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Location, location, location: How to get the steroid where you need it, in chronic rhinosinusitis
What almost all current guidelines on chronic rhinosinusitis have in common is the importance of intranasal steroid (INCS) use. However, it is increasingly understood that the efficacy of INCS depends on their efficient delivery to the point of need, i.e....
Allergen specific subcutaneous immunotherapy helps in prolonged control of allergic rhinitis
One of the commonest allergens involved in perennial allergic rhinitis is house dust mite. A good proportion of these cases prove intractable to treatment with oral and intranasal antihistamines and intranasal steroid sprays. Immunotherapy is considered a useful alternative and...
IL-25 and nasal polyps, another target
Immune response in chronic rhinosinusitis with nasal polyps (CRSwNP) is mainly via type 2 T-helper (Th2) cells while Th1 cells characterise chronic rhinosinusitis without nasal polyps (CRSsNP) immune response. CRSwNP is heterogeneous on a cytological level causing a varied response...
Preoperative risk factors: when do you need to refer to the haematologist?
It is essential that clinicians are able to identify and assess which patients are in the high risk category for bleeding during ENT surgery. A full history, including medications, herbal remedies taken, any other medical co-morbidities and family history of...
How best can we manage Samter’s Triad/AERD?
The classic ‘Samter’s Triad’ of asthma, chronic rhinosinusitis with nasal polyposis (CRSwNP), and aspirin sensitivity is now referred to as aspirin-exacerbated respiratory disease (AERD) or non-steroidal anti-inflammatory-exacerbated respiratory disease. We often come across in our rhinology setting, patients with recalcitrant...
Nasal dermoids
This article goes through the fairly specific and unique condition of paediatric midline nasal dermoids. It goes through the epidemiology and then the embryology, reminding the reader that a protrusion of dura extends from the anterior cranial fossa through the...
Reduction in recurrent cholesteatoma rates with bony obliteration tympanoplasty technique
This large retrospective study from the Erasmus Medical Centre in Rotterdam compares outcomes in traditional canal wall up (CWU) and canal wall down (CWD +/- partial obliteration of mastoid bowl) mastoid surgery for cholesteatoma with bony obliteration tympanoplasty (BOT, which...
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...
Cognitive function is preserved in episodic vestibular disorders
Cognitive deficit in bilateral vestibular failure in particular, but also in unilateral vestibular failure, is well documented. The authors designed this prospective study to determine if deficits in cognition, as well as anxiety and depression, were present in episodic vestibular...
