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Marco Aurelio Fornazieri3 , Renata Ribeiro de Mendonca Pilan4 , Fabio de Rezende Pinna5 , Francini Grecco de Melo Padua6 , Richard Louis Voegels7 1 MD, ENT, PhD student at Faculdade de Medicina da USP. 2 MD, FACS (Professor of the Department of Otolaryngology-Head and Neck Surgery, Division of Clinical Outcomes Research, Washington University School of Medicine, St. Louis, MO 63110, USA). 3 MD, ENT (Fellow in Rhinology at HCFMUSP). 4 MD, ENT, PhD student at Faculdade de Medicina da USP. 5 PhD (Assistant Physician at HCFMUSP). 6 PhD, MD, ENT. 7 Professor (Director of Rhinology at HCFMUSP Associate Professor at FMUSP). Faculdade de Medicina da Universidade de São Paulo. Send correspondence to: Rua Dr. Eneas de Carvalho Aguiar, 255/ 6o andar - 6167 - Cerqueira Cesar - São Paulo - SP. CEP: 05403-000. Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Paper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on June 11, 2011; and accepted on December 13, 2011. cod. 8121. Chronic rhinosinusitis is a disease of undefined etiology that significantly impacts the quality of life of its patients. Various studies carried out in countries other than Brazil have shown endoscopic sinus surgery as an effective means of treating this condition. Objective: This study aims to analyze, with the aid of SNOT-20, the association between endoscopic sinus surgery and disease-specific quality of life of Brazilian patients treated for chronic rhinosinusitis accompanied or not by nasal polyps. Materials and Methods: This prospective study enrolled patients submitted to endoscopic sinus surgery after drug therapy failed to improve their symptoms. They were assessed based on questionnaire SNOT-20p before and 12 months after surgery. Improvement on total scores and on the five items deemed more important by each patient were assessed. The study also looked into the correlation between preoperative scores and postoperative improvement and if there were any gender-related improvement differences. Results: Forty-three patients aged 44 (19), md (IQR), 65% of whom (26/43) were males. Statistically significant improvement was seen on SNOT-20 and SNOT-20(5+) and a correlation was established between preoperative scores and postoperative improved scores (p The future in Rhinology: from local treatment, to monoclonals and influencing the microbiome Over the last few decades, rhinology has been one of the most dynamic and progressive areas of ENT. We have not experienced such an intense period of development since the introduction of nasal corticosteroids in the 1970s. In this issue of our Journal, we report on the first Rhinology Future Debate organized by EUFOREA (European Forum for Research and Education in Allergy and Airways diseases) (1). For the first time in Rhinology, a peer to peer scientific exchange with key experts in the field of rhinology and key medical colleagues from leading industries let to a brainstorming and discussion event on a number of hot issues in Rhinology. Apart from this report in Rhinology, all the debates were recorded and distributed on-line (www.rhinology-future.com). The debate touched upon a number of hot issues like the improvements in local treatment in chronic rhinosinusitis (CRS), the development of biologicals for chronic rhinosinusitis with nasal polyps (CRSwNP), the role of balloons in sinus surgery in Europe, and the place of navigation in daily practice. In this way, EUFOREA aims at maximizing the education of the target groups on novel developments, allowing a critical appraisal of the future and a more rapid implementation of promising novel tools, techniques and/or molecules in clinical practise in Europe. These new developments and optimal information of practitioners and patients alike, combined with a precision approach to the patients and the disease (2), will significantly change our daily practice. In the near future, we can expect most of our patients to be treated effectively with high dose local corticosteroids (3-5), and if that is insufficient, with monoclonal antibodies (6,7). Surgery will only be needed for a limited group of patients. The decision to operate (again) can be difficult for patients and otorhinolaryngologists alike. CRS is a chronic inflammatory disease that usually cannot be solved by surgery alone. We explain our patients that the primary goal of the surgery is to open the sinuses and improve the access for local treatment and that nasal irrigations (8) and anti-inflammatory treatment after surgery is mandatory (9). Although we know certain symptoms, like smell (10) and postnasal drip are more difficult to treat than others like blockage (11) and sleep impairment (12,13), in recent years a number of studies have
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