Developmental anomaly – A duplicate fronto-ethmoidal sinus complex

Background: Fronto-ethmoidal sinus tumors can be benign or malignant. Case presentation: This case reports a patient with a long-standing frontal sinus lesion who presented with seizures. Imaging findings suggested malignancy. The patient underwent craniofacial resection – intraoperative findings revealed a lesion centered in the anterior ethmoid sinuses with extension into the frontal sinus, characterized by multiple bony septations. Histology was negative for malignancy. These findings were similar to that of ethmoid sinus morphology, which are of endochondral bony origin. As the lesion has been long-standing, this was postulated to be a duplicate ethmoid sinus. Conclusion: This is the first reported case of a possible duplication of the ipsilateral ethmoid sinus. This aids clinicians in diagnosing patients who present similarly, avoiding extensive surgical procedures with significant morbidity risk. Keywords: Paranasal sinus, Ethmoid sinus, Development anomaly, Tumo

Next-generation allergic rhinitis care in Singapore : 2019 ARIA care pathways

Allergic rhinitis (AR) is prevalent in Singapore, with a significant disease burden. Afflicting up to 13% of the population, AR impairs quality of life, leads to reduced work productivity and is an independent risk factor for asthma. In the last 2 decades, local studies have identified patient and physician behaviours leading to suboptimal control of the disease. Yet, there is an overall lack of attention to address this important health issue. Allergic Rhinitis and its Impact on Asthma (ARIA) is a European organisation aimed at implementing evidence-based management for AR worldwide. Recent focus in Europe has been directed towards empowering patients for self-management, exploring the complementary role of mobile health, and establishing healthcare system-based integrated care pathways. Consolidation of these ongoing efforts has led to the release of the 2019 ARIA care pathways. This review summarises the ARIA update with particular emphasis on the current status of adult AR in Singapore. In addition, we identify unmet needs and future opportunities for research and clinical care of AR in the local context