Early recognition aiding better prognosis?

As we are all aware, acute invasive fungal rhinosinusitis (AIFR) is a life-threatening disease which typically affects immunocompromised patients. It is diagnosed via typical signs, symptoms and presentation but gold standard is by biopsy of tissues demonstrating infiltration fungal hyphae....

How safe is ESS really?

Endoscopic sinus surgery (ESS) is a very frequently performed operation, both in America and worldwide. This ambitious project looked at the health data of more than 105 million patients across 60 1US HCOS. The cohort of 116,669 patients who underwent...

Office treatment for persistent rhinorrhoea

Vasomotor rhinitis (VR) is a common condition across the world. Patients suffering from VR commonly have symptoms of persistent bilateral rhinorrhoea, that can have a significant negative impact on their quality of life. Vasomotor rhinitis can be treated medically with...

Globus, reflux or perhaps both?

We rarely do an ENT clinic without encountering a patient with persistent or recurring feeling of a lump or foreign body in the throat. We are also familiar with patients dreading to hear the C word after the endoscopic examination...

Adult Rhinosinusitis Clinical Practice Guideline update

This is a summary of the ‘Clinical Practice Guideline: Adult Sinusitis’ from the American Academy of Otolaryngology-Head and Neck Surgery Foundation. This is an update of the 2015 version. Evidenc-based statements: 1a. Differential diagnosis of acute rhinosinusitis: Clinicians should distinguish...

Eosinophilic complications during dupilumab therapy

Dupilumab is a humanised monoclonal antibody that targets type 2 inflammation by blocking IL-4 and IL-13 signalling. Reported adverse events from its use include injection site erythema, conjunctivitis, arthralgia and hypereosinophilia. The potential for more severe eosinophilic-related complications such as...

Not the answer yet, but it may be in the future

AI is certainly a topical issue these days and radiomics refers to techniques which allow the extraction of quantitative features from medical imaging to produce large data sets for clinical problem solving. This paper looks at CT imaging of the...

Budesonide nasal irrigation for chronic rhinosinusitis: is it effective and safe?

Budesonide respules used in nasal irrigations as part of chronic rhinosinusitis management are usually at a dose of 0.25 mg to 2 mg, which is substantially higher compared to budesonide nasal spray, typically ranging from 64 to 256 micrograms. Hence,...

Posterior nasal neurectomy – long-term data shows tailing off of benefits but still improvement after three years

It is well understood that allergic rhinitis has a very detrimental effect on quality of life for afflicted patients. This study looks at patients with allergic rhinitis but no other associated sinonasal or respiratory diagnoses. Patients with a history of...

Congenitally anosmic patients do have fewer olfactory foramina

It has been previously established that patients with Kallman’s syndrome (very much associated with anosmia) have a similar number of cribriform plate foramina when compared to controls. As non-invasive CT assessment of the cribriform plate is now possible in cadavers,...

Saddle nose deformity repair – structured approach

We often come across saddle noses in our specialist rhinology clinics. The saddle nose deformity represents collapse of the cartilaginous and / or bony nasal support structures resulting in dorsal height loss. Acquired cases are due to trauma or surgery...

Temperature-controlled radiofrequency treatment of the nasal valve confers sustained benefit

Aiming to investigate long-term efficacy and safety (three years post treatment), this was an extension of a previous multicentre, prospective, single-blinded, randomised controlled trial that investigated the effectiveness and safety of temperature-controlled radiofrequency treatment (TCRF) to the nasal valve (NV)...