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Sinonasal undifferentiated carcinoma – slowly getting there

The rarest of the rare, sinonasal tumours form only a small part of the total number of head and neck tumours and undifferentiated carcinoma (SNUC) is one of the rarest of this group. There is some data (and some expert...

CRSwNP initiation, not always an interleukin fault

CRSwNP, similar to asthma, is an inflammatory disorder (type II) with eosinophilia and raised IL-5 and IL-13. Inflammation in CRSwNP is thought to be started by IL-25, IL-33 and thymic stromal lymphopoietin (TSLP), all of which form an important part...

Balloons – more complicated than first thought?

This study describes the complications seen after balloon sinuplasty (BSP) - a commonly performed procedure (particularly in the USA where it is often performed as an office procedure) versus traditional functional endoscopic sinus surgery (FESS). The data source was a...

An eye-opening resection technique

It is widely accepted that the gold standard treatment of inverted papilloma of the maxillary sinus (IPMS) is endoscopic excision via medical maxillectomy or mega antrostomy, and these approaches can be augmented by a Caldwell-Luc or canine fossa trephination if...

Daflon – a new way to treat idiopathic epistaxis

Epistaxis is a common ENT emergency and most cases are idiopathic. Flavonoids are natural substances with variable phenolic structures that are found in fruit and vegetables and take effect on blood vessels. Daflon is proposed to control epistaxis by “improving...

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...

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...

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...

Potential benefits of turbinate sparing medial maxillectomy

Whilst endoscopic medial maxillectomy (EMM) has good results as the standard treatment option for tumours arising in the maxillary sinus, postoperative problems of crusting, epiphora and paraesthesia are not uncommon. This paper looks at modified EMM aimed at sparing the...

How much does CRS affect Eustachian tube dysfunction symptoms?

We know that chronic rhinosinusitis (CRS) and Eustachian tube dysfunction (ETD) are both very common, and that the two often co-exist but this paper looks to establish the prevalence and severity of ETD in CRS patients, and how much treatment...

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...