Exostoses of the paranasal sinuses.

While bony exostoses of the external auditory canal have long been recognized as a complication of cold-water swimming, bony exostoses of the paranasal sinuses have not been previously reported. We present an unusual case of multiple exostoses of the paranasal sinuses, which began coincident with nasal irrigation with cold gentamicin solution. The patient had had prior endoscopic sinus surgery. Topical antibiotic gentamicin irrigation lessened recurrence of bacterial sinus episodes. He admitted to using the irrigation directly from the refrigerator daily for two years. A biopsy was consistent with exostosis. Patients should be counseled to avoid irrigating their paranasal sinuses with cold irrigants. Laryngoscope, 2010.

The role of food allergy in otolaryngology disorders.

PURPOSE OF REVIEW: Food allergy is often an unrecognized clinical entity that has been implicated as a cause in many types of chronic inflammatory conditions. This review serves to provide an update on how food allergy plays a role in otolaryngology disorders. RECENT FINDINGS: The incidence of food allergy has been on the rise over the last decade. Currently, about 6% of children and 3-4% of adults are thought to be affected by food allergy. The middle and inner ear are immunologically responsive and this includes responsiveness to food hypersenstivities. Both chronic otitis media with effusion and Meniere's disease can improve with treatment of food allergies. Some evidence supports a link between rhinitis and nasal polyps and food allergies. Finally, there is increasing literature about eosinophilic esophagitis, which is a relatively newly recognized disease with many otolaryngologic associations. Many of these patients may have food allergy, and treatment of their food allergy may be effective in treating the disease. SUMMARY: In chronic inflammatory disorders of the head and neck, especially those involving the upper aerodigestive tract, food allergy must be considered in the differential. Patients with food allergy often do not respond to conventional treatments, and it can often be a challenge to arrive at the proper diagnosis. Further research is warranted to improve our understanding of the role of food allergy in otolaryngology disorders, as well as our diagnostic and treatment methods.

The use of porous polyethylene implants to correct nasal valve collapse.

OBJECTIVE: To evaluate the long-term outcome of correction of nasal valve collapse with a porous polyethylene implant. STUDY DESIGN AND SETTING: Retrospective review from November 1999 to December 2005. Nasal valve collapse was corrected with a porous polyethylene implant in 12 adults. Main outcome measures included relief of nasal obstruction and complications. Independent variables included other causes of nasal obstruction and need for revision surgery. Simple statistical analysis was performed. RESULTS: Median follow-up was 5.6 years (58 months). 75% had complete resolution of nasal obstruction. 100% had complete resolution of nasal obstruction at 6 months and had coexisting causes of nasal obstruction. The implant extrusion rate was 21%. 42% went on to have revision surgery. CONCLUSION: Correction of nasal valve collapse with a porous polyethylene implant provided good long-term symptomatic relief of nasal obstruction, but with significant incidence of infection, implant extrusion, and need for revision surgery. The use of this implant should be reserved for cases in which autogenous graft material is not available.