We have an increasingly aged population, and hence older and older patients are presenting with sinonasal issues and the potential need for endoscopic sinus surgery (ESS). The authors sought to identify if older patients (age >70) have more complications post ESS than younger patients, and specifically looked at octogenarians (age >80) and whether they pose the highest risk. Using a retrospective analysis of patient records over a four-year period, they found that older patients were more likely to have sinonasal tumour resections, although these were more likely to be benign than malignant, but the majority of patients in both groups underwent surgery for chronic rhinosinusitis or nasal polyps. Interestingly the younger patient group had the higher rate of surgical complications - 8% vs. 4% in the elderly group, although this was not statistically significant. More predictably, the elderly group had a higher rate of medical complications - 2% vs. 0.7%, but again this was not statistically significant. The most interesting finding was that there were no differences in complication rates between the two groups when age >80 was compared to age <80. It is encouraging as I have experienced an increasing volume of older patients with sinonasal problems which are amenable to surgery, so it is of value to know that the risks are only marginally higher than for a younger cohort, and so can be discussed on a case-by-case basis. Admittedly the sample size was small and so more research would be useful.