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A comparison between biologic and surgical treatment (FESS) for chronic rhinosinusitis with polyposis

In recent years, it is being increasingly recognised that chronic rhinosinusitis with nasal polyps (CRSwP) is a type 2 chronic inflammation based on IL-4 and IL-13, and the novel monoclonal antibody, such as dupilumab, is likely to have a major...

Saddle nose deformity repair – structured approach

We often come across saddle noses in our specialist rhinology clinics. The saddle nose deformity represents collapse of the cartilaginous and / or bony nasal support structures resulting in dorsal height loss. Acquired cases are due to trauma or surgery...

Large septal perforation repair

Repair of large nasal septal perforations (NSP) can be challenging due to limited availability of surrounding nasal tissue, mucosal tension and diminished vascularity. The authors of this manuscript included 38 studies involving 408 patients with large NSP, with aetiologies ranging...

More markers for sinonasal diseases

In this study, nasal mucus cystatin SN levels were compared in patients with controlled and uncontrolled chronic rhinosinusitis (CRS). Cystatin SN is an epithelium-derived cytokine which regulates cysteine proteases and enhances IL-5 mediated activation of eosinophils. The study included 98...

Use of topical steroids and antibiotics, compared to systemic antibiotics in the treatment of acute rhinusinusitis

Acute rhinusinusitis is mainly initiated by viral infections. Bacterial infection is usually superadded. The inflammatory cascade upregulates the pro-inflammatory mediators resulting in pain, nasal obstruction and nasal discharge. Local application of steroids and antibiotics could provide a higher concentration of...

Advances in diagnosis and management of allergic rhinitis

This article reviews advances in the diagnosis and management of allergic rhinitis. Recent advances in the diagnosis of allergic rhinitis include testing of local immunoglobulin E (IgE), urinary test to diagnose aspirin hypersensitivity and optical rhinometry to assess degree of...

The polyp shrinker

Inflammatory markers, including T2 cells beta common (βc) cytokines IL-3, IL5 and granulocyte-macrophage colony-stimulating factor (GM-CSF), are known to play an important role in chronic rhinosinusitis with nasal polyps (CRSwNP). CSL311, a monoclonal antibody (mAb), was developed to target human...

Simple preoperative tests predicting outcomes for ESS patients?

We are all familiar with patients suffering extensive nasal polyps who relapse all to soon after careful and thorough endoscopic sinus surgery (ESS). This paper looks to answer whether we can predict which patients will do well, and which less...

Can SNOT-22 predict the need for surgery?

In this prospective Belgian study, the authors looked at whether the baseline Sino-Nasal Outcome Test-22 (SNOT-22) was able to predict the need for surgery and localise the pathology of rhinology patients and healthy volunteers. A total of 66 healthy volunteers...

Multisystem pathology in refractory otitis media with effusion

Recurrent middle ear effusion is a common problem and so is rhinosinusitis with polyposis. It is not often thought that the problem could be linked to multisystem pathology, such as eosinophilic granulomatous with polyposis. Therefore, repeated grommet insertions and surgical...