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Surgery or medicine: when should we stop trying to be conservative?

Although most otolaryngologists would agree that surgery improves the outcomes of patients with CRS when medical treatment has failed, both Cochrane reviews state that there is no proof of improved efficacy of surgery over medicine – however, that was after...

A new biomarker for chronic rhinosinusitis

This Chinese study looked at the feasibility of periostin (usually found in bone and lung tissue) as a biomarker for chronic rhinosinusitis. They sampled ethmoid mucosa in 12 patients with chronic rhinosinusitis without nasal polyposis (CRSsNP) and 25 patients with...

Saline irrigation in CRSwNP after surgery

This article, largely from Germany, aims to prove the effectiveness of nasal saline irrigation in postoperative patients with CRS with nasal polyps. A prospective, single blinded randomised trial was designed with an irrigation and non-irrigation arm. Patients who underwent sinonasal...

IL-25 and nasal polyps, another target

Immune response in chronic rhinosinusitis with nasal polyps (CRSwNP) is mainly via type 2 T-helper (Th2) cells while Th1 cells characterise chronic rhinosinusitis without nasal polyps (CRSsNP) immune response. CRSwNP is heterogeneous on a cytological level causing a varied response...

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...

The search for the holy grail of rhinosinusitis: another step towards phenotyping in CRS wNP?

For many years, scientists and clinicians have been trying to understand the infinite variability within the term ‘rhinosinusitis’ using radiology, basic science, epidemiology and then using their insights to solve the riddle of management: how to explain why some patients...

More aggressive FESS for recalcitrant CRS is the key

This is an interesting paper assessing the effectiveness of endoscopic modified medial maxillectomy (MMM) in cases of recalcitrant chronic rhinosinusitis (CRS), (the technique was also used for tumours, cystic fibrosis, FB, odontogenic disease and AFS) in 551 patients. The technique...

UPDATED: Modified snorkelling mask for surgery

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What is balloon eustachian tuboplasty (BET)?

Eustachian tube dysfunction (ETD) is the result of a combination of factors that interfere with the mucosal functional or cartilaginous structures. Failure to open the eustachian tubes can cause aural pain, pressure in the ears, muffled hearing, crackling/popping sounds in...

CT guided cochlear implant programming improves performance

There is currently no national (UK) consensus on imaging patients for cochlear implantation. This paper may change that. It has shown increased hearing and quality of life in paediatric cochlear implant (CI) users when the programming has been assisted by...

Nasal decongestants don’t improve Eustachian tube function

Prescribing nasal steroids and decongestants. It’s something most of us do routinely, in an effort to reduce chronic middle ear effusion in an adult by trying to improve eustachian tube (ET) patency. This study used clever devices (tube manometry and...

CATE in people with dementia

Behavioural hearing tests may be difficult to perform for people with dementia. The aim of this study was to investigate if the cortical automatic threshold estimation (CATE) may be used as an alternative to the pure tone audiometry test. Six...