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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...

Not so innocent, after all: a meta-analysis of the effects of intranasal corticosteroids on growth

The use of intranasal corticosteroids has revolutionised the management of allergic rhinitis and rhinosinusitis and there is now significant evidence of their safety. The problem with side-effects is that clinical studies are designed to demonstrate efficacy, but are underpowered to...

Recalcitrant chronic rhinosinusitis: What to do next?

Whilst the majority of patients with chronic rhinosinusitis (CRS) will significantly improve with treatment, we are sometimes left with a ‘hard-core’ of nasal cripples who fail to improve despite our best efforts. How can we deal with these patients? Valerie...

Getting your nose dry: endoscopic vidian neurectomy – an old technique given new life

We are often faced with patients with intractable watery rhinorhea – patients with no demonstrable allergy, a diagnosis of NAR and no response to ipratropium or capsaicine. For such patients, vidian neurectomy has been devised – an old technique that...

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,...

Otolaryngology - Head and Neck Surgery: Rapid Clinical and Board Review

This is a book written by a group of ENT surgeons from the Mayo Clinic, and a plastic surgeon from Colorado, and is aimed at US residents throughout their training, in particular in preparation for their board exams. As such,...

A safe and useful surgical procedure for allergic rhinitis?

Although the best management of allergic rhinitis is medical, intractable cases are not uncommon. Immunotherapy helps but is more practical if there is a single allergen involved. The authors compare the effects of submucosal inferior turbinoplasty alone with submucosal turbinoplasty...

Adenoidal hypertrophy in children with allergic rhinitis

Nasal congestion in children with allergic rhinitis can be confounded by adenoidal hypertrophy. This retrospective Turkish study examines this association in more detail. The sample studied was 566 children (age 2-18) that were diagnosed (based on ARIA guidelines) and treated...

Smoking and immunotherapy – does it worsen outcome?

This interesting study aimed to address the issue of smoking in patients who had their allergic rhinits treated by sublingual immunotherapy (SLIT). Assessment was with validated quality of life questionnaires. There were 163 patients recruited in Greece who had completed...

Pollen forecasting apps: don’t worry, bee happy!

Hay fever sufferers rejoice! Around a fifth of people in the UK self-report to having hay fever (allergic rhinitis). In the majority of cases, this is thought to be a sensitivity to grass pollen. Symptoms may present as nasal congestion,...

Sarcoidosis and the nose

This retrospective case note review from Mount Sinai in New York looked at just 14 patients with sarcoidosis. Individual ENT units in the UK are likely to see relatively few of these patients, unless there is a major tertiary referral...

The effect of cocaine or adrenaline dressing during endoscopic sinus surgery

A randomised controlled study of 37 patients took place that underwent endoscopic sinus surgery for chronic rhinosinusitis and received adrenaline or cocaine-soaked patties. The study showed no difference in the mean surgical field scores between adrenaline and cocaine sides. Adequate...