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A new era in the treatment of recalcitrant nasal polyps?
Chronic rhinosinusitis with nasal polyps (CRSwNP) can be difficult to treat effectively in patients with aggressive or recalcitrant disease. Omalizumab (Xolair) is a monoclonal anti-IgE antibody with proven benefits for patients with moderate/severe asthma and CRSwNP, but this study looks...
How safe is sinonasal surgery for the operating surgeon in times of COVID-19?
I’m sure we have all wondered how safe we are in the operating theatre from virus circulating in the room and therefore the risk of subsequent COVID-19 infection. The authors addressed this by measuring the airborne particle concentrations in the...
Serum biomarkers for CRSwNP
This cross-sectional comparative study looked at 50 patients with nasal polyps who, at the time of diagnosis, also had a blood test evaluating serum total IgE, IL-17 and Pentraxin-3. The study assesses whether these blood markers are useful in the...
Why do some people get their smell back so quickly after a COVID infection whilst others don’t?
Of course, we are all too familiar with the effect that COVID-19 infection has on our sense of taste and smell, but why do most patients get better whilst, for many, the misery lingers on and on? This paper looks...
When to operate on a patient without chronic disease?
As ENT surgeons, we spend a lot of time managing chronic rhinosinusitis, so a review and update on the management of the acute disease is always helpful. The standard medical treatment of antibiotics, nasal steroids and nasal decongestants are reported...
Eosinophilic or not eosinophilic: dupilumab seems to work
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammation with interleukin (IL)-4, IL-13, and IL-5. Tissue eosinophilia in nasal polyps dramatically increased over a 10-20-year period. Classification of the severity of eosinophil status is expected to lead to...
Not as rare as we think? Silent sinus syndrome incidence on CT heads
It is relatively uncommon to come across a case of silent sinus syndrome (SSS), but not as rare as the prevalence in the literature might suggest – the authors of this study note that only 100 cases are reported in...
Does sleep quality improve when we adequately treat CRS?
In addition to the well-known symptoms associated with chronic rhinosinusitis (CRS), patients often suffer with poor sleep quality which is also detrimental to health and wellbeing. This meta-analysis looked at 35 papers reporting outcomes for CRS patients post surgery on...
Should we be utilising the pre-lacrimal approach for maxillary sinus inverted papilloma?
For some time now, gold standard management of the maxillary sinus inverted papilloma has been endoscopic medial maxillectomy (EMM). Recently the endoscopic prelacrimal recess approach (EPLRA) has been reported to provide good access whilst preserving the nasolacrimal duct and inferior...
A new treatment for septal perforations?
Nasal septal perorations are notoriously difficult to close surgically and can be extremely symptomatic and debilitating for the patient. This paper describes the use of carvacrol (a monoterpene phenol of the family Lamiacaea which is often found in essential oils)....
How best to follow up a sinonasal cancer?
Sinonasal malignancies are rare tumours and, in the UK, are usually treated in tertiary treatment centres but may well be followed up long term in the patient’s local hospital, so advice on how best to manage these patients is invaluable....
