There is much we can do to improve the airway of patients with chronic sinus disease, especially those with polyps. However, the olfactory outcomes are usually disappointing and patients miss this important sensory modality, which has an effect on their quality of life. These authors report a study in which a gelatin dressing was placed high in the nose, as close as possible to the olfactory epithelium, at the conclusion of sinus surgery. The gelatin had been impregnated with triamcinolone. The 60 patients were divided into two groups, one of which did not receive the triamcinolone. The outcome for smell was good in the treated group, but follow-up was only 8 weeks. While this is gratifying, it is the long-term effect that is demoralising for this group of patients and I would be surprised if this short-term gain was translated into a superior long-term gain.

The effect of an absorbable gelatin dressing impregnated with triamcinolone within the olfactory cleft on polypoid rhinosinusitis smell disorders.
Bardaranfar MH, Ranjbar Z, Dadgarnia MH, et al.
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Edward W Fisher

MA DM FRCS, University Hospitals Birmingham NHS Trust (Heartlands and Good Hope Hospitals); Editor, Journal of Laryngology and Otology.

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