Journal Reviews
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...
Chronic rhinosinusitis, are we treating the same disease?
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....
Interleukins, cilia and polyps
Interleukins (ILs) including IL13 (Th2 cytokine) are inflammatory mediators and their role in asthma has been detailed before. This study explores IL13 receptor expression in chronic rhinosinusitis with nasal polyps (CRSwNP). The authors investigate protein and mRNA expression levels of...
Is a chest x-ray necessary in making urgent referrals for suspected head and neck cancer?
The article presents an audit on urgent referrals for suspected head and neck cancer in 2144 patients. Only 8.6% of cases proved positive for head and neck cancer. The Scottish Referral Guidelines were adhered only in 55.1% of cases. Interestingly,...
QOL studies for anterior skull base surgeries
The Anterior Skull Base Nasal Inventory-12 (ASK Nasal-12) is a standard tool for assessment of quality of life (QOL) in patients who have undergone endonasal transsphenoidal surgery. As nasal trauma and rhinological complications following endonasal transsphenoidal surgery can influence QOL,...
Anatomy revision
This article is well-received as an article that goes into appropriate length and depth regarding the embryology and subsequent growth of the paediatric nose (internal and external), nasopharynx and all of the individual sinuses. It has excellent line diagrams of...
Outcomes in rhinosinusitis
This review goes through the various different ways of assessing outcomes and describes the pros, cons and limitations of each. The different methods are described in the context of guidelines in diagnosis and management and compared with other conditions such...
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...
Cadaveric variation of nasolacrimal duct lateral nasal wall landmarks
Twenty mid-sagittal head sections of 10 fresh frozen cadavers were studied after removal of the nasal septum. This study showed that the most anterior projection of the middle turbinate head was noted to be anterior to the nasolacrimal duct in...
Waiting for smell to recover after post-viral hyposmia
The patient with post-viral anosmia will always want to know how long they must wait to reach a plateau. This study from South Korea of a comparatively small group (20 controls and 63 patients) tells us that favourable prognostic indicators...
The stubborn polyp cases are ‘different’
The widely different behaviour of nasal polyp disease between patients is a major feature of rhinology practice and makes counselling of patients difficult when approaching their first operative intervention. Setting aside aspirin sensitivity (Samter’s triad), which is known to be...
What are the best minimal surgical techniques used for concha bullosa?
This prospective endoscopic and radiologic evaluation studied 42 patients who underwent concha bullosa surgery, amounting to a total of 55 conchae surgeries. The patients were allocated consecutively to either of the two groups. The presurgical and one year postsurgical endoscopic...
