How to manage the concha bullosa in FESS

It is an interesting concept to assess how much impact the presence of a large concha bullosa (CB) has on both severity of chronic rhinosinusitis (CRS) and also postoperative outcomes after FESS. The authors accept that the paper has limitations...

A classification of a new cell - the retrosphenoid cell

This is a concise paper which describes a previously undefined type of cell within the sphenoethmoidal complex. It identifies the retrosphenoid cell, differentiated from an Onodi cell by being entirely within the posterior wall of the sphenoid sinus, lying between...

An alternative view and access point

Fungal sinusitis is a common problem and it is well recognised that it can be difficult to remove all of the fungal matter from the maxillary sinus to ensure no recurrence or residual disease. This study describes a technique utilising...

The search for the holy grail of rhinosinusitis: another step towards phenotyping in CRS wNP?

For many years, scientists and clinicians have been trying to understand the infinite variability within the term ‘rhinosinusitis’ using radiology, basic science, epidemiology and then using their insights to solve the riddle of management: how to explain why some patients...

Sinus implants to treat recalcitrant polyps

It is well established that the burden of chronic rhinosinusitis on healthcare costs and patients’ quality of life is high, and that current mainstream treatment options of oral or topical steroids are not without problems. This paper compares two RCTSs...

SNOT-25 to assess CRS - a new tool

The SNOT-22 is a well-established validated instrument, designed to evaluate the rhinosinusitis-specific health status and health-related QOL, however makes only one broad reference to productivity. The objective of this paper is to evaluate a modified SNOT-25 created to better assess...

CRSwNP and smell – is it just the obstruction?

Anosmia and hyposmia are symptoms of CRS both with and without nasal polyps and can significantly affect quality of life. The nature of anosmia/hyposmia is thought to be both sensory-neural and conductive. These authors studied a mouse model in which...

Balloons – more complicated than first thought?

This study describes the complications seen after balloon sinuplasty (BSP) - a commonly performed procedure (particularly in the USA where it is often performed as an office procedure) versus traditional functional endoscopic sinus surgery (FESS). The data source was a...

The snotty child?

This article is interesting for those of us who see children regularly in secondary care but rarely see them with chronic rhinosinusitis. The authors remind the reader of the EPOS guidelines for diagnosis of CRS in children: two or more...

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....

Balloon compared to FESS – long-term patient satisfaction

Balloon compared to FESS – long-term patient satisfaction This paper is the first controlled study of balloon sinoplasty’s long-term efficacy, with a follow-up extending over five years. There were 208 patients analysed and 88 recruited. Exclusions were nasal polyps grade...

Method of delivery: all topical nasal corticosteroids are not made equal

There is an increasing body of evidence that the role of surgery for chronic rhinosinusitis is to facilitate the delivery of topical medical treatment – most notably, topical corticosteroids. Two recent studies, one using flow dynamics and another one examining...