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Running a post-COVID smell clinic
Over the past year, much of our effort as a speciality has been directed towards crisis management and keeping services afloat. Our practice has changed in untold ways, but unprecedented numbers of patients with smell disorders will increasingly require our...FESSing up
This story is dedicated to my dear friend and much-missed colleague, Heinz Stammberger, with whom some of these moments were shared (or endured). Having used a rigid endoscope in my postgrad thesis in the early 1980s to show that the...
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...
Elevated intracranial pressure versus migraines versus sinusitis?
This narrative review discusses the challenges faced by an otolaryngologist to differentiate elevated intracranial pressure (eICP), migraines and chronic rhinosinusitis (CRS). Facial pain, pressure, aural fullness, muffled hearing and tinnitus are often common symptoms described by patients with all three...
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...
