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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...

Budesonide nasal irrigation for chronic rhinosinusitis: is it effective and safe?

Budesonide respules used in nasal irrigations as part of chronic rhinosinusitis management are usually at a dose of 0.25 mg to 2 mg, which is substantially higher compared to budesonide nasal spray, typically ranging from 64 to 256 micrograms. Hence,...

Early recognition aiding better prognosis?

As we are all aware, acute invasive fungal rhinosinusitis (AIFR) is a life-threatening disease which typically affects immunocompromised patients. It is diagnosed via typical signs, symptoms and presentation but gold standard is by biopsy of tissues demonstrating infiltration fungal hyphae....

Eosinophilic complications during dupilumab therapy

Dupilumab is a humanised monoclonal antibody that targets type 2 inflammation by blocking IL-4 and IL-13 signalling. Reported adverse events from its use include injection site erythema, conjunctivitis, arthralgia and hypereosinophilia. The potential for more severe eosinophilic-related complications such as...