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Should we routinely perform steroid injections following microlaryngeal excision of benign lesions?
This retrospective cohort study assessed a single surgeon’s outcomes before and after the routine administration of intralesional triamcinolone following microsurgical removal of benign vocal fold lesions (polyps, nodules and cysts). A total of 211 patients were recruited for the study....The Dilemma of Beethoven’s Deafness
Beethoven was one of the world’s greatest musicians, and his deafness is well known. Many details of his medical conditions are known, and various theories of his hearing loss have been proposed. Ludwig van Beethoven was born in 1770 in...
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 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...
Widen the ostium or keep it: that is the question
The original concept of wide endoscopic sphenoethmoidectomy for sinonasal polyposis has been a well-established principle since 1995. However, with the evolution of the understanding of sinonasal physiology, this might change. The authors present arguments based on the evolutionary and developmental...
Predictors of postoperative improvement after endoscopic sinus surgery in patients with chronic rhinosinusitis
Improvement after endoscopic sinus surgery in patients with chronic rhinosinusitis varies considerably. If elaborate preoperative and intraoperative data could be used to predict the postoperative course, management and length of the follow-up could be adjusted to provide optimal care. Two...
Preoperative CT checklist (using the ‘CLOSE’ mnemonic) improves identification of anatomical variants for endoscopic sinus surgery
Computed tomography (CT) scans of the paranasal sinuses act as roadmaps for endoscopic sinus surgery (ESS) and careful inspection preoperatively warns the operating surgeon of critical anatomical variants. This study aimed to investigate if implementation of a pre-ESS CT checklist...
Managing spontaneous CSF leaks secondary to benign intracranial hypertension
Spontaneous CSF leaks are a rare entity. In this paper, a Spanish group report their experience managing the condition using endoscopic surgery in 35 patients over an eight year period. Leak locations included the cribriform plate (18/35), ethmoid roof (15/35)...
A new biomarker for chronic rhinosinusitis
This Chinese study looked at the feasibility of periostin (usually found in bone and lung tissue) as a biomarker for chronic rhinosinusitis. They sampled ethmoid mucosa in 12 patients with chronic rhinosinusitis without nasal polyposis (CRSsNP) and 25 patients with...
Transverse venous sinus stenosis – a risk factor for CSF leak in patients with idiopathic intracranial hypertension
This was a multicentre (six French tertiary hospitals) retrospective case-controlled study aiming to investigate the rate of transverse venous sinus stenosis (TVSS) in patients with idiopathic intracranial hypertension (IIH) with nasal cerebrospinal fluid (CSF) leaks. They compared the preoperative MRI...
A spoonful of sugar… helps the operated sinuses calm down?
Ottoviano et al. present a prospective double-blinded RCT to assess the effect of a nasal gel containing silver sucrose octasulfate (Silsos Gel) on wound healing after endoscopic sinus surgery. The placebo used was a glycol gel. Thirty-four consecutive patients were...
