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Contemporary Rhinology: Science and Practice
Andrew C. Swift Sean Carrie Christopher de Souza
Editors
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Andrew C. Swift • Sean Carrie
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Christopher deSouza
Editors
Contemporary Rhinology: Science and Practice
Editors
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Andrew C. Swift Liverpool Head and Neck Centre Liverpool University Hospitals Foundation Trust Liverpool, UK
Christopher deSouza Department of Otolaryngology Tata Memorial Hospital Mumbai, Maharashtra, India
Sean Carrie Otolaryngology Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne, UK
ISBN 978-3-031-28689-6 ISBN 978-3-031-28690-2 (eBook)
https://doi.org/10.1007/978-3-031-28690-2
© Editors 2023 This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microlms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specic statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Foreword
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Since the 1980s, rhinology has genuinely experienced its “Golden Age” with the advent of new diagnostic techniques, medical treatments, and surgical approaches. This has been underpinned by an increasing understanding of the anatomy, physiology, and pathophysiology of the respective conditions and an appreciation of the interplay of the nose and sinuses with the lower respi­ratory tract and the rest of the body. Furthermore, rhinology has embraced the application of an evidence-based approach with an exponential rise in ran­domized controlled trials and prospective cohorts, enabling individualized precision medicine and surgery.
This book offers not only a contemporary approach to rhinology but also one which is comprehensive. It covers both the scientic aspects of the spe­ciality but also provides clear practical advice on clinical management in both adults and children. It is, therefore, of use to a broad constituency of readers and practitioners from the motivated medical student, through the ENT trainee, interested primary care physician, to the general otorhinolaryngolo­gist and tertiary care rhinologist. It is increasingly recognized that optimum management of many rhinologic conditions, such as recalcitrant allergic rhi­nitis or chronic rhinosinusitis, sinonasal neoplasia, and rarities such as vascu­litis and hereditary hemorrhagic telangiectasia, is ideally undertaken by multidisciplinary teams that provide the widest range of expertise and great­est benet to patients and clinicians alike. Similar synergies exist at the sino­orbital interface and skull base. All of these topics are addressed in this book, so there are also allergists, immunologists, pulmonologists, oncologists, oph­thalmologists, neurosurgeons, gastroenterologists, and rheumatologists among many others who would nd the contents of this book of value.
In commissioning this book, the editors have spread their net widely to include an array of experts from many countries and subspeciality interests so the advice represents a distillation of up-to-date information, irrespective of the healthcare system.
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It is happenstance to be in the right place at the right time and that is cer­tainly true for those of us with an interest in the nose and sinuses in recent decades. However, one should recognize that it is more important to know how to take advantage of being in the right place at the right time, and this book facilitates that aspiration.
ProfessorValerieJ.Lund,CBE
Royal National Ear, Nose and Throat
and Eastman Dental Hospital, UCLH
London, UK
Foreword
Preface
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A complete understanding of the nose, paranasal sinuses, and the respiratory tract is best regarded as a work in progress and a subject that is constantly developing. Whilst the ongoing pandemic was a major setback, it also pro­vided opportunities for discovery and became an important landmark in rhi­nological and olfactory knowledge. We have used this to our advantage and included the newly learnt knowledge about the SARS-CoV-2 coronavirus within this book.
Medical technology and computing have continued to rapidly improve, enabling high-quality imaging and visualization of previously obscured structures to be seen with outstanding clarity.
In parallel with this, our understanding of the basic science, the physiol­ogy, and medical disorders of the nasal and paranasal passages greatly improved, facilitating better understanding of treatment strategies and modal­ities that led to better patient outcomes.
From the historical perspective, the eld of rhinology has gained much scientic acclaim. In the 1970s and 1980s, studies on mucociliary ow, insti­gated by Professor Walter Messerklinger and aided by Heinz Stammberger, underpinned a novel concept of surgical techniques for the nose and sinuses, leading to the term “Functional Endoscopic Sinus Surgery (FESS).” This term has stood the test of time but is now used loosely to describe any mini­mally invasive sinus surgery, even when extensive resection is performed.
The year 2004 marks a landmark event, when Linda Buck and Richard Axel were awarded the Nobel Prize for their work on olfaction. The SARS­CoV- 2 virus subsequently led to a huge expansion in olfactory research and a whole wealth of new information.
The heightened prole of rhinology has led to a whole new generation of endoscopic sinus surgeons, who have been at the forefront of a dramatic expansion in the scale and scope of various endoscopic techniques. Surgical procedures that were once considered “challenging and fraught with danger” are now rendered as routine operations. This advance has been achieved by certain more serious procedures being focused in specialist centers dedicated to controlling risk and minimizing complications, leading to improved patient outcomes.
The net effect of the above changes has been to place rhinology at the forefront of surgery. This incredible journey began with the development of the rigid endoscope, alongside dedicated CT and MRI imaging techniques. We can only wonder as to what other advancements lie on the horizon, how
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these will affect our current management protocols and the outcomes for the wide range of rhinological disorders.
We, the editors, are immensely grateful to our contributory authors, who are all experts within their elds. Each author has produced a state-of-the-art, extremely valuable contribution, each taking many hours of planning, research, development, and writing. We thank each and every one of the authors for their commitment and support.
We hope the readers of this book will be lled with awe and wonder at the extreme complexity of the nose and the paranasal sinuses. We also hope that this will lead to an unending desire to study this fascinating, complex, and specialist organ that continues to surprise us all. We would strongly encour­age our younger colleagues to develop an interest into the art and science of the diseases of the nose, and hope that this book will be the catalyst for this dedicated journey.
Liverpool, UK AndrewC.Swift Newcastle, UK SeanCarrie Mumbai, Maharashtra, India Christopherde Souza
Preface
Contents
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Section I The Basic Science of Rhinology: Understanding
the Nose and Sinuses
1 Embryology of the Nose and Paranasal Sinuses . . . . . . . . . . . . . 3
Daniel W. Scholeld and Neil Cheng-Wen Tan
2 Applied Anatomy of the Nose and Sinuses . . . . . . . . . . . . . . . . . . 13
Rajiv K. Bhalla
3 Physiology: Nasal Airflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Giancarlo Ottaviano
4 Physiology of the Nose and Paranasal Sinuses:
Mucociliary Clearance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Mikkel C. Alanin and Christian von Buchwald
5 Immunology of the Nose and Paranasal Sinuses . . . . . . . . . . . . . 51
Stephen Ball and Richard Douglas
6 Allergy and the Nose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Cecilia Ahlström Emanuelsson and Nick Makwana
7 Genetics and Disorders of the Nose and Sinuses . . . . . . . . . . . . . 81
Emily Anderson and Victoria McKay
8 The Current Concepts of Biofilms and Superantigens . . . . . . . . 91
Sarah Vreugde and Peter-John Wormald
9 Bacteria, Viruses and Fungi in Healthy
and Diseased Paranasal Sinuses . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Tary Yin and Raymond Kim
10 Sleep Disorders and the Nose: What Is the Evidence Base? . . . . 117
Thomas Verse and Stefan Müller
11 The Nose and the Effects of SARS- CoV- 2 Pandemic . . . . . . . . . . 127
Carl Philpott
Section II The Assessment of the Nose and Sinuses
12 Clinical Assessment of the Nose and Olfaction . . . . . . . . . . . . . . . 141
Nirmal Kumar and John Rocke
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13 Outcome Metrics and Measurement Tools for Rhinological
Treatment Modalities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Joanne Rimmer
14 Radiological Imaging in Rhinology . . . . . . . . . . . . . . . . . . . . . . . . 159
Andrew S. McQueen and Joanna K. Dixon
Section III Paediatric Sinonasal Disorders
15 Congenital Sinonasal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Grace C Khong and Raymond W. Clarke
16 Paediatric Rhinosinusitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
Peter George Deutsch and Ann-Louise McDermott
17 Paediatric Nasal Masses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Michelle Wyatt and Claire Frauenfelder
18 Paediatric Nasal Deformity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
Claire Marie McLarnon
Section IV Inammatory Sinus Disorders
19 Non-allergic Rhinitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
Wout Backaert and Laura Van Gerven
Contents
20 Allergic Rhinitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
Quentin Gardiner
21 Current Scientific Understanding of Rhinosinusitis . . . . . . . . . . 267
Sietze Reitsma and Wytske J. Fokkens
22 New Innovations and Treatments
for Chronic Rhinosinusitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277
Wytske J. Fokkens and Sietze Reitsma
23 Clinical Assessment and Management
of Acute Rhinosinusitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Stephen R. Ell and Richard Wei Chern Gan
24 Clinical Assessment and Management of CRSsNP . . . . . . . . . . . 301
Sietze Reitsma
25 Clinical Assessment and Management of Chronic
Rhinosinusitis with Nasal Polyposis . . . . . . . . . . . . . . . . . . . . . . . 309
Claire Hopkins and Jo-Lyn McKenzie
26 Primary Atrophic Rhinitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321
Isma Z. Iqbal
27 Fungal Sinus Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327
Christopher de Souza, Aishan Patil, Anish Patil, and Rosemarie de Souza