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Validating a new international cholesteatoma classification – a necessary but challenging task
A European and Japanese joint consensus statement was published in 2017 which proposed a new cholesteatoma staging classification (EJS), with four stages. This follow-up publication aims to assess the internal and external validity of the staging system using existing prospectively...
Cocaine detection hours after FESS
This is a very interesting article from Australia regarding the bioavailability of cocaine following atomised application prior to endoscopic sinus surgery. The well-established practice of preparing the nasal mucosa for sinus surgery involves the placement of a usually modified Moffett’s...
Nasal physiology and septal perforations
This interesting article from North Carolina and New York aims to assess the impact of anterior septal perforations on nasal physiology, using computational fluid dynamics and computer simulation. A computerised 3D model was constructed of a normal patient aged 37,...
CRSwNP, another monoclonal antibody
Interleukins 4, 5 and 13 were shown to be important factors in type 2 inflammation, which characterises chronic rhinosinusitis with nasal polyposis (CRSwNP). In CRSwNP non-responders and those who recur short after-surgery monoclonal antibodies might be an answer. Examples include...
Standardising videofluoroscopy assessment for bottle-fed babies
Swallowing problems in babies may occur for many reasons including complex medical problems, premature birth, and low birth-weight. Dysphagia causes several further morbidities such as poor nutrition and compromised respiration, often raising distress for both infants and their caregivers. Early...
A single blinded RCT comparing triamcinolone with 5-FU treatment for keloid scars
This single blinded RCT compared 43 patients with 50 symptomatic keloids that were randomised to two matched groups of 25 scars, receiving either 5-fluorouracil (5-FU) or current first line treatment, triamcinolone (TAC). The surgeon administering the injectable treatments was unblinded,...
Predicting CSF leaks pre FESS: Gera classification - a new tool?
An interesting study from Italy looking at an anterior skull base classification that may be useful in predicting risk of intraoperative CSF leak during FESS surgery. Traditionally we have used the Keros classification system, developed in 1962 to categorise olfactory...
Occlusal splint, injections or arthrocentesis in myofascial pain
Facial pain is a fairly common complaint and may present in a myriad of symptoms. These patients present to both dentists and general practitioners and could end up referred to a number of specialists. Temporomandibular disorders may originate from either...
Does Eustachian tube dysfunction improve with FESS?
This multinational study prospectively collected SNOT-22 data to determine the prevalence and severity of, and whether endoscopic sinus surgery (ESS) had improved, symptoms of Eustachian tube dysfunction in patient with chronic rhinosinusitis (CRS). The SNOT-22 includes two questions which are...
Occupational dust exposure and nasal polyposis
This interesting European cross-sectional study demonstrates a link between occupational dust exposure and the presence of nasal polyposis. A random sample of textile workers (215) and retail store employees (101) in Portugal was taken, with clinical data gathered through a...
Prognostic value of neutrophil-to-lymphocyte ratio in HPV-positive oropharyngeal cancer
The authors propose that high neutrophil-to-lymphocyte ratio (NLR) is associated with poor disease-free survival (DFS) in patients with human papillomavirus positive (HPV+) oropharyngeal cancer (OPC). This is a retrospective study that compared the outcomes of 43 patients treated for HPV+...
