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THRIVE: redefining airway management in endoscopic oesophageal surgery

Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) is no longer just a tool to help anaesthetists secure a difficult airway. Thanks to the work of authors like Yang and colleagues, it is being revolutionised to provide apnoeic oxygenation during endoscopic...

Dupilumab prospective RCT for CRSwNP, a multinational trial of 60 patients with a 16-week CT follow-up

This transcontinental work describes a randomised, double blind, placebo controlled parallel group study over a 16-week period, assessing 60 patients with CRSwNP by CT scan scores. All patients had a four-week period of intranasal corticosteroids followed by randomisation to add...

Budesonide irrigation in polyposis

It is very well known through many RCTs and now meta-analyses that saline-based irrigation is beneficial in patients after sinus surgery. It is also demonstrated that intranasal steroids are beneficial postoperatively but there is also a trend for steroid based...

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....

Still not smelling

Post-Covid anosmia/hyposmia is a troublesome persistent symptom for lots of patients. Management is still elusive. This was a nationwide survey of ENT practitioners. Of the 715 surveyed members, only 7.4% responded. Most performed a nasal endoscopy, 60% ordered an MRI...

Factor favouring the need for revision FESS in chronic sinusitis with polyps – a multivariate analysis including phenotypes

Chronic rhinosinusitis with polyposis is a type 2 inflammation with risks of recurrence and need for revision operations. This is known to depend on the endotype and phenotype factors. This is a retrospective study of 212 patients. Of these, 112...

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...

A review of topical treatments for chronic rhinosinusitis

Topical nasal treatment is considered the mainstay treatment for chronic rhinosinusitis (CRS). The authors reviewed the effectiveness of saline irrigation, topical corticosteroids, topical antibiotics and topical antifungals in the treatment of CRS. Large volume saline irrigation was found to be...

Blocked nose in children with allergic rhinitis

Nasal obstruction is a classic symptom in children with allergic rhinitis. While the nasal obstructive disorders including septal deformity, turbinate hyperplasia and adenoidal enlargement are widely recognised in adult nasal blockage, their relationship with paediatric allergic rhinitis however, is scarcely...

Growing up smelling the roses

How often do we ask about sense of smell in children? Undoubtedly, the olfactory function is seldom formally assessed in the paediatric population, although evidence exists to suggest its potential links with handicap in children’s learning and development. This large...

Rhinotillexomania - how bad can nose picking get?

This is a fascinating first case report of rhinotillexomania associated with empty nose syndrome (ENS). Rhinotillexomania encompasses compulsive, pathological nose picking and is a variant of self-harm. Tranchito and Chhabra describe an elderly patient presenting with longstanding symptoms of nasal...

Loss of smell in the age of COVID-19

Loss of smell (LOS) is a debilitating symptom with increasing interest for the medical community due to its high prevalence in COVID-19. In the present paper, a team of 15 experts provide recommendations for the investigation and management of patients...