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CRSwNP initiation, not always an interleukin fault
CRSwNP, similar to asthma, is an inflammatory disorder (type II) with eosinophilia and raised IL-5 and IL-13. Inflammation in CRSwNP is thought to be started by IL-25, IL-33 and thymic stromal lymphopoietin (TSLP), all of which form an important part...
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...
Association of childhood OME with obesity
Many factors influence the development of otitis media with effusion (OME) in children, some of them being increased plasminogen factor inhibitor (PAI-1) levels, eustachian tube obstruction and gastro-oesophageal reflux. These factors are also associated with obesity. Sixty children with mean...
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...
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...
Balloon dilatation is an effective adjunct
This is a good study design, sufficiently powered, comparing medical management to balloon sinus dilatation. All patients had failed medical management and were thoroughly assessed preoperatively with Lund-Mackay score confirming abnormal CT findings, SNOT 20 index score, chronic sinusitis score...
Subannular T-tubes for adhesive otitis
This Italian study looked at the success rates of a novel method to manage adhesive otitis media (chronic otitis media with adhesion of the tympanic membrane to the promontory). The authors looked at 22 patients with unilateral chronic adhesive otitis...
Factors affecting compliance of follow-up of patients with chronic otitis media
Patients with retraction pockets and small cholesteatomas need good surveillance as well as those surgically treated for cholesteatomas. This is particularly important in closed techniques where a second look or diffusion weighted MRI can pick up any recurrence or residual...
The stubborn polyp cases are ‘different’
The widely different behaviour of nasal polyp disease between patients is a major feature of rhinology practice and makes counselling of patients difficult when approaching their first operative intervention. Setting aside aspirin sensitivity (Samter’s triad), which is known to be...
Factor favouring the need for revision FESS in chronic sinusitis with polyps – a multivariate analysis including phenotypes
Chronic rhinosinusitis with polyposis is a type 2 inflammation with risks of recurrence and need for revision operations. This is known to depend on the endotype and phenotype factors. This is a retrospective study of 212 patients. Of these, 112...
Passive smoking and rhinosinusitis
One would expect that subjects exposed to more passive smoke would have a significantly increased level of rhinosinusitis. This study looked at a reasonable number of sinusitis and control subjects (404 and 165) using hair nicotine as an assessment of...
