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Paediatric pituitary surgery - is it lagging behind?

Endoscopic sellar surgery, especially for adenomas, is a relatively safe, straightforward surgery with (mostly) reproducible results and few complications. However, the evolution of pituitary surgery was a long process, starting from open/transfrontal approaches all the way to transsphenoid to the...

FESS for recurrent acute rhinosinusitis: at last, some data

As noted in both the EPOS 2012 and in the (more recent) ICARS 2016, there is a paucity of evidence on the effectiveness of surgery for recurrent acute rhinosinusitis (RARS). The authors used a control group of patients with CRSsNP,...

Balloon dilatation is an effective adjunct

This is a good study design, sufficiently powered, comparing medical management to balloon sinus dilatation. All patients had failed medical management and were thoroughly assessed preoperatively with Lund-Mackay score confirming abnormal CT findings, SNOT 20 index score, chronic sinusitis score...

Sellar surgery – when to prepare for repair

Endoscopic sellar surgery, especially for adenomas, is a relatively safe, straightforward surgery with (mostly) reproducible results and few complications. One of the commonest complications is the creation of a CSF leak with the subsequent need for repair (there is usually...

Long-term results for dupilumab are very promising!

Eosinophilic chronic rhinosinusitis (eCRS) is complicated by frequent early and aggressive recurrence of polyps after both medical and surgical treatment regimes. Dupilumab is an anti-IL-4/IL-3 receptor monoclonal antibody and has been previously studied in the SINUS-52 study, with an observation...

Is GERD linked to CRS?

We are all well aware that both chronic rhinosinusitis and reflux are prevalent in our populations. This meta-analysis looked at 25 studies investigating the association between GERD, LPR and CRS, therefore evaluating more than 117,000 patients. The results are fascinating...

The microbiological environment of the paranasal sinuses

This article reviews the ecology of the sinuses and tries to make sense of the confusing literature on the subject. This covers the details of molecular studies, particularly those which attempt to differentiate normal sinuses from those in patients with...

Olfactory neuronal damage in sinusitis

So many patients with nasal disorders have poor olfactory function, yet sometimes the nose may seem comparatively clear of conductive problems. This study postulated that neuronal damage in the olfactory apparatus would lead to a leakage of neuron specific enolase...

Is epistaxis affected by the weather?

In this Bosnian study, the authors attempted to determine if air pressure, temperature and humidity had any effect on idiopathic epistaxis. The study took place over a three-year period and included 300 patients. A comparison was performed of meteorological data...

Does albumin have an effect on nasal polyposis?

Sometimes a short paper catches your eye! What causes chronic rhinosinusitis? What causes polyps? Fungi? Biofilms? Allergy? Maybe the lack of albumin? The two authors of this short paper present data that may suggest that the lack of albumin can...

Smell and mental health

This national survey from Korea asked questions about many aspects of health and one of these was about sense of smell. The prevalence of olfactory problems was 5% in the adult group surveyed, and other studies would suggest that this...

An effective treatment for post Covid-19 smell loss?

It is well understood that calcium levels in the nasal mucous affect the ability to smell, with higher levels having a negative impact, and some studies have shown increased calcium levels in patients suffering with Covid-19-related olfactory dysfunction. Calcium chelating...