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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...
Surgery for class III malocclusions pharyngeal airway and sleep apnoea effects
Thirty-three patients from Brazil were assessed for obstructive sleep apnoea and hypopnoea syndrome pre- and six months postoperatively. The 33 patients were made up of nine having mandibular set back surgery, six maxillary advancement and 18 bi-maxillary surgery. They identified...
Saline irrigation in CRSwNP after surgery
This article, largely from Germany, aims to prove the effectiveness of nasal saline irrigation in postoperative patients with CRS with nasal polyps. A prospective, single blinded randomised trial was designed with an irrigation and non-irrigation arm. Patients who underwent sinonasal...
Postoperative recovery in children after ENT surgery
This Belgian prospective study reported on the postoperative recovery time after routine ENT surgery (grommets, adenotonsillectomy), and compared parental estimations of postoperative pain with those of the child themselves (however, the authors do admit that many of the children included...
FESS for recurrent acute rhinosinusitis: at last, some data
As noted in both the EPOS 2012 and in the (more recent) ICARS 2016, there is a paucity of evidence on the effectiveness of surgery for recurrent acute rhinosinusitis (RARS). The authors used a control group of patients with CRSsNP,...
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...
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...
Gamma Knife surgery for persistent or recurrent trigeminal neuralgia
Treatment of trigeminal neuralgia continues to be challenging. The treatment options include pharmacotherapy, or failing this, surgical options like microvascular decompression (MVD), radiofrequency ablation, pencil beam convolution and Gamma Knife surgery. The authors of this article have presented a series...
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...
Facial nerve grafting – what’s the wait?
An uninterrupted facial nerve after resection of cerebellopontine angle (CPA) tumour does not always translate into preserved facial animation. Fortunately there is a high probability spontaneous recovery may occur and hence patients are typically observed for 12 months postoperatively. However,...
