Will endoscopic sinus surgery (ESS) provide an improved quality of life (QoL) for patients with medically recalcitrant chronic rhinosinusitis (CRS) who have minimally affected computed tomography (CT) scans of the paranasal sinuses? Background: Although most otolaryngologists have encountered patients with symptoms and endoscopic findings suggestive of CRS, CT evaluation may demonstrate minimal mucosal disease in some […]
Researchers Find Evidence of Esophageal-Nasal Reflex
Does a neural reflex exist that links the esophagus and the nasal airway, possibly explaining a mechanism for the association between gastroesophageal reflux (GER) disease and chronic rhinosinusitis (CRS)? Background: Many studies have shown an association between GER and CRS. The leading theory on the pathogenic mechanism is direct reflux of gastric acid into the proximal […]
Smoking Increases Risk of Inverted Papilloma Recurrence
What clinical and environmental factors can predict recurrence or malignant transformation of sinonasal inverted papilloma (IP)? Background: IP is a benign neoplasm that is locally aggressive, with a less than 10 percent recurrence rate and potential for malignant transformation. Few studies have reported the effects of environmental factors, especially cigarette smoking, on recurrence rates of IP. […]
Balloon Dilation Useful for Revision Frontal Sinusotomy
Is the balloon a useful tool for revision frontal sinusotomy to efficiently and safely allow subsequent instrumentation of the frontal outflow tract using larger, more aggressive instruments? Background: Reports of drill-out frontal sinusotomy outcomes have emphasized the importance of mucosal preservation and the avoidance of circumferential mucosal disruption in maximizing long-term success. The frontal sinus outlflow […]
Researchers Identify Patients at Risk for MRSA
What patients are at risk for methicillin-resistant Staphylococcus aureus (MRSA) infection following septorhinoplasty and the need for antibiotic prophylaxis? Background: Local infection is a rare complication following septorhinoplasty, but it has been suggested that at least half of the patients who undergo septorhinoplasty or rhinoplasty will be colonized with Staphylococcus aureus (S. aureus), and a percentage of […]
Intranasal Corticosteroid Not Recommended as Monotherapy for Acute Rhinosinusitis
Is an intranasal corticosteroid (INCS) effective monotherapy for treatment of acute rhinosinusitis? Background: Acute rhinosinusitis is often treated with antibiotics as if it were a bacterial infection; however, estimates suggest that approximately 98 percent of cases may be of viral etiology. The natural history of acute sinusitis, even in cases of bacterial disease, is spontaneous resolution […]
Polydioxanone Foil Can Be Used to Support the Nasal Septum
Is polydioxanone foil an effective material for stabilizing septal segments in nasal septal reconstruction? Background: Post surgical nasal septal integrity must be restored if a functionally and aesthetically healthy nose is desired. When autogenous cartilage for reconstruction is unavailable or procurement is excessively morbid, allografts are often considered. Resorbable polydioxanone foil may be useful in nasal […]
Irradiated Homologous Costal Cartilage Used Effectively in Rhinoplasty
Can irradiated homologous costal cartilage be safely and reliably utilized as a grafting material for primary and secondary rhinoplasty? Background: Early reports on irradiated homologous costal cartilage (IHCC) used in nasal grafting were confounded by many factors, making its long-term survivability difficult to assess. Preliminary results from the first large-scale study limiting grafts to nasal reconstruction […]
Steroid-Impregnated Nasal Dressing Improves Post-ESS Healing
What is the impact of steroid-impregnated absorbable nasal dressing on wound healing and surgical outcomes after endoscopic sinus surgery (ESS)? Background: Wound healing has been a significant determinant of successful outcomes in ESS, with factors leading to poor surgical outcomes including scarring/synechiae, ostial or middle meatal obstruction, infection and persistent inflammation in the opened sinus cavities. […]
Trial Assesses Shorter Moxifloxacin Therapy
What is the efficacy and safety of a five-day moxifloxacin regimen in the treatment of acute bacterial rhinosinusitis (ABRS)? Background: There is a lack of clarity regarding the role of antimicrobials in ABRS treatment. Although current guidelines encourage the use of antimicrobials, it is difficult to identify appropriate patients. Additionally, there would be benefits to reducing […]