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2346 results found

A new era in the treatment of recalcitrant nasal polyps?

Chronic rhinosinusitis with nasal polyps (CRSwNP) can be difficult to treat effectively in patients with aggressive or recalcitrant disease. Omalizumab (Xolair) is a monoclonal anti-IgE antibody with proven benefits for patients with moderate/severe asthma and CRSwNP, but this study looks...

When to operate on a patient without chronic disease?

As ENT surgeons, we spend a lot of time managing chronic rhinosinusitis, so a review and update on the management of the acute disease is always helpful. The standard medical treatment of antibiotics, nasal steroids and nasal decongestants are reported...

Can we predict how much benefit patients will get from ESS with a novel monoclonal antibody

Mepolizumab (Nucala) is a humanised IgG1 monoclonal antibody that acts as an IL-5 antagonist. It has been shown to be highly effective in treating severe asthma. It is hypothesised that it will be effective for patients with recalcitrant CRSwNP. This...

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...

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...

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...

Daflon – a new way to treat idiopathic epistaxis

Epistaxis is a common ENT emergency and most cases are idiopathic. Flavonoids are natural substances with variable phenolic structures that are found in fruit and vegetables and take effect on blood vessels. Daflon is proposed to control epistaxis by “improving...

Systemic steroid therapy for reduction of macrophage migration inhibition factor in the control of nasal polyposis

It is believed that macrophage migration inhibitory factor mediates inflammation by stimulating the release of other pro-inflammatory cytokines. The use of systemic steroids in control of nasal polyposis is an established treatment. In this study the authors have aimed at...

The relevance of rhinoplasty and septorhinoplasty from the commissioners

The rising costs of running the National Health Service and its overburdened resources has led to the constant monitoring of the low clinical value treatments. The operations of rhinoplasty and septorhinoplasty inevitably fall into this group and are subject to...

Zinc and rhinosinusitis

Patients with chronic rhinosinusitis (CRS) in general, and those with nasal polyps (CRSwNP) in particular, have been shown to have down-regulation of tight junction genes. Zinc, on the other hand, is well-known for its role in immune regulation and deficiency...

Obstructive sleep apnoea: Does maxillomandibular advancement work?

This is a paper from the Netherlands reviewing 62 patients who underwent maxillomandibular advancement for moderate to severe obstructive sleep apnoea. The authors observed a 71% success rate with mean apnoea hypopnea index (AHI) reduction of 69%. There was no...

Surgery or medicine: when should we stop trying to be conservative?

Although most otolaryngologists would agree that surgery improves the outcomes of patients with CRS when medical treatment has failed, both Cochrane reviews state that there is no proof of improved efficacy of surgery over medicine – however, that was after...