P.K. Shenoy, MD, FRCS, DLO, FACS, ENT Service Chief, Campbellton Regional Hospital, Campbellton, NB, Canada.

Dr. Lyew Warren, MD, FRCSC, Consultant Pathologist, Campbellton Regional Hospital, Campbellton, New Brunswick, Canada.

Abstract
Nasal vestibular mass are not commonly seen in ENT practice. We are presenting a patient with a large right nasal vestibular mass, who complained of nasal obstruction and epistaxis. Differential diagnosis of the similar growths in the nasal vestibule with their pathology and the treatment options, have been reviewed from the literature.
Key Words: Nasal vestibular mass, papilloma, 0 and 30 degree endoscopes, lateral rhinotomy.

Michael Gordon, MD, MSc, FRCPC, Medical Program Director, Palliative Care, Baycrest Geriatric Health Care System, Professor of Medicine, University of Toronto, Toronto, ON.

The prevalence of dementia appears to be increasing in most western countries. That when coupled with the increased average age of the older population has leads to an expectation that projections of financial costs to individuals, families and to society will grow over the next few decades. The current study, out of the United States, based on a number of robust data bases coupled with in-depth interviews has resulted in projections of the current true costs of caring for elderly people living with dementia. It also allowed for the projection of future costs over the next three decades. The results are quite mind-boggling: "We found that dementia leads to total annual societal costs of $41,000 to $56,000 per case, with a total cost of $159 billion to $215 billion nationwide in 2010. Our calculations suggest that the aging of the U.S. population will result in an increase of nearly 80% in total societal costs per adult by 2040."