A new era in the treatment of recalcitrant nasal polyps?

Chronic rhinosinusitis with nasal polyps (CRSwNP) can be difficult to treat effectively in patients with aggressive or recalcitrant disease. Omalizumab (Xolair) is a monoclonal anti-IgE antibody with proven benefits for patients with moderate/severe asthma and CRSwNP, but this study looks...

Biologicals for severe chronic rhinosinusitis with nasal polyps. Any use?

Recent advances and knowledge of inflammatory endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP) led to introduction of biological agents such as monoclonal antibodies targeting IgE (omalizumab) and Interleukins (ILs) such as IL4R alpha (dupilumab) and IL5. The European Academy...

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...

COVID-19 in patients with chronic rhinosinusitis with polyps. Are they at risk?

COVID-19 entry factors are highly present in nasal epithelial cells. These factors include ACE2 and TMPRSS2. Their presence in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) was not investigated before. Authors investigated expression of ACE2 and TMPRSS2 in two...

Can we predict how much benefit patients will get from ESS with a novel monoclonal antibody

Mepolizumab (Nucala) is a humanised IgG1 monoclonal antibody that acts as an IL-5 antagonist. It has been shown to be highly effective in treating severe asthma. It is hypothesised that it will be effective for patients with recalcitrant CRSwNP. This...

Simple preoperative tests predicting outcomes for ESS patients?

We are all familiar with patients suffering extensive nasal polyps who relapse all to soon after careful and thorough endoscopic sinus surgery (ESS). This paper looks to answer whether we can predict which patients will do well, and which less...

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...

Earlier intervention to correct anosmia?

This is an interesting study aimed to determine the timing for successful surgical intervention in improving the sense of smell in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). A total of 86 CRSwNP patients with loss of smell and...

Those little friends in our noses

Human microbiota plays an important role in both health and disease including metabolism, immunomodulation, and a potential role in chronic inflammatory conditions such as chronic rhinosinusitis (CRS). The authors aimed to investigate the sinonasal microbiome using 16S rRNA gene sequencing...

Eustachian tube dysfunction usually improves following endoscopic sinus surgery

This study investigated effects of endoscopic sinus surgery (ESS) on eustachian tube dysfunction (ETD) and factors associated with improvement. This was a retrospective study which included 302 patients over 17 years old who underwent ESS between 1 December 2016 and...

Location, location, location: How to get the steroid where you need it, in chronic rhinosinusitis

What almost all current guidelines on chronic rhinosinusitis have in common is the importance of intranasal steroid (INCS) use. However, it is increasingly understood that the efficacy of INCS depends on their efficient delivery to the point of need, i.e....

A classification of a new cell - the retrosphenoid cell

This is a concise paper which describes a previously undefined type of cell within the sphenoethmoidal complex. It identifies the retrosphenoid cell, differentiated from an Onodi cell by being entirely within the posterior wall of the sphenoid sinus, lying between...

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