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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...

SNOT-25 to assess CRS - a new tool

The SNOT-22 is a well-established validated instrument, designed to evaluate the rhinosinusitis-specific health status and health-related QOL, however makes only one broad reference to productivity. The objective of this paper is to evaluate a modified SNOT-25 created to better assess...

Helicobacter pylori infection delays mucociliary clearance in the nose

Chronic rhinosinusitis is not uncommonly a difficult condition to treat and therefore any possible association of this condition with factors outside the nose and sinuses is the subject of worthwhile research. Impairment of mucociliary clearance is paramount to upper respiratory...

Dacryocystorhinostomy revisited

In this technical variant, instead of seeking the lacrimal sac, the authors describe a retrograde technique. They first identify the nasolacrimal duct at the level of the most anterior insertion of the inferior turbinate in the lateral nasal wall. The...

An unrecognised anatomical variant which may help frontal sinus surgery

Anatomic variants in the frontal sinus have significant implications in endoscopic sinus surgery. In this illustrative study, the authors describe a newly-observed anatomical variant – a mucosa lined prism‑shaped space between the most superior part of the nasal septum and...

Chronic rhinosinusitis, are we treating the same disease?

Chronic rhinosinusitis (CRS) is a heterogenic disease. The effects of heterogeneity on treatment outcome are not very clear. Authors used clinical features such as endoscopic findings scores and full blood count findings in addition to analysis of 35 molecular markers....

A review of significant issues in the management of obstructive sleep apnoea in children

There are considerable variations in the management of obstructive sleep apnoea in children and this suggests a need for more research and evidence-based information. In this review article, the authors address four key issues. Literature compares tonsillectomy with tonsillotomy, the...

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...

What is balloon eustachian tuboplasty (BET)?

Eustachian tube dysfunction (ETD) is the result of a combination of factors that interfere with the mucosal functional or cartilaginous structures. Failure to open the eustachian tubes can cause aural pain, pressure in the ears, muffled hearing, crackling/popping sounds in...

A new bio-glue for neurosurgical wound closures

Dural closures need to be tight to prevent cerebrospinal fluid leaks. Traditional wound closure techniques involve sutures and DuraSeal which is the only FDA approved polyglycol hydrogel sealant with proven safety and efficacy profile. This article describes a new sealant,...

Paediatric nasopharyngeal carcinoma

Between 11 and 18% of nasopharyngeal carcinomas (NPC) occur in the paediatric age group but there are no specific management guidelines for this age group. Tunisia is a region with an intermediate incidence of NPC, the authors studied 40 cases...

Diagnosis of obstructive sleep apnoea hypopneoa syndrome (OSAHS) without sleep studies

Polysomnography is considered the ‘gold standard’ in the diagnosis of sleep apnoea but it is expensive and difficult to perform in children. Diagnosis based on subjective judgement is often inaccurate. An accurate diagnostic scale based on clinical parameters could obviate...