This review examines the latest evidence for photodynamic therapy (PDT) in treating chronic rhinosinusitis. MedLine, EMBASE and TRIP Database searches were conducted using the terms: "photodynamic" or "phototherapy" or "photo" and "sinusitis" or "rhinosinusitis," date range January 2000 to May 2020. A total of 192 records were initially identified, after duplicates and exclusions, 9 full papers and 3 abstracts were included. All study types including in-vitro, animal and human studies were evaluated. Whilst there is in-vitro evidence for the efficacy of PDT's bactericidal effect on drug resistant bacteria and biofilm viability, there are few clinical studies. PDT is a promising area of research, but larger, focused studies looking at the safety, delivery, efficacy, and patient selection are required before it can be considered a viable treatment for CRS.
Abstract Background Frontal sinus stents have been introduced to reduce frontal sinus re-stenosis after surgery and to improve outcomes. Method This study was a retrospective analysis of 19 patients who had endoscopic sinus surgery with approach to the frontal sinus and insertion of a soft sinus stent. Results The frontal recess was patent in 78.9 per cent and stenosed in 21.1 per cent of patients; no completely closed recesses were observed. Mean follow up was 20.7 months, and time period of stenting was 9.8 months on average; complications were observed in 47.4 per cent of the patients, with post-operative sinonasal infection being the most common. Conclusion In the authors’ experience, indications for frontal sinus stenting include recalcitrant chronic rhinosinusitis after multiple functional endoscopic sinus surgeries (especially in chronic rhinosinusitis with nasal polyps), patients with history of important craniofacial surgery or trauma, and recurrent mucoceles. The stent was overall well tolerated as only minor complications were observed. Close clinical follow up is mandatory.
Extract Who are allied health professionals? This term covers a number of different professional groups including. ... They all have different roles and these are explained in the following pages. Modern ENT practice has become multidisciplinary and the involvement of these professionals, alongside members of the medical team, has enhanced patient care significantly. There are many other personnel who are equally important to patient care, such as physiotherapists and occupational therapists. These are not discussed in this handbook. It is important to use these professional services properly. Get to know the names of the staff in your department, and find out their particular skills and interests. Try to sit in on their clinics to obtain first-hand knowledge of their areas of expertise. Communicate with these other professionals and give them the respect that their expertise deserves. The audiologist The majority of an audiologist's work is with older people and young children. These age groups comprise the majority of hearing problems. The audiologist has a wide-ranging role, encompassing many aspects of patient care.
Opsoclonus myoclonus syndrome (OMS) is a rare neurological condition causing rapid jerking involuntary eye movements and myoclonus. The combination of opsoclonus and myoclonus have led to condition being coined the "dancing eyes, dancing feet syndrome". There are a wide variety of paraneoplastic and para-infectious aetiologies for OMS and therefore a detailed workup is needed as OMS symptoms can precede the commencement of symptoms from the underlying triggering disease process. In this case report, we present a case of sphenoid sinusitis in a pregnant lady. We detail her presentation, investigatory work-up and treatment. We also review the pathophysiological theories that can lead to OMS in the current literature.
Abstract Objective Functional endoscopic sinus surgery for chronic rhinosinusitis improves sinus drainage and intranasal medication delivery. This study compares medication delivery with commonly used devices in normal and altered anatomy (post functional endoscopic sinus surgery) using sinus surgery models (Phacon). Methods Medication delivery was simulated via nasal drops, nasal spray and an irrigation device (Neilmed Sinus Rinse). Coverage was then calculated from endoscopic pictures taken at various anatomical sites in the normal nose and post functional endoscopic sinus surgery. Results In the normal nose, nasal spray did not penetrate the sphenoid sinus, and drops bypassed the vestibule anteriorly. Neilmed Sinus Rinse provided superior coverage at the sphenoid site following sphenoidectomy and the frontal site following Draf III. After ethmoidectomy, nasal drops overall provided less coverage than the other methods. Conclusion Neilmed Sinus Rinse generally provided the best distribution, followed by the nasal spray and then nasal drops. The type and extent of surgery also affects medication delivery.
Background This is an update of a Cochrane Review first published in The Cochrane Library in Issue 1, 2007. Benign nasal polyps are lesions that arise from the mucosa of the nasal cavity or one or more of the nasal sinuses. The presenting symptoms are nasal obstruction, watery anterior rhinorrhoea (excessive nasal secretions) or mucopurulent postnasal drip (or both), hyposmia and anosmia (reduced or absent sense of smell) with a concomitant alteration in taste and infrequently pain over the dorsum of the nose, forehead and cheeks. The main aim of treatment is to relieve these symptoms. The aetiology of polyps is uncertain, therefore treatment options differ, consisting of a combination of medical and surgical management. Medical therapy is mainly in the form of steroids, administered topically or systemically via the oral route. Objectives To assess the effects of oral steroids in patients with multiple nasal polyps. Search methods We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ISRCTN and additional sources for published and unpublished trials. The date of the most recent search was 12 October 2010, following a previous search in April 2006. Selection criteria Randomised controlled trials and controlled clinical trials comparing oral steroids with no intervention, or placebo, or comparing doses or schedules of oral steroids in patients with multiple nasal polyps. Data collection and analysis Two authors independently assessed study quality. We contacted study authors for additional information. Main results Three trials (166 patients) met our inclusion criteria and showed a short‐term benefit of a short (two to four‐week) course of oral steroids of variable doses and duration when compared to placebo. There was an objective reduction of polyp size and a subjective improvement of nasal symptoms and quality of life. However, due to the moderate to low quality of these trials it was not possible to quantify the overall size of this effect. There was no report of significant adverse effects of treatment with a short course of steroids. Authors' conclusions The authors found three randomised controlled trials, albeit of moderate to poor quality, that suggest a short‐term benefit of oral steroids in patients with multiple nasal polyps. To address the issue more thoroughly well‐designed, prospective, randomised controlled trials are still needed.
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)