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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...

Role of maxillary sinus irrigation as an adjuvant to current management of chronic rhinusitis without polyposis

Several decades have passed since irrigation of maxillary sinuses generally became a treatment of the past. A more recent concept of biofilms may have evoked new interest in this past procedure, fraught with its own issues. In this study, the...

Anatomic guidelines to endolymphatic sac in transmastoid approach – a cadaveric study

This study involved cadaveric dissection using transmastoid approach in cadaveric embalmed five half heads and posterior fossa approach in fourteen. The sac was identified by electron microscopy. The relatively consistent measurements were the relationship of the operculum to the internal...

Is Dymista® useful for paediatric allergic rhinitis?

Allergic rhinitis (AR) affects up to 14.6% of the paediatric population. Whilst a recent Cochrane review has considered the evidence for intranasal corticosteroids as `weak and unreliable’ in paediatric AR, this product is a novel formulation combining Fluticasone and Azelastine...

CRSwNP, another monoclonal antibody

Interleukins 4, 5 and 13 were shown to be important factors in type 2 inflammation, which characterises chronic rhinosinusitis with nasal polyposis (CRSwNP). In CRSwNP non-responders and those who recur short after-surgery monoclonal antibodies might be an answer. Examples include...

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...

Patients with severe uncontrolled CRSwNP respond to biologics in the real world

Clinical trials have demonstrated that biologics are effective in treating patients with chronic rhinosinusitis with nasal polyps (CRSwNP). This multicentre (15 tertiary care centres in France) observational prospective cohort study aims to examine the effectiveness of biologics in treating CRSwNP...

Use of a diode laser for the removal of a frontal sinus osteoma

In this How I Do It, Professor Sergei Karpischenko introduces a gentle method of reduction of mobilised frontal sinus osteoma which has been successfully used in five patients in his university clinic using a diode laser in contact mode. Osteoma...

Transnasal endoscopic repair of CSF leaks

This Italian study was a retrospective review of 110 consecutive patients who underwent repair of their CSF leak via the transnasal endoscopic approach from 2003 to 2013. All surgery was performed by the same primary surgeon and patients with a...

Reliability of Koos classification

Vestibular schwannoma (VS) tumour size has been considered the primary determinant of hearing outcomes and facial nerve function according to several published studies. Varying methods are used to estimate the size and volume of the VS with very little consensus...

Quo vadis FESS? Future directions in functional endoscopic sinus surgery

Endoscopic sinus surgery is now so ubiquitous that it is hard to imagine a time when it was not part of our clinical practice. Valentin Tomazic takes a look at its early development and looks ahead to endoscopic sinus surgery...

Paranasal sinus osteoma management

The authors aimed to determine the best approach to paranasal osteoma excision. They conducted a retrospective study of 41 patients with paranasal sinus osteoma (PNSO) at a tertiary centre in Turkey. PNSO was present in: the frontal sinus in 26...