Is it as dangerous as it looks?

A common bony protrusion that occurs over the hard palate is sometimes mistaken for a malignancy especially when it is large. This bony growth is a torus palatinus (TP), which is a benign bony prominence over the hard palate. It occurs most commonly in bilateral multiple form, and is often located at the canine to premolar area. A basic knowledge of the assessment and management of TP is important,, particularly for the first-line family physician to ensure that the correct information is given to the patient

Knowledge, Attitude, and Practice of Intranasal Corticosteroid in Allergic Rhinitis Patients: Development of a New Questionnaire

Objectives: The knowledge gap and attitude of allergic rhinitis (AR) patients using intranasal corticosteroid (INCS) led to the poor outcome of their disease. We aimed to develop and validate a new questionnaire to assess the knowledge, attitude, and practice (KAP) of AR patients that can be used to assess and understand the factors affecting compliance of INCS. Methods: The questionnaire comprised development and validation stages. A self-administered questionnaire was developed after a comprehensive literature review. It was subjected to content and face validity before a revised final version was drafted. Exploratory factor analysis was used to assess the validity of the questionnaire. Cronbach’s alpha was used to verify internal consistency. Results: The development phase resulted in a questionnaire consisting of 14 items. Explanatory factor analysis revealed four factors associated with KAP. The four factors were extracted, and 12 items were kept. The factors were attitude domain with four items (factor 1), practice domain with four items (factor 2), and knowledge domain with four items (factor 3 has two items, and factor 4 has two items). The Cronbach’s alpha of the four factors ranged from 0.614 to 0.809. The final questionnaire consists of 3 domains with 12 items (the knowledge domain with four questions; the attitude domain with four questions; the practice domain with four questions) and was valid and reliable. Conclusions: The newly developed questionnaire has adequate validity and reliability. It is a useful tool to improve the treatment of AR patients by understanding the factors affecting their compliance

Giant rhinolith: A case report

Rhinolith is a stone that form in the nose. It is an uncommon disease that may present asymptomatically. It is usually occur secondary to retained foreign bodies. Sometimes, it can be cause by fungal infection. It can be seen on radiographs as a radiopaque object in the nasal fossa and may be confused with several pathologic entities that will call for more invasive surgical procedures. Here we present a case of giant rhinolith possibly arising from retained foreign body, and discuss its clinical and radiologic features. Keywords: Foreign bodies, Nasal cavity, Unilateral nasal obstructio

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Adenoid cystic carcinoma (ACC) of sinonasal is an uncommon tumour that progresses slowly and generally manifested in advanced stage. Surgical management of sinonasal ACC can be challenging to the attending surgeon as they need to outweigh the decision between tumour clearance and morbidity of the patient. Multimodality treatment is the mainstay of treatment for sinonasal ACC and prognosis depends on the histological subtype of tumour, patient factor and treatment modalities opted. We are presenting 2 cases of sinonasal ACC manifested in different age groups in our centre with different types of surgical approaches opted and their outcomes

Zonula occludens and nasal epithelial barrier integrity in allergic rhinitis

Allergic rhinitis (AR) is a common disease affecting 400 million of the population worldwide. Nasal epithelial cells form a barrier against the invasion of environmental pathogens. These nasal epithelial cells are connected together by tight junction (TJ) proteins including zonula occludens-1 (ZO-1), ZO-2 and ZO-3. Impairment of ZO proteins are observed in AR patients whereby dysfunction of ZOs allows allergens to pass the nasal passage into the subepithelium causing AR development. In this review, we discuss ZO proteins and their impairment leading to AR, regulation of their expression by Th1 cytokines (i.e., IL-2, TNF-α and IFN-γ), Th2 cytokines (i.e., IL-4 and IL-13) and histone deacetylases (i.e., HDAC1 and HDAC2). These findings are pivotal for future development of targeted therapies by restoring ZO protein expression and improving nasal epithelial barrier integrity in AR patients