

Objective: To describe a makeshift blue light filter for endoscopic visualization of a traumatic cerebrospinal fluid leak repair using intrathecal fluorescein and its application in one patient. Methods: Study Design:Surgical Instrumentation Setting:Tertiary Government Training Hospital Patient:One Results: Intra-operative endoscopic identification of fistulae sites was achieved using intrathecal injection of fluorescein that fluoresced using our makeshift blue light filter in a 43-year-old man who presented with a 3-month history of rhinorrhea due to skull base fractures along with multiple facial and upper extremity fractures he sustained after a fall from a standing height of 6 feet. He underwent transnasal endoscopic repair of cerebrospinal fluid fistulae in the planum sphenoidale, clivus and sellar floor. Post-operatively, there was complete resolution of rhinorrhea with no complications noted. Conclusion Our makeshift blue light filter made from readily available materials may be useful for endoscopic identification of CSF leaks using fluorescein in a low- to middle-income country setting like ours.
Human ; Male ; Adult (a Person 19-44 Years Of Age) ; Skull Fracture, Basilar ; Cranial Fossa, Posterior

Objective: To report the case of a woman who underwent smell training for post-infectious olfactory dysfunction presumably from COVID-19. Methods: Design: Case Report. Setting: Tertiary Private Training Hospital. Patient: One. Result: A 41-year-old woman who developed olfactory dysfunction attributed to COVID-19 underwent smell training. At baseline, her responses were mostly “no smell,” and those reported as “can smell a bit” were rated as distorted. After three months, she could now smell items that she previously could not smell, but these smells were still distorted. At the time of this writing, she was on her 4th month of smell training. Conclusion Although we cannot rule out spontaneous resolution of anosmia in our patient, we would like to think that smell training contributed to her recovery of smell.
Anosmia ; Anosmia ; Olfactory Bulb ; Olfaction Disorders