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A spoonful of sugar… helps the operated sinuses calm down?

Ottoviano et al. present a prospective double-blinded RCT to assess the effect of a nasal gel containing silver sucrose octasulfate (Silsos Gel) on wound healing after endoscopic sinus surgery. The placebo used was a glycol gel. Thirty-four consecutive patients were...

Back to basics: nasendoscopy beats CT, again!

There are few otolaryngologists (or patients) who have not been confronted with a computed tomography scan referring to a deviated septum. In a very similar way to the accidental findings of sinus mucosal thickening, the clinician is left in a...

The stubborn polyp cases are ‘different’

The widely different behaviour of nasal polyp disease between patients is a major feature of rhinology practice and makes counselling of patients difficult when approaching their first operative intervention. Setting aside aspirin sensitivity (Samter’s triad), which is known to be...

Interleukins, cilia and polyps

Interleukins (ILs) including IL13 (Th2 cytokine) are inflammatory mediators and their role in asthma has been detailed before. This study explores IL13 receptor expression in chronic rhinosinusitis with nasal polyps (CRSwNP). The authors investigate protein and mRNA expression levels of...

The septum and breathing

The authors compared the improvement in nasal obstructive symptoms in two groups of patients. One group underwent septoplasty alone and the other septoplasty accompanied with compensatory turbinoplasty. They used the Nasal Obstruction Symptom Evaluation (NOSE) [12] and visual analog scale...

Location, location, location: How to get the steroid where you need it, in chronic rhinosinusitis

What almost all current guidelines on chronic rhinosinusitis have in common is the importance of intranasal steroid (INCS) use. However, it is increasingly understood that the efficacy of INCS depends on their efficient delivery to the point of need, i.e....

Serum biomarkers for CRSwNP

This cross-sectional comparative study looked at 50 patients with nasal polyps who, at the time of diagnosis, also had a blood test evaluating serum total IgE, IL-17 and Pentraxin-3. The study assesses whether these blood markers are useful in the...

A more comprehensive management for eosinophilic chronic rhinosinusitis after FESS

In recent years there has been increasing recognition of eosinophilic chronic rhinosinusitis which, in particular, results in persistent symptoms and recurrence of nasal polyps, even after FESS surgery. It therefore calls for measures adjuvant to FESS to stop persistence of...

A new treatment for septal perforations?

Nasal septal perorations are notoriously difficult to close surgically and can be extremely symptomatic and debilitating for the patient. This paper describes the use of carvacrol (a monoterpene phenol of the family Lamiacaea which is often found in essential oils)....

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...

Factor favouring the need for revision FESS in chronic sinusitis with polyps – a multivariate analysis including phenotypes

Chronic rhinosinusitis with polyposis is a type 2 inflammation with risks of recurrence and need for revision operations. This is known to depend on the endotype and phenotype factors. This is a retrospective study of 212 patients. Of these, 112...

Freud’s Friend, Fliess

Wilhelm Fliess, a Berlin rhinologist, was for many years Sigmund Freud’s closest friend and confidant. He was born in Poland in 1858. In 1887, he visited Vienna for postgraduate studies, and met the famous psychoanalyst, Freud [1]. They were immediate...