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The MACRO Trial: defining best management of chronic rhinosinusitis
A major UK trial in The Lancet finds ESS provides greater symptom relief than long-term macrolides for adults with CRS, supporting earlier surgery and fewer antibiotics. The MACRO Programme was established in 2016 when the UK National Institute of Health...
GORD and CRS – is there an association?
This international collaboration assessed 32 papers which had published original data on the experimental, diagnostic, treatment or prognostic association between GORD and CRS. The study aims to systematically review the evidence for a role of GORD in CRS. Case control,...
Cystic fibrosis – sinus surgery delays chronic Gram-negative lung infection
This prospective clinical follow-up study is of 106 patients with cystic fibrosis in Copenhagen. Morbidity and mortality in CF are significantly associated with pulmonary colonisation and infection, usually with Gram-negative bacteria. Initially this can be well treated with antibiotics until...
Radiation-induced dysphagia in head and neck cancer
This is a helpful reference paper that provides an overview of the biomolecular effects of radiation on the tissues of the upper aero-digestive tract. The authors explain that radiation injuries occur in a repetitive and accruing manner over the duration...
Stem cells in nasal polyposis
Chronic rhinosinusitis with nasal polyps (CRSwNP) is common and is multifactorial with increased T-helper 2 response and active role of interleukin 5. It can be associated with asthma and control of CRSwNP improves lower airway disease. Due to constant cellular...
Fungal rhinosinusitis
Allergic fungal rhinosinusitis (AFRS) has been defined by the following characteristics: presence of nasal discharge, nasal obstruction, decreased sense of smell or facial pressure for 12 weeks, mucin within the sinus cavity containing fungal hyphae and degranulating eosinophils, endoscopic evidence...
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...
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...
Eustachian tube dysfunction usually improves following endoscopic sinus surgery
This study investigated effects of endoscopic sinus surgery (ESS) on eustachian tube dysfunction (ETD) and factors associated with improvement. This was a retrospective study which included 302 patients over 17 years old who underwent ESS between 1 December 2016 and...
Biologicals for severe chronic rhinosinusitis with nasal polyps. Any use?
Recent advances and knowledge of inflammatory endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP) led to introduction of biological agents such as monoclonal antibodies targeting IgE (omalizumab) and Interleukins (ILs) such as IL4R alpha (dupilumab) and IL5. The European Academy...
Nasal polyps, does size matter?
This study from Germany investigates the correlation between nasal polyp size and return of olfactory function following endoscopic sinus surgery. Olfaction is affected more in patients with CRSwNP than with CRSsNP and the best chance of smell recovery occurs in...
