A more comprehensive management for eosinophilic chronic rhinosinusitis after FESS

In recent years there has been increasing recognition of eosinophilic chronic rhinosinusitis which, in particular, results in persistent symptoms and recurrence of nasal polyps, even after FESS surgery. It therefore calls for measures adjuvant to FESS to stop persistence of...

CRS vs. migraine: which is the culprit in most headaches?

‘Sinus headache’ is a common diagnosis according to patients and primary care physicians, but relatively infrequent in the eyes of otolaryngologists. This study examines 104 patients with a primary headache syndrome (PHS) and 130 patients with CRS, looking at SNOT-22...

Can we avoid FESS in patients with true isolated odontogenic sinusitis?

This is a useful study looking at how best to manage patients with odontogenic sinusitis and if FESS can be safely avoided. The authors treated patients by removing the odontogenic cause of the rhinosinusitis by extracting the offending tooth and...

An objective office-based method for diagnosing allergic rhinitis

There are several signs of allergic rhinitis which, helped with skin prick and blood tests, can diagnose the problem. However, an endoscopic, on-the-spot test may surmount clinical uncertainties and invasive testing to acquire the same goal. In this study, the...

Does minimally invasive surgery under local anaesthesia have a role in the management of chronic rhinusinusitis?

A formal FESS procedure usually done under local anaesthesia is considered as gold standard in the management of chronic rhinusinusitis. However, success is hampered by a significant recurrence rate of polyps requiring revision surgery, long waiting lists, reluctance of elderly...

Closure of septal perforations

This Belgian retrospective observational study looked at the success rate and predictive factors for success when bilateral advancement flaps were used via an external approach. In total, 111 patients were included in the study over a 16-year period. The mean...

Is posterior epistaxis really ‘posterior’?

In absence of any clear bleeding points seen on the septum, it is generally presumed that the epistaxis is posterior, especially when simple cauterisation of the septum does not help and may progress to sphenopalatine ligation. In this publication, the...

SNOT-25 to assess CRS - a new tool

The SNOT-22 is a well-established validated instrument, designed to evaluate the rhinosinusitis-specific health status and health-related QOL, however makes only one broad reference to productivity. The objective of this paper is to evaluate a modified SNOT-25 created to better assess...

Tramadol soaked nasal packs for post-septoplasty analgesia

Having had a septoplasty a number of years ago for the potential treatment of snoring, I was intrigued by this paper which compared the analgesic effect of tramadol-soaked and lignocaine-soaked nasal packs following septoplasty. In my practice, I have always...

Systemic steroid therapy for reduction of macrophage migration inhibition factor in the control of nasal polyposis

It is believed that macrophage migration inhibitory factor mediates inflammation by stimulating the release of other pro-inflammatory cytokines. The use of systemic steroids in control of nasal polyposis is an established treatment. In this study the authors have aimed at...

Widen the ostium or keep it: that is the question

The original concept of wide endoscopic sphenoethmoidectomy for sinonasal polyposis has been a well-established principle since 1995. However, with the evolution of the understanding of sinonasal physiology, this might change. The authors present arguments based on the evolutionary and developmental...

Predictors of postoperative improvement after endoscopic sinus surgery in patients with chronic rhinosinusitis

Improvement after endoscopic sinus surgery in patients with chronic rhinosinusitis varies considerably. If elaborate preoperative and intraoperative data could be used to predict the postoperative course, management and length of the follow-up could be adjusted to provide optimal care. Two...

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