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....

How to manage the concha bullosa in FESS

It is an interesting concept to assess how much impact the presence of a large concha bullosa (CB) has on both severity of chronic rhinosinusitis (CRS) and also postoperative outcomes after FESS. The authors accept that the paper has limitations...

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...

Promising surgical technique for pulsatile tinnitus caused by sigmoid sinus dehiscence?

Pulsatile tinnitus (PT) can be caused by sigmoid sinus dehiscence (SSD). The authors report the results of 17 patients who underwent sandwich surgical technique for sigmoid sinus (SS) wall reconstruction for the treatment of pulsatile tinnitus caused by sigmoid sinus...

An alternative view and access point

Fungal sinusitis is a common problem and it is well recognised that it can be difficult to remove all of the fungal matter from the maxillary sinus to ensure no recurrence or residual disease. This study describes a technique utilising...

The search for the holy grail of rhinosinusitis: another step towards phenotyping in CRS wNP?

For many years, scientists and clinicians have been trying to understand the infinite variability within the term ‘rhinosinusitis’ using radiology, basic science, epidemiology and then using their insights to solve the riddle of management: how to explain why some patients...

Sinus implants to treat recalcitrant polyps

It is well established that the burden of chronic rhinosinusitis on healthcare costs and patients’ quality of life is high, and that current mainstream treatment options of oral or topical steroids are not without problems. This paper compares two RCTSs...

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...

Outcomes of temporal bone-resurfacing for pulsatile tinnitus associated with vascular wall anomalies

This month’s Ed’s choice is an interesting systematic review into the management of pulsatile tinnitus. There are impressive results from resurfacing of symptomatic anatomical abnormalities of the temporal bone and I suspect that referrals for further imaging and otology clinic...

Sphenopalatine ganglion block in endoscopic sinus surgery reduces intra and post-operative morbidity

The authors present results of a meta-analysis to investigate the role of sphenopalatine ganglion block (SPGB) in reducing postoperative pain in endoscopic sinus surgery (ESS). An electronic database search (Pubmed, SCOPUS, Google Scholar, Embase, and the Cochrane Register of Controlled...