Chronic rhinosinusitis (CRS) is a heterogenic disease. The effects of heterogeneity on treatment outcome are not very clear. Authors used clinical features such as endoscopic findings scores and full blood count findings in addition to analysis of 35 molecular markers....
Precision medicine (PM) with its ‘four Ps’ (personalised, predictive, preventive and participatory) is about appreciating differences between individuals when offering management options for health problems. Multiple groups interested in rhinology such as EPOS and ARIA supported a review of the...
As noted in both the EPOS 2012 and in the (more recent) ICARS 2016, there is a paucity of evidence on the effectiveness of surgery for recurrent acute rhinosinusitis (RARS). The authors used a control group of patients with CRSsNP,...
COVID-19 entry factors are highly present in nasal epithelial cells. These factors include ACE2 and TMPRSS2. Their presence in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) was not investigated before. Authors investigated expression of ACE2 and TMPRSS2 in two...
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...
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...
Staphylococcus aureus has long been linked to chronic rhinosinusitis, particularly recalcitrant cases. In this article, Alkis Psaltis describes how newer techniques have shown higher rates of S. aureus infection than were previously thought, and explains how the bacteria are able...
For a comparatively short piece, this article manages to pack in a lot of important information about a complex emerging area of rhinology – immunologically targeted therapy (biologics). Immunologically targeted therapy is a rapidly progressing and expanding domain which is...
As our understanding of the pathophysiology of CRS evolves, so do our treatment strategies. It is accepted that in many cases, the main role of surgery is to allow better penetration of topical therapies to the sinus cavities. What, then,...
In recent years there has been increasing recognition of eosinophilic chronic rhinosinusitis which, in particular, results in persistent symptoms and recurrence of nasal polyps, even after FESS surgery. It therefore calls for measures adjuvant to FESS to stop persistence of...
Improvement after endoscopic sinus surgery in patients with chronic rhinosinusitis varies considerably. If elaborate preoperative and intraoperative data could be used to predict the postoperative course, management and length of the follow-up could be adjusted to provide optimal care. Two...
This review examines the possible causative relationship between allergic rhinitis (AR) and chronic rhinosinusitis (CRS) that has long been proposed. Many observational and experimental studies exist, however no clear and definitive connection has been established. This is mainly due to...