Management of Post-Infectious Anosmia and Hyposmia: A Systematic Review.

Background: Anosmia and hyposmia significantly affect patients' quality of life and have many etiologies, including trauma, inflammatory conditions including chronic rhinosinusitis, neoplasm, and viral infections, such as rhinovirus and SARS-CoV-2.

Objective: Our purpose was to establish whether a consensus exists regarding optimal management of olfactory dysfunction and to provide insight into the treatment of anosmia in the current climate of increased prevalence secondary to COVID-19. Thus, we aimed to systematically review the literature on the management of non-Chronic-rhinosinusitis- related anosmia/hyposmia.

Diagnosis of Anosmia and Hyposmia: A Systematic Review.

Background: Anosmia and hyposmia have many etiologies, including trauma, chronic sinusitis, neoplasms, and respiratory viral infections such as rhinovirus and SARS-CoV-2. We aimed to systematically review the literature on the diagnostic evaluation of anosmia/hyposmia.

Methods: PubMed, EMBASE, and Cochrane databases were searched for articles published since January 1990 using terms combined with Medical Subject Headings (MeSH).

Invasive Cryptococcal Meningitis Presenting as a Skull Base Mass in An Immunocompetent Host: A Case Report.

 Encephalitis due to has been seen almost exclusively in patients with severe compromise of their immune systems, such as acquired immune deficiency syndrome (AIDS). Fungal sinusitis with frank invasion through the cranial base and subsequent seeding of the central nervous system is rare, but should be considered in the differential of patients presenting with meningitis and sinus/skull base lesions even without obvious immune compromise. Improvements in diagnostic testing has increased the ability to correctly identify and new antimicrobials have allowed a condition that once carried a high morbidity and mortality to be managed with better outcomes.

Isolated sphenoid sinus opacification: A systematic review.

Objective: Unilateral sphenoid sinus opacification (SSO) on imaging is a common incidental radiologic finding. Inflammatory sinus disease is rarely isolated to one sinus cavity therefore SSO raises the potential for neoplastic etiology. The clinical significance of SSO was evaluated and compared to maxillary sinus opacification (MSO).

Frontal sinus surgery and sinus distribution of nasal irrigation.

Background: Effective mucus lavage and delivery of topical pharmaceuticals are central to successful management of chronic rhinosinusitis (CRS). The frontal sinus remains difficult to penetrate with topical therapies. This study evaluates the benefit of Draf III frontal dissection compared to traditional Draf IIa for distribution of topical therapies.

The Olfactory Strip and Its Preservation in Endoscopic Pituitary Surgery Maintains Smell and Sinonasal Function.

Background The return of olfaction and of sinonasal function are important end points after pituitary surgery. Opinions differ on the impact of surgery because techniques vary greatly. A modified preservation of the so-called olfactory strip is described that utilizes a small nasoseptal flap and wide exposure.

Long-term outcomes in medial flap inferior turbinoplasty are superior to submucosal electrocautery and submucosal powered turbinate reduction.

Background: Techniques for inferior turbinate reduction vary from complete turbinectomy to limited cauterization. Surgical methods differ on the degree of tissue reduction and reliance on surgical tissue removal vs tissue ablation. The outcome and morbidity from 3 different turbinate techniques are compared.

Outside-In Frontal Drill-Out: How I Do It.

Background: The Draf 3 frontal sinusotomy, or modified Lothrop procedure has been used to treat recalcitrant rhinosinusitis, frontal sinus mucocoeles or to provide access for cerebrospinal fluid leaks, frontoethmoid fractures, frontal sinus tumors and skull base tumors.

Objective: To describe authors approach to the "Outside-In Frontal Drill-Out".

Methods: Descriptive.

Costal Cartilage Lateral Crural Strut Graft vs Cephalic Crural Turn-in for Correction of External Valve Dysfunction.

Importance: External nasal valve dysfunction (EVD) is a common cause of nasal obstruction.

Objective: To evaluate costal cartilage lateral crural strut grafts vs cephalic crural turn-in to support the weak lateral crus in patients with EVD.

Design, Setting, And Participants: In this prospective cohort study, patients with clinically diagnosed EVD were assessed at the Tertiary Rhinologic Center and underwent a costal cartilage underlay graft to the lateral crus or a cephalic turn-in cruralplasty.

How I Do It: Medial Flap Inferior Turbinoplasty.

Introduction: Techniques for inferior turbinate reduction vary from complete turbinectomy to limited cauterization. Surgical methods differ on the degree of tissue reduction and reliance on surgical tissue removal versus tissue ablation.

Method: The technique and surgical steps of our preferred method of turbinate reduction are presented.

Sinonasal morbidity following tumour resection with and without nasoseptal flap reconstruction.

Background: Sinonasal function can be affected by multiple treatment modalities but surgical techniques, such as the nasoseptal flap or Draf 3 procedure, have been implicated in poor post-treatment function. Prior studies have rarely used comparable populations and this study aims to assess the impact of surgical technique, mainly the nasoseptal flap, on sinonasal function in a group of comparable patients.

Methods: A prospective cohort of patients undergoing endoscopic surgery for sinonasal and skull base tumours was studied.

Long-term outcomes in endoscopic dacryocystorhinostomy.

Purpose Of Review: This study reviews the current body of literature with recent updates and briefly describes the powered endoscopic dacryocystorhinostomy (DCR) approach.

Recent Findings: This review highlights recent studies including a meta-analysis of outcomes in DCR approaches, and compares each method to external DCR. When analyzed by method, endoscopic DCR with powered instrumentation success rates are comparable to the external approach, whereas the laser-assisted endoscopic DCR had a lower success rate.

Advances in subcutaneous immunotherapy.

Purpose Of Review: Current limitations in subcutaneous immunotherapy (SCIT) include the length of time required to achieve tolerance as well as the potential for systemic side-effects. Advances in allergen immunotherapy include targeted therapies to B-cell and T-cell pathways that can lead to more rapid desensitization and potentially the prevention of allergic disease.

Recent Findings: Novel molecularly engineered compounds and delivery vehicles allow for rapid and efficient desensitization.

Handheld micromanipulator for robot-assisted stapes footplate surgery.

Stapes footplate surgery is complex and delicate. This surgery is carried out in the middle ear to improve hearing. High accuracy is required to avoid critical tissues and structures near the surgical worksite.

Identification of genetic and chemical modulators of zebrafish mechanosensory hair cell death.

Inner ear sensory hair cell death is observed in the majority of hearing and balance disorders, affecting the health of more than 600 million people worldwide. While normal aging is the single greatest contributor, exposure to environmental toxins and therapeutic drugs such as aminoglycoside antibiotics and antineoplastic agents are significant contributors. Genetic variation contributes markedly to differences in normal disease progression during aging and in susceptibility to ototoxic agents.

Partial glucocorticoid agonist-like effects of imipramine on hypothalamic-pituitary-adrenocortical activity, thymus weight, and hippocampal glucocorticoid receptors in male C57BL/6 mice.

Abnormal hypothalamic-pituitary-adrenocortical (HPA) activity may provide clues to the neurochemistry of depression. Psychotic depression has one of the highest rates of elevated HPA activity and is most often responsive to the tricyclic class of antidepressants. Because successful treatment resolves HPA as well as psychiatric symptoms, we hypothesized, in light of evidence that tricyclic antidepressants can affect glucocorticoid receptor function, that these drugs would mimic glucocorticoid feedback inhibition of HPA activity.