Background: Sinonasal inverted papillomas (SNIPs) are benign epithelial growths with high recurrence rates after surgical management. This study aims to evaluate SNIP recurrence rates after endoscopic surgery and to provide a comparison of published staging systems. Methods: This chart review evaluated primary and revision SNIP cases from January 2008 to December 2016 at a tertiary sinus centre. Data was collected on patient demographics, origin site, surgical approaches, follow-up duration, recurrence, and smoking history. Each case was staged using Krouse, Oikawa, Cannady, Han, and Kamel systems. Results: 52 primary and 22 revision SNIP patients had a mean follow-up of 42.3 (range:3-55) months. 11 primary cases (21.1%) and 5 revision cases (22.7%) had recurrences. Primary and revision cases had a mean time to recurrence of 24.0 (range:3-55) and 14.6 (range:10-20) months respectively. Smoking history had an OR of 0.63 (CI 95%: 0.18-2.22) for recurrence. The age group of 20-39 years featured the highest rates of recurrence. Patient groups defined by each staging system were compared by Kaplan-Meier survival analyses and logrank tests. Chi-squared values for Krouse, Oikawa, Cannady, Han, and Kamel systems were 6.73 (p>0.05), 7.02 (p>0.05), 6.19 (p=0.045), 8.23 (p=0.042) and 3.29 (p>0.05) respectively. Conclusion: Recurrence rates found in this study are comparable to published literature. No statistical significance was found to associate smoking with recurrence. Han and Cannady staging systems were found to define patient groups that correlated well with recurrence. Staging systems should play a role in the management of SNIPs, especially to identify patients requiring additional post-surgical monitoring.

Polydioxanone could be used to achieve rigid repair of endoscopic skull base defects. These early results, although promising, require validation in clinical trials.

The analysis of results was limited to a systematic review and qualitative analysis of the eligible studies. Based on this systematic review we identified 8 studies reporting a statistically significant effect of pre-operative depression on post-operative pain and 10 studies reporting no statistically significant effect of pre-operative depression on post-operative pain. Therefore, the quality of presented data is poor and makes it challenging to answer further questions. Large epidemiologic studies in this field are needed to provide further evidence.

These findings suggest that there is a risk of adrenal suppression and raised IOP associated with the long-term use of topical nasal budesonide via MAD. Otolaryngologists should consider periodic surveillance for these adverse events in this patient cohort.

Following FESS, patients report less pain during removal of GM than Silastic spacers. However, the likelihood of synechiae and scarring did not differ between either of the spacers.

The use of nasal floor mucoperiosteal free grafts in endoscopic surgery offered the advantage of ease of harvest, coverage of large defects, and multiple applications of use, with minimal donor-site morbidity.

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Background Despite the well-appreciated variability in sphenoid sinus anatomy, there are no documented cases of retrosphenoid cells in the literature to date. Objective This study defines and determines the prevalence of retrosphenoid cells as identified on computed tomography (CT) imaging and intraoperative endoscopy and reviews the prevalence of other related anatomical variants of the sphenoid sinus. Methods Retrospective study of 300 random noncontrast sinus CT scans of patients with chronic rhinosinusitis presenting to a tertiary rhinology center. All identifiable anatomic variations and any presence of retrosphenoid cells and their pneumatization patterns were recorded. The prevalence of various anatomic variations of the sphenoid sinus was also calculated. Results A total of 300 sinus CT scans were included in the study. Protrusion of both the internal carotid artery (42.6%) and optic nerve (19.7%) into the sinus was more prevalent than the dehiscence of either one. A retrosphenoid cell was identified in 2% of CT scans. Other anatomic variants were less prevalent. Conclusion Meticulous review of preoperative imaging is key in identifying rare and complex sphenoid cell variations in planning surgical approaches and potential treatment strategies for the unusually pneumatized sphenoid air cells. Various manifestations of sinus disease can be localized to this area, and suspicion of a retrosphenoid cell should be raised in patients presenting with recalcitrant headache.