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A new treatment for chronic rhinitis

The review paper looks at the efficacy of cryoablation of the posterior nasal nerve (PNN) to treat chronic rhinitis, an increasingly popular method of treating a highly prevalent and morbidity-inducing disease. Five studies were included in the meta-analysis, all dating...

More aggressive FESS for recalcitrant CRS is the key

This is an interesting paper assessing the effectiveness of endoscopic modified medial maxillectomy (MMM) in cases of recalcitrant chronic rhinosinusitis (CRS), (the technique was also used for tumours, cystic fibrosis, FB, odontogenic disease and AFS) in 551 patients. The technique...

Allergen specific subcutaneous immunotherapy helps in prolonged control of allergic rhinitis

One of the commonest allergens involved in perennial allergic rhinitis is house dust mite. A good proportion of these cases prove intractable to treatment with oral and intranasal antihistamines and intranasal steroid sprays. Immunotherapy is considered a useful alternative and...

IL-25 and nasal polyps, another target

Immune response in chronic rhinosinusitis with nasal polyps (CRSwNP) is mainly via type 2 T-helper (Th2) cells while Th1 cells characterise chronic rhinosinusitis without nasal polyps (CRSsNP) immune response. CRSwNP is heterogeneous on a cytological level causing a varied response...

Mobile phones to assess productivity in rhinitis

Uncontrolled and moderate to severe allergic rhinitis (AR) has significant negative impact on work productivity. Work Productivity and Activity Impairment Allergic Specific Questionnaire (WPAI:AS) used to measure that impact showed this. Work productivity seems to improve when AR is treated....

Precision medicine in allergic rhinitis and chronic rhinosinusitis

Precision medicine (PM) with its ‘four Ps’ (personalised, predictive, preventive and participatory) is about appreciating differences between individuals when offering management options for health problems. Multiple groups interested in rhinology such as EPOS and ARIA supported a review of the...

Poor allergic rhinitis control increases the overall costs

Allergic rhinitis and asthma are common and can have significant effects on quality of life. However, not many studies have focused on the economic effects. The authors of this study performed a large-scale (over 60,000 patients) observational study to analyse...

Sublingual house dust mite immunotherapy

House dust mite immunotherapy in allergic rhinitis was shown to be effective in trials with a relatively small number of participants. The authors of this study performed a multicentre double-blind randomised controlled trial to investigate effects of house dust mite...

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...

Medical control of allergic rhinitis in children

The authors of this randomised trial aim to answer an important question – which is better: daily versus on demand use of intranasal steroids (fluticasone probionate) or antihistamines (levocetirizine dihydrochloride) for symptomatic control of allergic rhinoconjunctivitis secondary to pollen? The...

Microbiome changes after endoscopic sinus surgery: all is not what it seems

As we keep fighting a losing battle with bacteria and antibiotics, it becomes clear that it is not about killing bacteria, not even diminishing the bacterial load, but rather about shifting the different types of bacteria that colonise and live...

Sinus surgery effects on asthma patients

Chronic rhinosinusitis (CRS) and asthma are related. The authors identified a gap in the literature and designed this study with a relatively large sample size of 86 patients. They included patients with comorbid asthma and CRS with or without polyps...