You searched for "elderly"
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...
Eosinophilic or not eosinophilic: dupilumab seems to work
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammation with interleukin (IL)-4, IL-13, and IL-5. Tissue eosinophilia in nasal polyps dramatically increased over a 10-20-year period. Classification of the severity of eosinophil status is expected to lead to...
Not as rare as we think? Silent sinus syndrome incidence on CT heads
It is relatively uncommon to come across a case of silent sinus syndrome (SSS), but not as rare as the prevalence in the literature might suggest – the authors of this study note that only 100 cases are reported in...
Does sleep quality improve when we adequately treat CRS?
In addition to the well-known symptoms associated with chronic rhinosinusitis (CRS), patients often suffer with poor sleep quality which is also detrimental to health and wellbeing. This meta-analysis looked at 35 papers reporting outcomes for CRS patients post surgery on...
Should we be utilising the pre-lacrimal approach for maxillary sinus inverted papilloma?
For some time now, gold standard management of the maxillary sinus inverted papilloma has been endoscopic medial maxillectomy (EMM). Recently the endoscopic prelacrimal recess approach (EPLRA) has been reported to provide good access whilst preserving the nasolacrimal duct and inferior...
A new treatment for septal perforations?
Nasal septal perorations are notoriously difficult to close surgically and can be extremely symptomatic and debilitating for the patient. This paper describes the use of carvacrol (a monoterpene phenol of the family Lamiacaea which is often found in essential oils)....
How best to follow up a sinonasal cancer?
Sinonasal malignancies are rare tumours and, in the UK, are usually treated in tertiary treatment centres but may well be followed up long term in the patient’s local hospital, so advice on how best to manage these patients is invaluable....
To scan or not to scan?
This comprehensive review article seeks to establish how useful is MRI in the evaluation of patients with a history of smell loss or distortion. Interestingly, while some studies found the imaging unhelpful, one paper described found a 25% rate of...
How much does FESS improve the sense of smell?
We are all familiar with patients who undergo a seemingly successful FESS but, in spite of this, have persistent smell dysfunction postoperatively. This study compares a surgical group with a control group, measuring olfactory function pre and postoperatively using Sniffin...
COVID-19 in patients with chronic rhinosinusitis with polyps. Are they at risk?
COVID-19 entry factors are highly present in nasal epithelial cells. These factors include ACE2 and TMPRSS2. Their presence in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) was not investigated before. Authors investigated expression of ACE2 and TMPRSS2 in two...
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...
