Key Points Unilateral nasal obstruction is the most common symptom in patients with either benign or malignant tumors of the sinonasal tract. Therefore, any patient with this complaint should be assessed with endoscopy, imaging studies, and, if required, histologic examination…
Key Points Endoscopic orbital surgery requires a multidisciplinary approach by an oculoplastic surgeon and an otolaryngologist with proficiency in both rhinologic and orbital surgery. Chronic epiphora should be investigated with a dacryocystogram, and possibly a scintillogram, prior to surgery, to…
Key Points Cerebrospinal fluid (CSF) rhinorrhea may be classified as traumatic (>90%) and nontraumatic (<10%). Approximately 80% of all traumatic leaks occur in the setting of accidental trauma, and the remaining traumatic CSF leaks occur after neurosurgical and rhinologic procedures.…
Key Points Epistaxis is a common otorhinolaryngologic complaint encountered by multiple medical disciplines and is the most common otorhinolaryngologic emergency. The vascular anatomy of the nose is extremely rich, with bilateral supply from both the external and internal carotid systems.…
Key Points Only instrument the frontal recess with good reason and sound intention. Functional drainage of the frontal sinus relies on preservation of the mucosa of the frontal recess. If the mucosa of the frontal recess cannot be preserved, a…
Key Points Primary functional endoscopic sinus surgery (FESS) is an effective technique for relieving sinus ostial obstruction, removing osteitic bony partitions, decreasing inflammatory burden, and preparing the nasal cavity for topical medications. The initial surgery represents the greatest chance for…
Key Points Primary surgery for chronic rhinosinusitis is almost exclusively performed endoscopically. Functional endoscopic sinus surgery (FESS) aims to restore mucociliary function by reestablishing physiologic sinus ventilation and drainage. Surgery should be personalized. The extent of surgery depends on symptoms…
Key Points Outcomes research for chronic rhinosinusitis (CRS) has evolved significantly over the last decade. Although many types of outcome measures exist, patient-reported outcomes measures (PROMs) are currently the most commonly used metrics. The 22-question Sinonasal Outcomes Test (SNOT-22) has…
Key Points Strongly Recommended Therapies High volume saline irrigations and topical intranasal corticosteroids are supported by a strong recommendation for the treatment of chronic rhinosinusitis with and without nasal polyps (CRSwNP and CRSsNP). Recommended Therapies Nonstandard delivery of topical intranasal…
Key Points Chronic rhinosinusitis (CRS) comprises a group of disorders that arise from complex inflammatory processes triggered by the interaction between an array of environmental agents and the host mucosal immune system. CRS is overwhelmingly idiopathic; however, few patients have…