A Comparative Anatomical Study Of Phana Marma In Ayurveda And Modern Sinus Anatomy With Special Reference To Dushta Pratishyaya (CHRONIC RHINOSINUSITIS)
Abstract
Background: The disease Dushta Pratishyaya is a chronic nasal condition affecting the nasal cavity and paranasal sinuses. In contemporary medicine, it correlates with chronic rhinosinusitis. According to Ayurvedic texts, Phana Marma, classified under Vaikalyakara Marma, is situated on either side of the nostrils and is associated with the Ghrana Sangyavaha Srotas. It plays a vital role in olfactory function. Olfactory loss may be partial (hyposmia) or complete (anosmia), & its duration depends on the underlying pathology.
Materials and Methods: This anatomical study of Phana Marma draws references from the Brihattrayi, Laghutrayi, and other classical Ayurvedic sources, supported by modern anatomical and clinical literature including journals, dissertations, and conference papers. The study included 31 patients who presented with symptoms such as rhinorrhea, nasal blockage, headache, and facial pain, unresponsive to medical treatment, with radiological findings of haziness, opacification, or air-fluid levels on 45° Water’s view X-ray of the paranasal sinuses. Patients with nasal tumors, polyps, allergic mucosal thickening, previous nasal surgeries, age below 18 or above 60.
Results: Out of 31 enrolled patients, 30 completed the study and were analyzed. A significant association was observed between the number of symptoms of Dushta Pratishyaya involving Phana Marma and the severity of mucosal thickening. As the number of symptoms increased, mucosal thickening progressed from mild to severe, with a statistically significant p-value (<0.05).
Conclusion: This study highlights the anatomical importance of Phana Marma by establishing its correlation with the olfactory epithelium, which is located in the upper third of the nasal cavity. The olfactory axons pass through the cribriform plate and connect receptors to the olfactory bulb. Any trauma or pathology affecting these structures can result in olfactory dysfunction. The findings affirm the Ayurvedic concept of Phana Marma and its practical correlation with modern sinus anatomy and clinical manifestations of Dushta Pratishyaya.
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Sharma PV. Susruta Samhita of Susruta with English Translation. Varanasi: Chaukhambha Visvabharati; 2010. Sharira Sthana, 6/27.
Dwivedi G. Origin of surgery in ancient India. Indian J History Sci. 2007;42(3):299–306.
Shastri A. Sushruta Samhita with Ayurveda Tatva Sandipika Hindi Commentary. Reprint ed. Varanasi: Chaukhambha Sanskrit Sansthan; 2012. Sharira Sthana, 6/4.
Tripathi B. Charaka Samhita with Charaka Chandrika Hindi Commentary. Reprint ed. Varanasi: Chaukhambha Surbharati Prakashan; 2013. Sharira Sthana, 6/28.
Paradkar HS. Ashtanga Hridaya of Vagbhata with Sarvanga Sundara Commentary. Reprint ed. Varanasi: Chaukhambha Surbharati; 2010. Sharira Sthana, 4/36.
Acharya YT. Charaka Samhita of Agnivesha with Ayurveda Dipika Commentary of Chakrapanidatta. Reprint ed. Varanasi: Chaukhambha Surbharati Prakashan; 2013. Chikitsa Sthana, 26/111–112.
Fokkens WJ, Lund VJ, Hopkins C, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl S29):1–464. doi:10.4193/Rhin20.600
Hastan D, Fokkens WJ, Bachert C, et al. Chronic rhinosinusitis in Europe—an underestimated disease. A GA²LEN study. Allergy. 2011;66(9):1216–23. doi:10.1111/j.1398-9995.2011.02570.x
Kennedy DW. Functional endoscopic sinus surgery: Technique. Arch Otolaryngol. 1985;111(10):643–49.
Schleimer RP. Immunopathogenesis of chronic rhinosinusitis and nasal polyposis. Annu Rev Pathol. 2017;12:331–57. doi:10.1146/annurev-pathol-052016-100401
Stammberger H. Functional endoscopic sinus surgery. Eur Arch Otorhinolaryngol. 1986;243(2):63–76.
Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline (update): Adult sinusitis. Otolaryngol Head Neck Surg. 2015;152(2 Suppl):S1–S39. doi:10.1177/0194599815572097
Ahmad N, Ghaffar A, Islam M, et al. Diagnostic accuracy of X-ray PNS Water’s view in chronic sinusitis. Pak J Med Health Sci. 2014;8(3):667–69.
Ibekwe TS, Nwaorgu OG, Onakoya PA. Radiological evaluation of chronic maxillary sinusitis using plain radiograph. West Afr J Med. 2008;27(2):104–7.
Mafee MF, Chow JM, Meyers R. Functional endoscopic sinus surgery: Anatomy, CT screening, indications, and complications. AJR Am J Roentgenol. 1993;160(4):735–44.
Ramadan HH, Hinerman RA. Correlation between CT scan and symptoms in chronic sinusitis. Otolaryngol Head Neck Surg. 2001;125(1):40–43.
Naeem M, Khan A, Shabbir S, et al. Diagnostic accuracy of X-ray PNS (Water’s view) in chronic sinusitis. J Ayub Med Coll Abbottabad. 2013;25(3–4):103–05.
Sushruta. Sushruta Samhita. 1st ed. Varanasi: Choukhamba Surbharati Prakashan; 2003.
Vagbhata. Ashtanga Sangraha. 1st ed. Varanasi: Choukhamba Surbharati Prakashan; 2003.
Vagbhata. Ashtanga Hridayam. 1st ed. Varanasi: Choukhamba Surbharati Prakashan; 2003.
Bhavamishra. Bhavaprakasha. 1st ed. Varanasi: Choukhamba Surbharati Prakashan; 2003.
Snell RS. Clinical Anatomy by Regions. 9th ed. Philadelphia: Wolters Kluwer; 2012.
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