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Managing CRS in pregnancy
An International team of experts from both sides of the Atlantic set out to perform a systematic review of the management of chronic rhinosinusitis in pregnancy. Despite a thorough search no scientific evidence was found that could form the basis...
Variations in obstructive level with increasing depth of sedation in DISE
This study highlights some of the controversies surrounding DISE (Drug Induced Sedation Endoscopy, or otherwise known as sleep nasendoscopy in the UK). On one hand it provides some evidence that the BIS (BiSpectral Index), recordings of patients while they are...
What to do with incidental findings on FDG PET/CT?
18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG PET/CT) is commonly used in head and neck cancer staging. This investigation frequently identifies incidental findings unrelated to the index head and neck cancer. To assess the nature of these incidental findings, notes of...
Diagnosis and treatment of snoring in adults – S2k Guideline of the German Society of Otorhinolaryngology, Head and Neck Surgery
This article summarises the work done by the German Society of Otorhinolaryngology, who have developed guidelines for the management of snoring. ‘S2k’ is German nomenclature for a consensus based guideline, which (for those of you interested in such things), is...
Vitamin C, a possible remedy for seasickness?
The internet is full of devices and medicines vying for superiority over which one is the best for preventing seasickness. This study was based on the following observations: elevated histamine levels trigger seasickness; blockade on histidine decarboxylase prevents seasickness while...
Prognostic value of neutrophil-to-lymphocyte ratio in HPV-positive oropharyngeal cancer
The authors propose that high neutrophil-to-lymphocyte ratio (NLR) is associated with poor disease-free survival (DFS) in patients with human papillomavirus positive (HPV+) oropharyngeal cancer (OPC). This is a retrospective study that compared the outcomes of 43 patients treated for HPV+...
Does Eustachian tube dysfunction improve with FESS?
This multinational study prospectively collected SNOT-22 data to determine the prevalence and severity of, and whether endoscopic sinus surgery (ESS) had improved, symptoms of Eustachian tube dysfunction in patient with chronic rhinosinusitis (CRS). The SNOT-22 includes two questions which are...
Predicting CSF leaks pre FESS: Gera classification - a new tool?
An interesting study from Italy looking at an anterior skull base classification that may be useful in predicting risk of intraoperative CSF leak during FESS surgery. Traditionally we have used the Keros classification system, developed in 1962 to categorise olfactory...
Cocaine detection hours after FESS
This is a very interesting article from Australia regarding the bioavailability of cocaine following atomised application prior to endoscopic sinus surgery. The well-established practice of preparing the nasal mucosa for sinus surgery involves the placement of a usually modified Moffett’s...
Nasal physiology and septal perforations
This interesting article from North Carolina and New York aims to assess the impact of anterior septal perforations on nasal physiology, using computational fluid dynamics and computer simulation. A computerised 3D model was constructed of a normal patient aged 37,...
