OBJECTIVE: Confocal laser endomicroscopy (CLE) is an optical imaging technique that allows in vivo, real-time, microscope-like assessment of superficial lesions. Although there is substantial data on CLE use in the upper GI tract, there is limited information regarding its application in the nasal cavity and paranasal sinuses. This study aims to assess the feasibility and diagnostic metrics of CLE in the nasal cavity and paranasal sinuses regarding differentiation between healthy/benign and malignant tissue. These structures show, however, a wider variety of frequent and concomitant benign and malignant pathologies, which could pose an increased challenge for optical biopsy by CLE.
METHODS: We performed CLE on a case series of six patients with various findings in the nose (three chronic rhinosinusitis, adenocarcinoma, meningoenzephalozele, esthesionneuroblastoma). Forty-two sequences (3792 images) from various structures in the nasal cavity and/or paranasal sinuses were acquired. Biopsies were taken at corresponding locations and analyzed in hematoxylin and eosin staining as a standard of reference. Three independent examiners blinded to the histopathology assessed the sequences.
RESULTS: Healthy and inflamed mucosa could be distinguished from malignant lesions with an accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 84.1%, 85.4%, 83.1%, 72.5%, and 92.1%, respectively, with a substantial agreement between raters (Fleiss κ = 0.62).
CONCLUSIONS: This technique shows, despite its limitations, potential as an adjunctive imaging technique during sinus surgery; however, the creation of a scoring system based on reproducible and defined characteristics in a larger more diverse population should be the focus of further research to improve its diagnostic value and clinical utility.
METHODS: NA Laryngoscope, 2024.

To determine if pharyngeal packs have an effect on postoperative pain and postoperative nausea and vomiting in functional endoscopic sinus surgery (FESS).
Forty-six patients scheduled for routine endoscopic sinus surgery were recruited into this study. The patients were randomly allocated to have or to not have pharyngeal packing prior to surgery.
The placement of pharyngeal packs during FESS is controversial. Theoretically, pharyngeal packs may prevent postoperative nausea and vomiting by preventing ingestion of blood during sinus surgery. However, prior studies have not conclusively demonstrated this to be the case in FESS. Pharyngeal packs have been associated with complications including throat pain, aspiration, and death. The objective of this randomized control trial was to determine if pharyngeal packs have an effect on postoperative throat pain, nausea, and vomiting in order to determine their importance during FESS. Patients were blinded to intervention. Postoperatively, throat pain and nausea/vomiting scores were recorded.
There was no significant difference in mean throat pain at 4 hours following surgery (P = 0.860). At 24 hours after surgery, patients without pharyngeal packing experienced more pain than those who had a throat pack placed (P = 0.002). There was no significant difference in the level of nausea at 4 hours after surgery (P = 0.315) or at 24 hours after surgery (P = 0.315).
We recommend against the routine use of placing pharyngeal packs during FESS.
1b. Laryngoscope, 127:2460-2465, 2017.

(1) To study the incidence of benign and malignant lesions of nose and paranasal sinuses (PNS). (2) To study various lesions in reference to sex differences and symptomatology. (3) To compare the findings of the study with other authors. The study was conducted over a period of 7 years both retrospectively and prospectively. The formalin fixed specimens were received with complete clinical and radiological features. Routine gross examination and required number of sections were taken and stained with hematoxylin and eosin. Periodic acid Schiffs and reticulin stains were used wherever necessary. The incidence of lesions in nasal cavity (NC) and PNS was 16.71 cases per year, non-neoplastic lesions constituted 86% of these cases and their incidence was 14.42% and neoplastic lesions constituted 12%. All the cases were carefully examined histopathologically and it was found that the region was affected by variety of lesions. Among 117 cases, 101 were non-neoplastic and 16 were neoplastic. The commonest site was NC, followed by PNS. They occur commonly in second and third decades with predominance in males. Amongst the non-inflammatory lesion, nasal polyp is the commonest lesion followed by rhinoscleroma and rhinosporidiosis. The common age group is second and third decades, with male predominance. Amongst benign neoplastic lesions capillary haemangioma was common followed by inverted papilloma. The common age group is second and third decades, with male predominance. Malignant lesions were comparatively less to that of benign lesions.

Inverted Papilloma is a unique neoplasm characterized by its tendency to destroy bone, tendency to recur after incomplete removal and association with malignancy. The uncertainty of its clinical features and projected behaviour has resulted in an ill-defined approach to its management. This is a prospective study of 30 patients of Inverted Papilloma admitted at Regional Institute of Medical Sciences, Imphal between August 2001 to July 2003. In this study, meticulous attention is given to the clinical presentation and management in a series of 30 patients with inverted papilloma. A majority of patients were between 50-70 years (40%) with a mean age of 52.3 years. M: F Ratio=3.3:1. Commonest presenting symptoms were unilateral nasal obstruction (93.3%), nasal discharge (40%) and epistaxis (36.6%). 90% of the patients had signs of involvement of the nasal cavity with one or more sinuses and 46% showed bony erosion on C.T. Scan studies. Surgery was the treatment of choice in 90% of the cases.