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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...

Improving smell outcomes after sinus surgery: impregnated dressings?

There is much we can do to improve the airway of patients with chronic sinus disease, especially those with polyps. However, the olfactory outcomes are usually disappointing and patients miss this important sensory modality, which has an effect on their...

Objective versus subjective – again!

The use of objective measurements of nasal airflow has a long history; however, its clinical application remains, at most, patchy. The main reason for that has been the lack of convincing studies showing a good correlation between the findings of,...

A novel way to reduce postoperative nausea and vomiting

This is an interesting RCT which evaluates the prophylactic effect of bilateral endoscopic injection of local anaesthetic in the sphenopalatine ganglion (SPG) on postoperative nausea and vomiting (PONV). It has a robust design, and is sufficiently powered and blinded, with...

Sinus implants to treat recalcitrant polyps

It is well established that the burden of chronic rhinosinusitis on healthcare costs and patients’ quality of life is high, and that current mainstream treatment options of oral or topical steroids are not without problems. This paper compares two RCTSs...

Potential benefits of turbinate sparing medial maxillectomy

Whilst endoscopic medial maxillectomy (EMM) has good results as the standard treatment option for tumours arising in the maxillary sinus, postoperative problems of crusting, epiphora and paraesthesia are not uncommon. This paper looks at modified EMM aimed at sparing the...

CRS vs. migraine: which is the culprit in most headaches?

‘Sinus headache’ is a common diagnosis according to patients and primary care physicians, but relatively infrequent in the eyes of otolaryngologists. This study examines 104 patients with a primary headache syndrome (PHS) and 130 patients with CRS, looking at SNOT-22...

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...

Lower respiratory involvement in allergic rhinitis and chronic sinusitis

The recent ARIA (Allergic Rhinitis and its Impact on Asthma) project has generated interest in simultaneous involvement of the lower respiratory airway in cases of chronic rhinosinusitis and allergic rhinitis. This study takes into account the extent of pulmonary function...

Intra orbital treatment to save the eye!

Invasive fungal sinusitis can be a devastating condition, and accepted management is surgical debridement of infected tissue, systemic antifungal treatment and reversal of immunosuppression. Orbital involvement is common, affecting up to 75% of cases, and in advanced disease orbital exenteration...