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Does minimally invasive surgery under local anaesthesia have a role in the management of chronic rhinusinusitis?

A formal FESS procedure usually done under local anaesthesia is considered as gold standard in the management of chronic rhinusinusitis. However, success is hampered by a significant recurrence rate of polyps requiring revision surgery, long waiting lists, reluctance of elderly...

How to manage the concha bullosa in FESS

It is an interesting concept to assess how much impact the presence of a large concha bullosa (CB) has on both severity of chronic rhinosinusitis (CRS) and also postoperative outcomes after FESS. The authors accept that the paper has limitations...

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...

Balloons – more complicated than first thought?

This study describes the complications seen after balloon sinuplasty (BSP) - a commonly performed procedure (particularly in the USA where it is often performed as an office procedure) versus traditional functional endoscopic sinus surgery (FESS). The data source was a...

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...

Preoperative CT checklist (using the ‘CLOSE’ mnemonic) improves identification of anatomical variants for endoscopic sinus surgery

Computed tomography (CT) scans of the paranasal sinuses act as roadmaps for endoscopic sinus surgery (ESS) and careful inspection preoperatively warns the operating surgeon of critical anatomical variants. This study aimed to investigate if implementation of a pre-ESS CT checklist...

Managing the most common branchial arch anomaly

This article is a well written, helpful summary of the management of the most common branchial anomaly in children – the second. These are characterised as cysts, sinuses or tracts between the anterior border of sternocleidomastoid, coursing between the internal...

Endoscopic Approaches to the Parsanasal Sinuses and Skull Base

This is an excellent book to cover the endoscopic approaches to the paranasal sinuses and skull base with a step-by-step anatomic dissection guide. The editors are a group of eminent skull base otolaryngologists and neurosurgeons in Barcelona, Spain, and they...

A new biomarker for chronic rhinosinusitis

This Chinese study looked at the feasibility of periostin (usually found in bone and lung tissue) as a biomarker for chronic rhinosinusitis. They sampled ethmoid mucosa in 12 patients with chronic rhinosinusitis without nasal polyposis (CRSsNP) and 25 patients with...

Microbiome changes after endoscopic sinus surgery: all is not what it seems

As we keep fighting a losing battle with bacteria and antibiotics, it becomes clear that it is not about killing bacteria, not even diminishing the bacterial load, but rather about shifting the different types of bacteria that colonise and live...

Anatomy for extended sinus surgery

In the world of image guidance and pushing the boundaries of what can be achieved endoscopically the assessment and understanding of preoperative imaging is critical for success. This paper highlights the anatomical variations in the pterygopalatine and sellar regions. The...

A Grand Day Out!

On 12 June, Emeritus Professor Valerie Lund was officially invested at Windsor Castle as Dame Commander of the British Empire for Services to Rhinology.