Journal Reviews
Dupilumab prospective RCT for CRSwNP, a multinational trial of 60 patients with a 16-week CT follow-up
This transcontinental work describes a randomised, double blind, placebo controlled parallel group study over a 16-week period, assessing 60 patients with CRSwNP by CT scan scores. All patients had a four-week period of intranasal corticosteroids followed by randomisation to add...
An objective office-based method for diagnosing allergic rhinitis
There are several signs of allergic rhinitis which, helped with skin prick and blood tests, can diagnose the problem. However, an endoscopic, on-the-spot test may surmount clinical uncertainties and invasive testing to acquire the same goal. In this study, the...
Those little friends in our noses
Human microbiota plays an important role in both health and disease including metabolism, immunomodulation, and a potential role in chronic inflammatory conditions such as chronic rhinosinusitis (CRS). The authors aimed to investigate the sinonasal microbiome using 16S rRNA gene sequencing...
Eustachian tube dysfunction usually improves following endoscopic sinus surgery
This study investigated effects of endoscopic sinus surgery (ESS) on eustachian tube dysfunction (ETD) and factors associated with improvement. This was a retrospective study which included 302 patients over 17 years old who underwent ESS between 1 December 2016 and...
Prevention better than cure?
This systematic review looks at methods of ‘barrier protection’ or ‘barrier-enforcing’ to minimise allergic rhinitis symptoms, using 15 RCTs. Whilst the authors admit that patient numbers were small in a number of these studies, generally it seems that barrier techniques...
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....
Laryngopharyngeal reflux - would mucolytics help?
With laryngopharyngeal reflux (LPR) being such a common presenting complaint to ENT clinics, who would not want to have more, effective treatment options for patients suffering with this annoying condition? In their small randomised, controlled trial, Chae et al put...
Does minimally invasive surgery under local anaesthesia have a role in the management of chronic rhinusinusitis?
A formal FESS procedure usually done under local anaesthesia is considered as gold standard in the management of chronic rhinusinusitis. However, success is hampered by a significant recurrence rate of polyps requiring revision surgery, long waiting lists, reluctance of elderly...
Sinus airflow after FESS using models and fluid dynamics
This is a very interesting study from Australia and New Zealand looking at flow of air into the nose and sinuses after FESS surgery. There is plenty of data regarding computational fluid dynamics for preoperative cases but not much for...
Potential benefits of turbinate sparing medial maxillectomy
Whilst endoscopic medial maxillectomy (EMM) has good results as the standard treatment option for tumours arising in the maxillary sinus, postoperative problems of crusting, epiphora and paraesthesia are not uncommon. This paper looks at modified EMM aimed at sparing the...
How much does CRS affect Eustachian tube dysfunction symptoms?
We know that chronic rhinosinusitis (CRS) and Eustachian tube dysfunction (ETD) are both very common, and that the two often co-exist but this paper looks to establish the prevalence and severity of ETD in CRS patients, and how much treatment...
The septum and breathing
The authors compared the improvement in nasal obstructive symptoms in two groups of patients. One group underwent septoplasty alone and the other septoplasty accompanied with compensatory turbinoplasty. They used the Nasal Obstruction Symptom Evaluation (NOSE) [12] and visual analog scale...
