In a 2016 survey of American Rhinologic Society (ARS) members on practice patterns regarding office-based rhinology procedures, 63% of the respondents reported an increase in the number of office-based procedures they performed over the last five years.
In endoscopic endonasal surgery for anterior skull base lesions, maximizing the anterior sphenoidotomy in the superior part is crucial for ensuring direct visualization and creating a wide working corridor. Authors describe a technique they devised that maximizes upper anterior sphenoidotomy while preserving the olfactory mucosa.
Chronic rhinosinusitis (CRS) is among the most prevalent chronic medical conditions globally. A survey of Canadian households reported the prevalence of CRS to be 5%. CRS is a clinical syndrome defined by persistent symptomatic inflammation of the mucosa in the nasal cavities and sinuses. A common subtype of CRS is CRS with nasal polyps (CRSwNP), which is identified through endoscopy or imaging
Currently, initial treatment approaches to ENS prioritize conservative management; given the complexity and severity of the condition, patients and clinicians should approach surgical options with caution.
ENS represents one of the more complex conditions in otolaryngology, characterized by the paradoxical feeling of nasal obstruction despite objectively patent airways. In addition to the feeling of severe nasal obstruction—one patient called it “suffocating with every breath”—patients also report dryness, burning, and crusting. The quality-of-life impact can be so great that some patients travel the world seeking multiple consultations and revision surgeries.
Current literature suggests that topical TXA could potentially be a useful adjunct in the management of anterior epistaxis.
Observation is the most cost-effective strategy for the initial management of AECRS when there is a low likelihood of bacterial infection; otherwise, upfront rescue medications are the most cost-effective.
Switching biologics for CRSwNP is frequent in Canadian rhinology; the most common switch is from mepolizumab to dupilumab, with inadequate CRSwNP control driving the switch.
For chronic rhinosinusitis with nasal polyps (CRSwNP), with or without asthma, without other underlying systemic disease factors, steroid-eluting stents may not add benefit over steroid rinses.
Epistaxis is a common emergency department (ED) presentation. Many cases are self-limited, but other cases may require an intervention to stop bleeding. Methods to manage epistaxis include nasal compression, topical vasoconstrictors, cautery, nasal packing, and even surgical ligation in severe cases.