Nasal douche and spray is not effective in delivering a nasal irrigation solution into paranasal sinuses in chronic rhinosinusitis.

Objective: Surgical masks and N95 filtering facepiece respirators (FFRs) prevent the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and protect medical personnel. Increased demands for surgical masks and N95 FFRs during the Coronavirus disease 2019 (COVID-19) pandemic has resulted in the shortage crisis. However, there is no standard protocol for safe reuse of the N95 FFRs. This systematic review aims to evaluate the effectiveness of existing decontamination methods of surgical masks and N95 FFRs and provide evidence-based recommendations for selecting an appropriate decontamination method. Methods: Systematic searches of Ovid MEDLINE and Ovid EMBASE electronic databases were performed. The date of the last search was 11 April 2020. Any trials studying surgical masks and/or N95 FFRs decontamination were included. Outcomes were disinfections of virus and bacteria, restorations of the filtration efficiency and the physical structure of the masks. Results: Fifteen studies and fourteen decontamination methods were identified. Low level of evidence supported four decontamination methods, which were ultraviolet germicidal irradiation (9 studies), moist heat (5 studies), microwave generated steam (4 studies), and hydrogen peroxide vapor (4 studies). Therefore, recommendations as an ‘option’ were given to these four methods while ‘recommendation against’ was given to the other ten methods. Conclusions: Low level of evidence supported the use of ultraviolet germicidal irradiation, moist heat, microwave generated steam, and hydrogen peroxide vapor for decontamination and reuse of N95 FFRs. These decontamination methods were effective for virus and bacterial disinfection, and restoration of the filtration efficiency and the physical structure of the FFRs.

There was no statistically significant difference in the success rates of both groups, but MMC seems to have a conspicuous effect on the healing process at the ostium.

Dexmedetomidine is beneficial in providing good visibility during functional endoscopic sinus surgery. Controlled hypotensive anaesthesia with this medicine decreases intra-operative bleeding and enhances surgical field quality.

Buffered isotonic saline with some degree of alkalinity may improve nasal symptoms. Isotonic saline irrigations, regardless of alkalinity, may not improve mucociliary function and nasal patency. Buffered isotonic saline with mild alkalinity is the most preferred.

Background In perennial allergic rhinitis (PAR), the skin-prick test (SPT) is a good diagnostic tool to identify the specific allergens. A nasal provocation test (NPT) is used to identify allergens and to confirm the diagnosis. The aim of this study was to determine the optimal cutoff values of symptom and peak nasal inspiratory flow (PNIF) changes after dust-mite NPT for predicting PAR. We also studied the relationship of the changes of symptoms in NPT and the wheal size of SPT. Methods One hundred five patients with perennial rhinitis underwent the NPT to Dermatophagoides pteronyssinus and the SPT. The NPT was assessed by changes in symptoms and PNIF. The optimal cutoff values of the symptoms score and PNIF changes after the NPT for predicting the SPT were determined using a receiver operating characteristic (ROC) curve. The relationship of the wheal sizes of SPT and the changes from the NPT were analyzed. Results Forty-eight patients had a positive SPT to D. pteronyssinus, of whom 33 patients had a positive NPT by increases of the symptom score. Twenty patients had a positive NPT by decreases of PNIF. The area under the ROC curve was 0.85 for symptom score changes and it was 0.612 for PNIF changes. There was a significant correlation between the wheal size of the SPT and symptom changes in the NPT. Conclusion Nasal provocation is a valuable test to confirm the diagnosis of D. pteronyssinus allergy, especially when the wheal from the SPT is small. The symptom change after the house-dust mite NPT is better than the PNIF change for predicting the PAR.

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Although a statistical difference exists between racial groups, clinically, the orbital floor is a useful fixed anatomic landmark for ESBS for both Asian and white populations.