Search

A novel way to reduce postoperative nausea and vomiting

This is an interesting RCT which evaluates the prophylactic effect of bilateral endoscopic injection of local anaesthetic in the sphenopalatine ganglion (SPG) on postoperative nausea and vomiting (PONV). It has a robust design, and is sufficiently powered and blinded, with...

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...

Is combined two wall decompression approach a better surgical outcome for Grave’s orbitopathy?

This retrospective study looked at the outcome of endoscopic medial wall combined with transcutaneous lateral orbital wall decompression in Graves’ orbitopathy. The following parameters were studied: reduction in proptosis; change in visual acuity and diplopia. A total of 36 orbits...

Multi-layered repair of lateral sphenoid CSF rhinorrhoea

This case series describes the author’s results with repairing lateral sphenoid encephalocoeles in seven patients. Alloderm inlay with abdominal fat onlay and nasoseptal flap onlay repair resulted in a 100% success rate with no recurrence of cerebrospinal fluid (CSF) rhinorrhoea,...

Removing nasal polyps assists with sleep

This small Scandinavian study looked at sleep quality in patients with CRS and nasal polyposis and whether this is improved by surgery, rated by questionnaires. A cohort of 42 Swedish patients in 2013-14 filled out four different validated sleep and...

Endoscopic Approaches to the Parsanasal Sinuses and Skull Base

This is an excellent book to cover the endoscopic approaches to the paranasal sinuses and skull base with a step-by-step anatomic dissection guide. The editors are a group of eminent skull base otolaryngologists and neurosurgeons in Barcelona, Spain, and they...

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...

Paediatric pituitary surgery - is it lagging behind?

Endoscopic sellar surgery, especially for adenomas, is a relatively safe, straightforward surgery with (mostly) reproducible results and few complications. However, the evolution of pituitary surgery was a long process, starting from open/transfrontal approaches all the way to transsphenoid to the...

FESS for recurrent acute rhinosinusitis: at last, some data

As noted in both the EPOS 2012 and in the (more recent) ICARS 2016, there is a paucity of evidence on the effectiveness of surgery for recurrent acute rhinosinusitis (RARS). The authors used a control group of patients with CRSsNP,...

Sellar surgery – when to prepare for repair

Endoscopic sellar surgery, especially for adenomas, is a relatively safe, straightforward surgery with (mostly) reproducible results and few complications. One of the commonest complications is the creation of a CSF leak with the subsequent need for repair (there is usually...

A review of endoscopic sinus surgery outcomes

This review discusses the outcome measures that may be considered in the assessment of patients with chronic rhinosinusitis (CRS) as well as the outcomes of endoscopic sinus surgery (ESS) published so far. The authors also discuss the role of peri-operative...

How should I excise sinonasal tumours, open or endoscopic? En bloc or piecemeal?

Sinonasal tumours often present late because initial symptoms mimic benign disease. They tend to produce more unilateral nasal symptoms, and patients with advance disease often describe paraesthesia and other cranial neuropathies. They only account for approximately 3% of upper aerodigestive...