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When to operate on a patient without chronic disease?

As ENT surgeons, we spend a lot of time managing chronic rhinosinusitis, so a review and update on the management of the acute disease is always helpful. The standard medical treatment of antibiotics, nasal steroids and nasal decongestants are reported...

Does sleep quality improve when we adequately treat CRS?

In addition to the well-known symptoms associated with chronic rhinosinusitis (CRS), patients often suffer with poor sleep quality which is also detrimental to health and wellbeing. This meta-analysis looked at 35 papers reporting outcomes for CRS patients post surgery on...

Is benign intracranial hypertension underdiagnosed in patients with spontaneous CSF leaks?

In ENT practice we come across spontaneous CSF leaks. Patients present either as unilateral watery rhinorrhoea or otorrhoea, or sometimes as hearing loss with a watery middle ear effusion. Clinicians, after confirming the diagnosis of CSF leak with beta 2...

Dacryocystorhinostomy revisited

In this technical variant, instead of seeking the lacrimal sac, the authors describe a retrograde technique. They first identify the nasolacrimal duct at the level of the most anterior insertion of the inferior turbinate in the lateral nasal wall. The...

Transverse venous sinus stenosis – a risk factor for CSF leak in patients with idiopathic intracranial hypertension

This was a multicentre (six French tertiary hospitals) retrospective case-controlled study aiming to investigate the rate of transverse venous sinus stenosis (TVSS) in patients with idiopathic intracranial hypertension (IIH) with nasal cerebrospinal fluid (CSF) leaks. They compared the preoperative MRI...

A comparison between biologic and surgical treatment (FESS) for chronic rhinosinusitis with polyposis

In recent years, it is being increasingly recognised that chronic rhinosinusitis with nasal polyps (CRSwP) is a type 2 chronic inflammation based on IL-4 and IL-13, and the novel monoclonal antibody, such as dupilumab, is likely to have a major...

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...

A useful adjuvant treatment for SNAC or IP

5-Fluorouracil (5FU) is a topical preparation used in the treatment of various dermatological, ocular and gynaecologic malignant and pre-malignant conditions, and this literature review looks at the efficacy of 5FU in treating inverted papilloma and sinonasal tumours. The authors cite...

Update on cholesteatoma

Surgery for cholesteatoma should be tailored to individual patients, considering patient and disease factors, to obtain a dry, safe and functional ear. In this article, the authors discuss the current definitions and classification system of middle ear cholesteatoma, as well...

How I do it Issue I

To skip directly to features, click the links below: Welcome from the editor - by Miles Bannister KTP laser in the office - by Markus Hess and Susanne Fleischer The surgical management of rhinophyma using a microdebrider - by Andrew...

Timing of surgery in chronic rhinosinusitis: does it matter?

While many patients with chronic rhinosinusitis respond to medical treatment, some do not. The next step for these patients is surgery, but how soon should this be offered? Sooner rather than later seems to be the answer, as Claire Hopkins...

Chronic cough hypersensitivity syndrome

We all have patients who give us a ‘heartsink’ feeling; for many of us, the coughing patient is exactly such a situation. In this overview, Bhaskar Ram and Sangeeta Maini outline their approach to diagnosis. Declan Costello, Editor. Introduction Chronic...