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A comparison between biologic and surgical treatment (FESS) for chronic rhinosinusitis with polyposis
In recent years, it is being increasingly recognised that chronic rhinosinusitis with nasal polyps (CRSwP) is a type 2 chronic inflammation based on IL-4 and IL-13, and the novel monoclonal antibody, such as dupilumab, is likely to have a major...
Post-operative debridement following FESS
Postoperative treatment pathways for patients following functional endoscopic sinus surgery (FESS) vary widely with the topic of debridement of the nasal cavity a subject of conjecture. This article is the result of two independent reviewers using the consort guidance for...Neurological idiopathic disease: a shared journey for NASA and medicine
Whilst Southampton can’t really be described as an extreme environment, experiments carried out in the city have certainly been taken out of this world. Robert Marchbanks discusses one of the associations between Southampton, The International Space Station and tympanic membrane...
Can SNOT-22 predict the need for surgery?
In this prospective Belgian study, the authors looked at whether the baseline Sino-Nasal Outcome Test-22 (SNOT-22) was able to predict the need for surgery and localise the pathology of rhinology patients and healthy volunteers. A total of 66 healthy volunteers...
Simple preoperative tests predicting outcomes for ESS patients?
We are all familiar with patients suffering extensive nasal polyps who relapse all to soon after careful and thorough endoscopic sinus surgery (ESS). This paper looks to answer whether we can predict which patients will do well, and which less...
The polyp shrinker
Inflammatory markers, including T2 cells beta common (βc) cytokines IL-3, IL5 and granulocyte-macrophage colony-stimulating factor (GM-CSF), are known to play an important role in chronic rhinosinusitis with nasal polyps (CRSwNP). CSL311, a monoclonal antibody (mAb), was developed to target human...
Advances in diagnosis and management of allergic rhinitis
This article reviews advances in the diagnosis and management of allergic rhinitis. Recent advances in the diagnosis of allergic rhinitis include testing of local immunoglobulin E (IgE), urinary test to diagnose aspirin hypersensitivity and optical rhinometry to assess degree of...
Use of topical steroids and antibiotics, compared to systemic antibiotics in the treatment of acute rhinusinusitis
Acute rhinusinusitis is mainly initiated by viral infections. Bacterial infection is usually superadded. The inflammatory cascade upregulates the pro-inflammatory mediators resulting in pain, nasal obstruction and nasal discharge. Local application of steroids and antibiotics could provide a higher concentration of...
Multisystem pathology in refractory otitis media with effusion
Recurrent middle ear effusion is a common problem and so is rhinosinusitis with polyposis. It is not often thought that the problem could be linked to multisystem pathology, such as eosinophilic granulomatous with polyposis. Therefore, repeated grommet insertions and surgical...Rhinoplasty for cleft nose deformity
Modern cleft lip and palate repairs produce excellent functional and aesthetic results at an early age. Tony Holmes, a craniofacial surgeon with over 40 years’ experience, shares his wisdom on the best timing and techniques for addressing the associated complex...
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...
