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Method of delivery: all topical nasal corticosteroids are not made equal
There is an increasing body of evidence that the role of surgery for chronic rhinosinusitis is to facilitate the delivery of topical medical treatment – most notably, topical corticosteroids. Two recent studies, one using flow dynamics and another one examining...
Immunotherapy – could it be cheaper?
Immunotherapy is the only treatment for allergy to alter the disease course. Limited data exist on direct and indirect costs of subcutaneous (SCIT) and sublingual (SLIT) immunotherapy in America. This article assesses the cost effectiveness worldwide of the two immunotherapies....
Measuring is understanding: an unsupervised PROM clustering of CRS patients
It has been clear for quite some years, at least for anyone dealing daily with chronic rhinosinusitis (CRS) patients, that CRS is an ‘umbrella’ diagnosis. There are significant differences between patients, including different demographic data, different endoscopic and radiographic images,...
Waiting for smell to recover after post-viral hyposmia
The patient with post-viral anosmia will always want to know how long they must wait to reach a plateau. This study from South Korea of a comparatively small group (20 controls and 63 patients) tells us that favourable prognostic indicators...
Recurrent ENT infections in children – is it a sign of primary immunodeficiency disease?
ENT clinicians often come across children with recurrent ear, sinus and pulmonary infections. These recurrent infections, albeit common in childhood, can represent an early sign of primary immunodeficiency diseases (PIDD). PIDD is an underdiagnosed group of genetic disorders involving absent...
CRSwNP and smell – is it just the obstruction?
Anosmia and hyposmia are symptoms of CRS both with and without nasal polyps and can significantly affect quality of life. The nature of anosmia/hyposmia is thought to be both sensory-neural and conductive. These authors studied a mouse model in which...
A trial of house dust mite sublingual tablet in children with allergic rhinitis
The house dust mite (HDM) is one of the commonest causative agents in allergic rhinitis (AR), affecting patients across all demographics. Recently, sublingual immunotherapy (SLIT) has been shown in clinical trials and meta-analysis to be effective compared to placebo in...
Recurrent seroma in cochlear implanted patients
Little is known about why some patients experience recurrent seromas over the implant package and in the absence of any cause, antibiotics are frequently prescribed as a precaution to protect the implant from infection. A tertiary referral centre selected five...
The hippo and the nose
Chronic rhinosinusitis with nasal polyps (CRSwNP) leads to histological changes including thickening of the basilar membrane and epithelial proliferation. Molecular mechanisms underlying these changes are still not fully clear. A signalling pathway called the hippo with Yes‐associated protein (YAP) as...
Allergic rhinitis, the usual suspects
Allergic rhinitis (AR) is characterised by allergen binding to IgE on mast cells and basophils and subsequent histamine, prostaglandine D2 (PGD2) and cysteinyl leukotrienes (cysLTs) release causing early-phase response. This is followed by late-phase response mediated by eosinophils. Other cells,...
The polyp shrinker
Inflammatory markers, including T2 cells beta common (βc) cytokines IL-3, IL5 and granulocyte-macrophage colony-stimulating factor (GM-CSF), are known to play an important role in chronic rhinosinusitis with nasal polyps (CRSwNP). CSL311, a monoclonal antibody (mAb), was developed to target human...
