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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...

Steroids pre-FESS

This meta-analysis and systematic review from the Netherlands and the UK aims to answer the question of whether corticosteroids inhaled and / or taken orally are beneficial to patients with chronic rhinosinusitis undergoing functional endoscopic sinus surgery. Refreshingly 18 RCTs...

Chronic rhinosinusitis and sleep

This is an interesting article from the Chung Shan Medical University in Taiwan. One-hundred-and-thirty-nine patients were enrolled into this five-year study. They all had chronic rhinosinusitis with or without polyposis and underwent sinus surgery. The aim was to investigate a...

The microbiological environment of the paranasal sinuses

This article reviews the ecology of the sinuses and tries to make sense of the confusing literature on the subject. This covers the details of molecular studies, particularly those which attempt to differentiate normal sinuses from those in patients with...

Olfactory neuronal damage in sinusitis

So many patients with nasal disorders have poor olfactory function, yet sometimes the nose may seem comparatively clear of conductive problems. This study postulated that neuronal damage in the olfactory apparatus would lead to a leakage of neuron specific enolase...

Smoking and immunotherapy – does it worsen outcome?

This interesting study aimed to address the issue of smoking in patients who had their allergic rhinits treated by sublingual immunotherapy (SLIT). Assessment was with validated quality of life questionnaires. There were 163 patients recruited in Greece who had completed...

Thalidomide in HHT

An interesting paper from a specialist centre in the Netherlands regarding the use of thalidomide in HHT patients. The St Antonius hospital has 1238 patients with HHT and 1% of these use thalidomide. The aim was to assess the benefits,...

Smell and mental health

This national survey from Korea asked questions about many aspects of health and one of these was about sense of smell. The prevalence of olfactory problems was 5% in the adult group surveyed, and other studies would suggest that this...

Combined sprays for allergic rhinitis maintenance

This meta-analysis looked at the reported efficacy for allergic rhinitis control of various topical sprays, particularly comparative studies. There were fewer ‘head to head’ studies than we would have hoped to exist. This review included intranasal anti-histamines, intranasal steroids and...

Getting your nose dry: endoscopic vidian neurectomy – an old technique given new life

We are often faced with patients with intractable watery rhinorhea – patients with no demonstrable allergy, a diagnosis of NAR and no response to ipratropium or capsaicine. For such patients, vidian neurectomy has been devised – an old technique that...