■ The medial and inferomedial part of the orbit as well as the orbital apex with the optic nerve ... more ■ The medial and inferomedial part of the orbit as well as the orbital apex with the optic nerve are easily accessible transnasally.
Operative Techniques in Otolaryngology-Head and Neck Surgery, 2006
... Richard Douglas MD, FRACS, FRACP, MRCP a and Peter-John Wormald MD, FRACS, FRCS, FCS(SA) Corr... more ... Richard Douglas MD, FRACS, FRACP, MRCP a and Peter-John Wormald MD, FRACS, FRCS, FCS(SA) Corresponding Author Contact Information , a , E-mail ... 1 SS Jaradeh, TL Smith and L.Torrico et al., Autonomic nervous system evaluation of patients with vasomotor rhinitis ...
Background:Silent sinus syndrome is characterised by spontaneous enophthalmos and hypoglobus, in ... more Background:Silent sinus syndrome is characterised by spontaneous enophthalmos and hypoglobus, in association with chronic atelectasis of the maxillary sinus, and in the absence of signs or symptoms of intrinsic sinonasal inflammatory disease. Traditionally, correction of the enophthalmos involved reconstruction of the orbital floor, which was performed simultaneously with sinus surgery. Recently, there has been increasing evidence to support the performance of uncinectomy and antrostomy alone, then orbital floor reconstruction as a second-stage procedure if needed.Methods:We performed a retrospective review of 23 cases of chronic maxillary atelectasis managed in our unit with endoscopic uncinectomy and antrostomy alone. All patients were operated upon by the same surgeon.Results:Twenty-two of the 23 patients had either complete or partial resolution. One patient had ongoing enophthalmos, and was considered for an orbital floor reconstruction as a second-stage procedure.Conclusion:Ou...
Otolaryngology-Head and Neck Surgery, Aug 23, 2013
Objectives:1) Validate a clinical staging system on disease “control” in chronic rhinosinusitis (... more Objectives:1) Validate a clinical staging system on disease “control” in chronic rhinosinusitis (CRS) proposed by the European Position Paper on Rhinosinusitis (EPOS) 2) Propose a new, data driven staging system.Methods:Prospective study over a 12‐month period of CRS patients who underwent endoscopic sinus surgery in tertiary care. The Sinonasal Outcome Test‐22 and endoscopy score along with patient's and physician's report on clinical progress were recorded at 6 and 12 months. Ordinal regression was used for modeling symptoms and endoscopic findings to build up “disease control” criteria. Patients were defined as either “controlled,” “partly controlled,” or “uncontrolled” according to both EPOS and proposed criteria. The agreements with physician's and patient's report were analyzed.Results:106 patients were assessed (49.1% female, age 49.0±13.9yrs). Nasal obstruction was the only symptom which predicted patient's report (maximum likelihood (ML) ‐3.6, P = 0.02). Mucosal inflammation (ML ‐2.4, P < 0.001) and thick and/or purulent discharge (ML‐2.5, P = 0.01) predicted physician's report. A new “NOSE” staging system of nasal obstruction, systemic medication used, and endoscopic inflammation was proposed. EPOS system had fair agreement (k 0.29, P < 0.001) with physician's and slight agreement (k 0.18, P = 0.01) with patient's report, while the NOSE system had better agreement with both physician's (k 0.40, P < 0.01) and patient's report (k 0.32, P < 0.01). Both systems predicted treatment outcome at 12 months (both, P < 0.05).Conclusions:The disease control assessment by EPOS staging system has slight agreement with patients and physicians. A new system using nasal obstruction, diseased mucosa, and discharge is proposed.
Topical corticosteroid is used as part of a comprehensive medical treatment for chronic rhinosinu... more Topical corticosteroid is used as part of a comprehensive medical treatment for chronic rhinosinusitis (CRS) without polyps. Nevertheless, there is insufficient evidence to show a clear overall benefit. Trials studying the efficacy of topical corticosteroid use various delivery methods in patients who have or have not had sinus surgery, which directly impacts on topical delivery and distribution. To assess the effects of topical steroid in patients with CRS without nasal polyps and perform a meta-analysis of symptom improvement data, including subgroup analysis by sinus surgery status and topical delivery 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 9 July 2010. All randomised trials in which a topically administered corticosteroid was compared with either a placebo, no treatment or alternative topically administered corticosteroid for the treatment of CRS without polyps in patients of any age. Two authors reviewed the search results and selected trials meeting the eligibility criteria, obtaining full texts and contacting authors where necessary. We documented our justification for the exclusion of studies. Two authors extracted data using a pre-determined standardised data form. Ten studies (590 patients) met the inclusion criteria. The trials were of low (six trials) and medium (four trials) risk of bias. The primary outcome was sino-nasal symptoms. When compared to placebo, topical steroid improved symptom scores (standardised mean difference -0.37; 95% confidence interval (CI) -0.60 to -0.13, P = 0.002; five trials, n = 286) and had a greater proportion of responders (risk ratio 1.69; 95% CI 1.21 to 2.37, P = 0.002; four trials, n = 263). With a limited number of studies, the subgroup analyses of patients who had received sinus surgery versus those who had not was not significant (P = 0.35). Subgroup analyses by topical delivery method revealed more benefit when steroid was administered directly to the sinuses than with simple nasal delivery (P = 0.04). There were no differences between groups for quality of life and adverse events. Topical steroid is a beneficial treatment for CRS without polyps and the adverse effects are minor. It may be included in a comprehensive treatment of CRS without polyps. Direct delivery of steroid to the sinuses may bring more beneficial effect. Further studies comparing different topical drug delivery methods to the sinuses, with appropriate treatment duration (longer than 12 weeks), are required.
Purpose of ReviewOsteitis is recognized as a common factor in recalcitrant chronic rhinosinusitis... more Purpose of ReviewOsteitis is recognized as a common factor in recalcitrant chronic rhinosinusitis (CRS). There is evidence for the association of osteitis with revision surgeries and CRS severity, in terms of higher Lund-Mackay scores. This is a narrative review on the osteitis in CRS patients.Recent FindingsEvidence to date is inconclusive with regard to the etiology and pathogenesis of this bony thickening. Histopathology of osteitis in primary CRS is likely a process of neo-osteogenesis and bone remodeling. For better understanding, various associating factors have been studied including an inflammatory pattern of rhinosinusitis. Recent studies have associated osteitis with nasal polyps and tissue eosinophilia with the increase in periostin expression and P-glycoprotein mucosal expression. There is no association of osteitis to symptoms or quality of life. Osteitis is an outcome of neo-osteogenesis rather than inflammatory processes in CRS patients without a prior history of surgery. While CT has become a staple in osteitis assessment, the standards for grading osteitic severity remain in an experimental stage. There is no association between the presence or severity of osteitis at the time of surgery and clinical outcomes at 1 year after surgery.SummaryThis review provides a comprehensive overview of the pathogenesis, epidemiology, and correlation with clinical and biological factors of osteitis in CRS patients.
Otolaryngology-Head and Neck Surgery, Dec 16, 2013
ObjectivesTo develop a chronic rhinosinusitis (CRS) disease control staging system that predicts ... more ObjectivesTo develop a chronic rhinosinusitis (CRS) disease control staging system that predicts patient and physician opinion. This involved exploring the predictive capacity of the proposed European Position Paper on Rhinosinusitis (EPOS) 2012 staging system and other potential scoring systems based on patient symptoms and objective criteria.Study DesignProspective study.SettingTertiary hospitals.Subjects and MethodsAdults CRS patients undergoing sinus surgery were prospectively enrolled from a tertiary clinic. The Sino‐Nasal Outcome Test 22, endoscopy score, and systemic medication were recorded at 6 and 12 months. A physician and patient report of their condition as either “controlled,”“partly controlled,” or “uncontrolled” was also recorded. Ordinal regression was used for modeling a staging system. The EPOS criteria and various combinations were assessed. Kappa agreements between the staging systems and patient/physician reports were analyzed.ResultsOne hundred six patients were assessed. Nasal obstruction (P =. 02), endoscopic mucosal inflammation (P <. 001), and thick and/or purulent discharge (P =. 01) associated with progress reports. A modified staging system of Nasal Obstruction, Systemic medication used, and Endoscopic inflammation (NOSE) was selected on predictive strengths. The EPOS and NOSE had significant agreement with physician's (k = 0.29, P <. 01, and k = 0.45, P <. 01) and patient's report (k = 0.18, P =. 01, and k = 0.32, P <. 01).ConclusionsThe disease control assessment by EPOS has slight agreement with patients and a physician. A simpler NOSE system using nasal obstruction, mucosa, and discharge is proposed.
Background Endoscopic sinus surgery with a middle meatal antrostomy is a common intervention in t... more Background Endoscopic sinus surgery with a middle meatal antrostomy is a common intervention in the treatment algorithm for maxillary sinus pathologies. However, this procedure has its origins in a time when simple ventilation of the sinus cavity was the primary (and only often) goal of surgery. In some patients, persistent mucociliary dysfunction occurs despite ventilatory surgery. Although the endoscopic modified medial maxillectomy (MMM) was originally described for tumour surgery, it provides a radical yet still functional option to overcome chronic sinus dysfunction. Objective The goal of this study was to describe the functional status of a post-MMM sinus cavity. Methods A consecutive series of patients who underwent at least a unilateral MMM by three tertiary rhinologists were retrospectively reviewed. Prospectively collected data included patient demographics (including age, gender, smoking status and comorbidities), disease-specific factors, microbiology, and preoperative p...
Journal of Neurological Surgery Part B: Skull Base
Objectives Sellar pathologies are frequently found on imaging performed to investigate headache. ... more Objectives Sellar pathologies are frequently found on imaging performed to investigate headache. However, both headache and incidental sellar lesions are common. Hence, this study prospectively examined headache prevalence, phenotype, and severity in patients with sellar pathologies and the impact of transsphenoidal surgery on headache. Methods Patients undergoing transsphenoidal resection of sellar lesions were consecutively recruited. At baseline, participants were defined as having headache or not and headache phenotype was characterized using validated questionnaires. Headache severity was assessed at baseline and 6 months postoperatively using the Headache Impact Test-6 (HIT-6) and Migraine Disability Assessment Score (MIDAS). Tumor characteristics were defined using radiological, histological, and endocrine factors. Primary outcomes included baseline headache prevalence and severity and headache severity change at 6 months postoperatively. Correlation between headache and radi...
Background A considerable volume of possible applications of artificial intelligence (AI) in the ... more Background A considerable volume of possible applications of artificial intelligence (AI) in the field of rhinology exists, and research in the area is rapidly evolving. Objective This scoping review aims to provide a brief overview of all current literature on AI in the field of rhinology. Further, it aims to highlight gaps in the literature for future rhinology researchers. Methods OVID MEDLINE (1946-2022) and EMBASE (1974-2022) were searched from January 1, 2017 until May 14, 2022 to identify all relevant articles. The Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews checklist was used to guide the review. Results A total of 2420 results were identified of which 62 met the eligibility criteria. A further 17 articles were included through bibliography searching, for a total of 79 articles on AI in rhinology. Each year resulted in an increase in the number of publications, from 3 articles published in 2017 to 31 articles published in ...
BackgroundSinonasal epithelial malignancies are uncommon tumours but represent a challenge to tre... more BackgroundSinonasal epithelial malignancies are uncommon tumours but represent a challenge to treatment given their close proximity to the orbit, brain and cranial nerves. Traditional external surgical approaches have potential for significant functional and cosmetic morbidity. An endoscopic approach provides the surgeon with good access for tumour removal and enables surveillance postoperatively. This study aimed to assess outcomes of an endoscopic approach to sinonasal epithelial malignancy and evaluate factors that may influence its utility.MethodsA case series was performed involving consecutive patients treated with endoscopic or endoscopic‐assisted surgery for epithelial sinonasal malignancy. Stratification included TNM staging, histopathology, surgical approach, margin status, perineural involvement and adjuvant or neoadjuvant therapy. At follow‐up, complications, local control, nodal status and evidence of distant metastases were recorded. Statistical analyses to identify ri...
Background: Nasal endoscopy is increasingly accessible to ENT surgeons. The characteristics of th... more Background: Nasal endoscopy is increasingly accessible to ENT surgeons. The characteristics of the allergic upper airway are not well recognised. Methodology: MEDLINE (1946-2021), EMBASE (1974-2021), and the Cochrane Library were searched on 16th November 2021 to identify articles that reported endoscopic findings of patients with documented allergy who had undergone nasal endoscopy. The review followed the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. Meta-analysis was performed by pooling sensitivities and specificities using the hierarchical summary receiver operating characteristics model. Results: A total of 4108 articles were identified, of which 15 manuscripts met the inclusion criteria. The included studies involved 4660 patients who had undergone nasal endoscopy. Middle turbinate (diffuse/polypoid) oedema (sensitivity 58.0%, specificity 84.5%), watery secretions (sensitivity 65.7%, specificity 76.5%), inferior turbinate hypertrophy (sensitivity 86.2%...
International Forum of Allergy & Rhinology, 2021
1 Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New Sou... more 1 Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, Australia 2 Woolcock Institute, University of Sydney, Sydney, Australia 3 Faculty of Medicine, Notre Dame University, Sydney, Australia 4 Faculty of Medicine, University of Sydney, Sydney, Australia 5 Department of Otolaryngology, Head and Neck Surgery, Concord General HospitalUniversity of Sydney, Sydney, Australia 6 Department of Otolaryngology Head and Neck Surgery, Royal Prince Alfred Hospital, Sydney, Australia 7 Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
■ The medial and inferomedial part of the orbit as well as the orbital apex with the optic nerve ... more ■ The medial and inferomedial part of the orbit as well as the orbital apex with the optic nerve are easily accessible transnasally.
Operative Techniques in Otolaryngology-Head and Neck Surgery, 2006
... Richard Douglas MD, FRACS, FRACP, MRCP a and Peter-John Wormald MD, FRACS, FRCS, FCS(SA) Corr... more ... Richard Douglas MD, FRACS, FRACP, MRCP a and Peter-John Wormald MD, FRACS, FRCS, FCS(SA) Corresponding Author Contact Information , a , E-mail ... 1 SS Jaradeh, TL Smith and L.Torrico et al., Autonomic nervous system evaluation of patients with vasomotor rhinitis ...
Background:Silent sinus syndrome is characterised by spontaneous enophthalmos and hypoglobus, in ... more Background:Silent sinus syndrome is characterised by spontaneous enophthalmos and hypoglobus, in association with chronic atelectasis of the maxillary sinus, and in the absence of signs or symptoms of intrinsic sinonasal inflammatory disease. Traditionally, correction of the enophthalmos involved reconstruction of the orbital floor, which was performed simultaneously with sinus surgery. Recently, there has been increasing evidence to support the performance of uncinectomy and antrostomy alone, then orbital floor reconstruction as a second-stage procedure if needed.Methods:We performed a retrospective review of 23 cases of chronic maxillary atelectasis managed in our unit with endoscopic uncinectomy and antrostomy alone. All patients were operated upon by the same surgeon.Results:Twenty-two of the 23 patients had either complete or partial resolution. One patient had ongoing enophthalmos, and was considered for an orbital floor reconstruction as a second-stage procedure.Conclusion:Ou...
Otolaryngology-Head and Neck Surgery, Aug 23, 2013
Objectives:1) Validate a clinical staging system on disease “control” in chronic rhinosinusitis (... more Objectives:1) Validate a clinical staging system on disease “control” in chronic rhinosinusitis (CRS) proposed by the European Position Paper on Rhinosinusitis (EPOS) 2) Propose a new, data driven staging system.Methods:Prospective study over a 12‐month period of CRS patients who underwent endoscopic sinus surgery in tertiary care. The Sinonasal Outcome Test‐22 and endoscopy score along with patient's and physician's report on clinical progress were recorded at 6 and 12 months. Ordinal regression was used for modeling symptoms and endoscopic findings to build up “disease control” criteria. Patients were defined as either “controlled,” “partly controlled,” or “uncontrolled” according to both EPOS and proposed criteria. The agreements with physician's and patient's report were analyzed.Results:106 patients were assessed (49.1% female, age 49.0±13.9yrs). Nasal obstruction was the only symptom which predicted patient's report (maximum likelihood (ML) ‐3.6, P = 0.02). Mucosal inflammation (ML ‐2.4, P < 0.001) and thick and/or purulent discharge (ML‐2.5, P = 0.01) predicted physician's report. A new “NOSE” staging system of nasal obstruction, systemic medication used, and endoscopic inflammation was proposed. EPOS system had fair agreement (k 0.29, P < 0.001) with physician's and slight agreement (k 0.18, P = 0.01) with patient's report, while the NOSE system had better agreement with both physician's (k 0.40, P < 0.01) and patient's report (k 0.32, P < 0.01). Both systems predicted treatment outcome at 12 months (both, P < 0.05).Conclusions:The disease control assessment by EPOS staging system has slight agreement with patients and physicians. A new system using nasal obstruction, diseased mucosa, and discharge is proposed.
Topical corticosteroid is used as part of a comprehensive medical treatment for chronic rhinosinu... more Topical corticosteroid is used as part of a comprehensive medical treatment for chronic rhinosinusitis (CRS) without polyps. Nevertheless, there is insufficient evidence to show a clear overall benefit. Trials studying the efficacy of topical corticosteroid use various delivery methods in patients who have or have not had sinus surgery, which directly impacts on topical delivery and distribution. To assess the effects of topical steroid in patients with CRS without nasal polyps and perform a meta-analysis of symptom improvement data, including subgroup analysis by sinus surgery status and topical delivery 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 9 July 2010. All randomised trials in which a topically administered corticosteroid was compared with either a placebo, no treatment or alternative topically administered corticosteroid for the treatment of CRS without polyps in patients of any age. Two authors reviewed the search results and selected trials meeting the eligibility criteria, obtaining full texts and contacting authors where necessary. We documented our justification for the exclusion of studies. Two authors extracted data using a pre-determined standardised data form. Ten studies (590 patients) met the inclusion criteria. The trials were of low (six trials) and medium (four trials) risk of bias. The primary outcome was sino-nasal symptoms. When compared to placebo, topical steroid improved symptom scores (standardised mean difference -0.37; 95% confidence interval (CI) -0.60 to -0.13, P = 0.002; five trials, n = 286) and had a greater proportion of responders (risk ratio 1.69; 95% CI 1.21 to 2.37, P = 0.002; four trials, n = 263). With a limited number of studies, the subgroup analyses of patients who had received sinus surgery versus those who had not was not significant (P = 0.35). Subgroup analyses by topical delivery method revealed more benefit when steroid was administered directly to the sinuses than with simple nasal delivery (P = 0.04). There were no differences between groups for quality of life and adverse events. Topical steroid is a beneficial treatment for CRS without polyps and the adverse effects are minor. It may be included in a comprehensive treatment of CRS without polyps. Direct delivery of steroid to the sinuses may bring more beneficial effect. Further studies comparing different topical drug delivery methods to the sinuses, with appropriate treatment duration (longer than 12 weeks), are required.
Purpose of ReviewOsteitis is recognized as a common factor in recalcitrant chronic rhinosinusitis... more Purpose of ReviewOsteitis is recognized as a common factor in recalcitrant chronic rhinosinusitis (CRS). There is evidence for the association of osteitis with revision surgeries and CRS severity, in terms of higher Lund-Mackay scores. This is a narrative review on the osteitis in CRS patients.Recent FindingsEvidence to date is inconclusive with regard to the etiology and pathogenesis of this bony thickening. Histopathology of osteitis in primary CRS is likely a process of neo-osteogenesis and bone remodeling. For better understanding, various associating factors have been studied including an inflammatory pattern of rhinosinusitis. Recent studies have associated osteitis with nasal polyps and tissue eosinophilia with the increase in periostin expression and P-glycoprotein mucosal expression. There is no association of osteitis to symptoms or quality of life. Osteitis is an outcome of neo-osteogenesis rather than inflammatory processes in CRS patients without a prior history of surgery. While CT has become a staple in osteitis assessment, the standards for grading osteitic severity remain in an experimental stage. There is no association between the presence or severity of osteitis at the time of surgery and clinical outcomes at 1 year after surgery.SummaryThis review provides a comprehensive overview of the pathogenesis, epidemiology, and correlation with clinical and biological factors of osteitis in CRS patients.
Otolaryngology-Head and Neck Surgery, Dec 16, 2013
ObjectivesTo develop a chronic rhinosinusitis (CRS) disease control staging system that predicts ... more ObjectivesTo develop a chronic rhinosinusitis (CRS) disease control staging system that predicts patient and physician opinion. This involved exploring the predictive capacity of the proposed European Position Paper on Rhinosinusitis (EPOS) 2012 staging system and other potential scoring systems based on patient symptoms and objective criteria.Study DesignProspective study.SettingTertiary hospitals.Subjects and MethodsAdults CRS patients undergoing sinus surgery were prospectively enrolled from a tertiary clinic. The Sino‐Nasal Outcome Test 22, endoscopy score, and systemic medication were recorded at 6 and 12 months. A physician and patient report of their condition as either “controlled,”“partly controlled,” or “uncontrolled” was also recorded. Ordinal regression was used for modeling a staging system. The EPOS criteria and various combinations were assessed. Kappa agreements between the staging systems and patient/physician reports were analyzed.ResultsOne hundred six patients were assessed. Nasal obstruction (P =. 02), endoscopic mucosal inflammation (P <. 001), and thick and/or purulent discharge (P =. 01) associated with progress reports. A modified staging system of Nasal Obstruction, Systemic medication used, and Endoscopic inflammation (NOSE) was selected on predictive strengths. The EPOS and NOSE had significant agreement with physician's (k = 0.29, P <. 01, and k = 0.45, P <. 01) and patient's report (k = 0.18, P =. 01, and k = 0.32, P <. 01).ConclusionsThe disease control assessment by EPOS has slight agreement with patients and a physician. A simpler NOSE system using nasal obstruction, mucosa, and discharge is proposed.
Background Endoscopic sinus surgery with a middle meatal antrostomy is a common intervention in t... more Background Endoscopic sinus surgery with a middle meatal antrostomy is a common intervention in the treatment algorithm for maxillary sinus pathologies. However, this procedure has its origins in a time when simple ventilation of the sinus cavity was the primary (and only often) goal of surgery. In some patients, persistent mucociliary dysfunction occurs despite ventilatory surgery. Although the endoscopic modified medial maxillectomy (MMM) was originally described for tumour surgery, it provides a radical yet still functional option to overcome chronic sinus dysfunction. Objective The goal of this study was to describe the functional status of a post-MMM sinus cavity. Methods A consecutive series of patients who underwent at least a unilateral MMM by three tertiary rhinologists were retrospectively reviewed. Prospectively collected data included patient demographics (including age, gender, smoking status and comorbidities), disease-specific factors, microbiology, and preoperative p...
Journal of Neurological Surgery Part B: Skull Base
Objectives Sellar pathologies are frequently found on imaging performed to investigate headache. ... more Objectives Sellar pathologies are frequently found on imaging performed to investigate headache. However, both headache and incidental sellar lesions are common. Hence, this study prospectively examined headache prevalence, phenotype, and severity in patients with sellar pathologies and the impact of transsphenoidal surgery on headache. Methods Patients undergoing transsphenoidal resection of sellar lesions were consecutively recruited. At baseline, participants were defined as having headache or not and headache phenotype was characterized using validated questionnaires. Headache severity was assessed at baseline and 6 months postoperatively using the Headache Impact Test-6 (HIT-6) and Migraine Disability Assessment Score (MIDAS). Tumor characteristics were defined using radiological, histological, and endocrine factors. Primary outcomes included baseline headache prevalence and severity and headache severity change at 6 months postoperatively. Correlation between headache and radi...
Background A considerable volume of possible applications of artificial intelligence (AI) in the ... more Background A considerable volume of possible applications of artificial intelligence (AI) in the field of rhinology exists, and research in the area is rapidly evolving. Objective This scoping review aims to provide a brief overview of all current literature on AI in the field of rhinology. Further, it aims to highlight gaps in the literature for future rhinology researchers. Methods OVID MEDLINE (1946-2022) and EMBASE (1974-2022) were searched from January 1, 2017 until May 14, 2022 to identify all relevant articles. The Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews checklist was used to guide the review. Results A total of 2420 results were identified of which 62 met the eligibility criteria. A further 17 articles were included through bibliography searching, for a total of 79 articles on AI in rhinology. Each year resulted in an increase in the number of publications, from 3 articles published in 2017 to 31 articles published in ...
BackgroundSinonasal epithelial malignancies are uncommon tumours but represent a challenge to tre... more BackgroundSinonasal epithelial malignancies are uncommon tumours but represent a challenge to treatment given their close proximity to the orbit, brain and cranial nerves. Traditional external surgical approaches have potential for significant functional and cosmetic morbidity. An endoscopic approach provides the surgeon with good access for tumour removal and enables surveillance postoperatively. This study aimed to assess outcomes of an endoscopic approach to sinonasal epithelial malignancy and evaluate factors that may influence its utility.MethodsA case series was performed involving consecutive patients treated with endoscopic or endoscopic‐assisted surgery for epithelial sinonasal malignancy. Stratification included TNM staging, histopathology, surgical approach, margin status, perineural involvement and adjuvant or neoadjuvant therapy. At follow‐up, complications, local control, nodal status and evidence of distant metastases were recorded. Statistical analyses to identify ri...
Background: Nasal endoscopy is increasingly accessible to ENT surgeons. The characteristics of th... more Background: Nasal endoscopy is increasingly accessible to ENT surgeons. The characteristics of the allergic upper airway are not well recognised. Methodology: MEDLINE (1946-2021), EMBASE (1974-2021), and the Cochrane Library were searched on 16th November 2021 to identify articles that reported endoscopic findings of patients with documented allergy who had undergone nasal endoscopy. The review followed the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. Meta-analysis was performed by pooling sensitivities and specificities using the hierarchical summary receiver operating characteristics model. Results: A total of 4108 articles were identified, of which 15 manuscripts met the inclusion criteria. The included studies involved 4660 patients who had undergone nasal endoscopy. Middle turbinate (diffuse/polypoid) oedema (sensitivity 58.0%, specificity 84.5%), watery secretions (sensitivity 65.7%, specificity 76.5%), inferior turbinate hypertrophy (sensitivity 86.2%...
International Forum of Allergy & Rhinology, 2021
1 Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New Sou... more 1 Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, Australia 2 Woolcock Institute, University of Sydney, Sydney, Australia 3 Faculty of Medicine, Notre Dame University, Sydney, Australia 4 Faculty of Medicine, University of Sydney, Sydney, Australia 5 Department of Otolaryngology, Head and Neck Surgery, Concord General HospitalUniversity of Sydney, Sydney, Australia 6 Department of Otolaryngology Head and Neck Surgery, Royal Prince Alfred Hospital, Sydney, Australia 7 Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
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Papers by Raymond Sacks