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Should we be utilising the pre-lacrimal approach for maxillary sinus inverted papilloma?
For some time now, gold standard management of the maxillary sinus inverted papilloma has been endoscopic medial maxillectomy (EMM). Recently the endoscopic prelacrimal recess approach (EPLRA) has been reported to provide good access whilst preserving the nasolacrimal duct and inferior...
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)....
How best to follow up a sinonasal cancer?
Sinonasal malignancies are rare tumours and, in the UK, are usually treated in tertiary treatment centres but may well be followed up long term in the patient’s local hospital, so advice on how best to manage these patients is invaluable....
To scan or not to scan?
This comprehensive review article seeks to establish how useful is MRI in the evaluation of patients with a history of smell loss or distortion. Interestingly, while some studies found the imaging unhelpful, one paper described found a 25% rate of...
A new idea for olfactory recovery, but not the evidence to support it
Smell training for olfactory loss of all types is a well-recognised treatment, and the typical regimen of rose, clove, lemon and eucalyptus is frequently used. This study looks to compare using eight essences rather than four to see if this...
The future of biologics?
This paper takes a deep dive into how eosinophilia affects the responsiveness of the host to the two monoclonal antibodies mepolizumab and bendralizumab, both of which are active against IL5. We know that eosinophils are attracted and trapped into the...
Do adhesions actually cause nasal blockage?
All of us who perform nasal surgery are familiar with the disappointing presence of nasal adhesions (NA) or synechiae in our postop patients. These can often lead to patients deriving less perceived benefit from their surgery than that which they...
A new treatment for chronic rhinitis
The review paper looks at the efficacy of cryoablation of the posterior nasal nerve (PNN) to treat chronic rhinitis, an increasingly popular method of treating a highly prevalent and morbidity-inducing disease. Five studies were included in the meta-analysis, all dating...
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...
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...
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...
