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Factors affecting compliance of follow-up of patients with chronic otitis media

Patients with retraction pockets and small cholesteatomas need good surveillance as well as those surgically treated for cholesteatomas. This is particularly important in closed techniques where a second look or diffusion weighted MRI can pick up any recurrence or residual...

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...

Passive smoking and rhinosinusitis

One would expect that subjects exposed to more passive smoke would have a significantly increased level of rhinosinusitis. This study looked at a reasonable number of sinusitis and control subjects (404 and 165) using hair nicotine as an assessment of...

3D ultrasonography for evaluation of muscles following facial palsy

Reconstructive surgery for facial nerve palsies is not recommended beyond two to three years after a degenerative facial nerve lesion. Since the time course of muscle atrophy is variable, this timeline is a rough guideline. The only assessment method currently...

CRSwNP initiation, not always an interleukin fault

CRSwNP, similar to asthma, is an inflammatory disorder (type II) with eosinophilia and raised IL-5 and IL-13. Inflammation in CRSwNP is thought to be started by IL-25, IL-33 and thymic stromal lymphopoietin (TSLP), all of which form an important part...

How to manage the concha bullosa in FESS

It is an interesting concept to assess how much impact the presence of a large concha bullosa (CB) has on both severity of chronic rhinosinusitis (CRS) and also postoperative outcomes after FESS. The authors accept that the paper has limitations...

How much does CRS affect Eustachian tube dysfunction symptoms?

We know that chronic rhinosinusitis (CRS) and Eustachian tube dysfunction (ETD) are both very common, and that the two often co-exist but this paper looks to establish the prevalence and severity of ETD in CRS patients, and how much treatment...

Those little friends in our noses

Human microbiota plays an important role in both health and disease including metabolism, immunomodulation, and a potential role in chronic inflammatory conditions such as chronic rhinosinusitis (CRS). The authors aimed to investigate the sinonasal microbiome using 16S rRNA gene sequencing...

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....

Does minimally invasive surgery under local anaesthesia have a role in the management of chronic rhinusinusitis?

A formal FESS procedure usually done under local anaesthesia is considered as gold standard in the management of chronic rhinusinusitis. However, success is hampered by a significant recurrence rate of polyps requiring revision surgery, long waiting lists, reluctance of elderly...

Is endoscopic approach more precise in addressing failed ventilation system in chronic mucosal ear disease?

Chronic mucosal disease, as opposed to cholesteatoma, is more directly related to failure of the ventilation system involving three channels. Isthmus anticus and isthmus posticus are channels in front and behind the long process of the incus and there is...

Eosinophilic or not eosinophilic: dupilumab seems to work

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammation with interleukin (IL)-4, IL-13, and IL-5. Tissue eosinophilia in nasal polyps dramatically increased over a 10-20-year period. Classification of the severity of eosinophil status is expected to lead to...