Allergic fungal rhinosinusitis - a new staging system.

Background: The existing Kupferberg post-operative endoscopic staging system for allergic fungal rhinosinusitis (AFRS) has 4 stages (0-3) based on the `global` appearance of one side of the nose. Patients may however show visual improvement and yet remain at the same stage due to persistence in one sinus cavity, thus making the staging system ineffective. The aim of this study was to validate a new system that allows greater sensitivity in characterising the inflammation seen endoscopically.

Olfactory dysfunction in allergic fungal rhinosinusitis.

Objective: To correlate patient reports of olfactory dysfunction after surgical intervention for allergic fungal rhinosinusitis (AFRS) with endoscopic findings, psychophysical testing, and quality-of-life scores.

Design: A prospective cohort study.

Setting: A tertiary care rhinology clinic at St Paul's Hospital, Vancouver, British Columbia, Canada.

Single-blind study of manuka honey in allergic fungal rhinosinusitis.

Background: Some patients continue to suffer from symptoms of sinusitis after maximal topical medical and surgical treatment for allergic fungal rhinosinusitis (AFRS). Manuka honey has well-documented antimicrobial and antifungal properties and is currently being used by physicians across the world for a wide variety of medical problems.

Objective: This study aimed to determine the effectiveness of Medihoney Antibacterial Medical Honey in patients who continue to suffer from AFRS resistant to conventional medical treatment after bilateral functional endoscopic sinus surgery and maximal postoperative medical management.

Pathogen yield and antimicrobial resistance patterns of chronic rhinosinusitis patients presenting to a tertiary rhinology centre.

Objectives: To examine the yield and resistance profile of pathogens in chronic rhinosinusitis (CRS) patients receiving culture-directed management and to pay particular attention to the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in this population.

Study Design: Retrospective review of a CRS microbiology database.

Participants: Consecutive CRS patients seen at the St.

Double-blinded, randomized, controlled trial of medicated versus nonmedicated merocel sponges for functional endoscopic sinus surgery.

Objective: This study aimed to compare differences between medicated and nonmedicated Merocel middle meatal spacers (MMSs) on sinonasal mucosal healing (histopathologic and endoscopic difference), patient discomfort, and pain on removal of the MMS following functional endoscopic sinus surgery.

Methods: Forty-eight patients with chronic rhinosinusitis undergoing bilateral functional endoscopic sinus surgery were enrolled in a prospective study. Patients were randomized and blinded to receive a medication-soaked Merocel MMS (either one of budesonide, gentamicin, or manuka honey) in one nostril and a nonmedicated Merocel MMS in the contralateral side.

Endoscopic management of inverted papillomas: long-term results--the St. Paul's Sinus Centre experience.

Objectives: To demonstrate that computer-assisted endoscopic management of inverted papillomas yields excellent long-term results in terms of preventing recurrence and minimizing significant morbidity and mortality.

Methods: A retrospective chart review of patients who are being followed up for tumour recurrence or have undergone tumour removal between 2000 and 2008. All cases were undertaken using the GE Instatrak 3500+ navigation system.

Prevention and management of complications in frontal sinus surgery.

Frontal sinus surgery continues to remain one of the most challenging areas for sinus surgeons. Many different techniques have been introduced for dealing with the frontal sinus. These can range from conservative, mucus membrane-preserving, strictly endoscopic techniques to radical endoscopic and open procedures using drills and burrs to create large openings, all with the aim of keeping the frontal sinus aerated, disease free, and functional in the long-term.

Endoscopic frontal sinusotomy-preventing recurrence or a route to revision?

Objectives/hypothesis: The Messerklinger technique is an endoscopic approach to sinus surgery designed to be minimally invasive and preserve mucosa and therefore physiological function. More recently there have been advocates for more radical endoscopic approaches to the frontal sinus such as the modified Lothrop procedure. This study aims to determine the effectiveness of endoscopic frontal sinusotomy in preventing recurrent frontal sinus disease and the need for any revision frontal sinus surgery.

Tumefactive fibroinflammatory lesion of the frontal sinus.

Objective: A 65-year-old man presented with a nine-month history of swelling in the midline of the forehead. After surgical intervention, this lesion was found to be a tumefactive fibroinflammatory lesion of the frontal sinus. This case report and review aims to report this new location for tumefactive fibroinflammatory lesion, and to discuss whether, in retrospect, there would have been alternative options to surgery.

The Leicester semi-automated olfactory threshold test--a psychophysical olfactory test for the 21st century.

Objective: Develop a useful and cost-effective olfactometer for routine clinical use by providing a standardised threshold test for patients with olfactory disorders presenting in the ENT clinic.

Method Of Study: A prospective study of olfactory thresholds in 48 healthy volunteers on 2 consecutive occasions, undergoing quantitative testing with an olfactometer. Further studies of 10 subjects performing 20 tests and 100 subjects performing a single test were performed.

Revision endoscopic sinus surgery: the St. Paul's Sinus Centre experience.

Objective: To determine the most common findings in patients undergoing revision endoscopic sinus surgery (ESS) presenting to a tertiary rhinology centre. It is our aim that by identifying these findings, the common pitfalls in primary ESS can be avoided to prevent the necessity for revision ESS.

Methods: The findings of 73 cases of revision ESS from July 2006 to March 2007 presenting to the St.

Image-guided endoscopic transsphenoidal removal of pituitary tumours.

Background: With continuing advancements in minimally invasive endoscopic nasal and sinus surgical techniques, image-guided endoscopic transsphenoidal approaches to the pituitary gland and anterior skull base have progressively become more popular.

Methods: Clinical records were reviewed retrospectively from 2001 to 2006. Twenty-nine consecutive patients with pituitary tumours underwent transnasal endoscopic surgery.

Patient quality of life improvements with and without computer assistance in sinus surgery: outcomes study.

Background: Chronic rhinosinusitis affects millions of North Americans and has been increasing annually since 1991. This study aimed to evaluate the effectiveness of functional endoscopic sinus surgery (FESS) done with the use of computer assistance (CASS) and without the use of computer assistance on patient quality of life. As of this writing, there is no published study that measures the difference in patient quality of life with and without image guidance in endoscopic sinus surgery.

Fungal cultures in patients with allergic fungal rhinosinusitis: improving the recovery of potential fungal pathogens in the Canadian laboratory.

Background: There is no uniform consensus on how to grow fungi from sinus aspirates in the Canadian setting. Protocols vary between institutions, and the positivity rate for fungal cultures ranges between 10 and 20% even when endoscopically obvious allergic mucin is being sent to the laboratory. The aim of this study was to compare the occurrence of positive fungal cultures obtained by our institution's fungal culture method with the occurrence obtained by the Mayo Clinic's fungal culture method.