As 2023 draws to a close, several articles in this final issue of the year deserve special mention. A systematic review by Fong et al., in this month's issue of The Journal of Laryngology & Otology, evaluated the effectiveness and safety profile of probiotics in chronic rhinosinusitis.Reference Fong, Lim, Gnanam and Charn1 From 948 records screened, 4 randomised, controlled trials were included in their review (2 were analysed in the most recent European Position Paper on Rhinosinusitis – 2020 guidelines, plus an additional 2 trials), with a total of 318 chronic rhinosinusitis patients. A meta-analysis of pooled Sino-Nasal Outcome Test (SNOT) score outcomes showed no reduction in SNOT scores from the initial assessment to the study endpoints. This suggests that, from a patient symptom perspective, overall symptom reduction may be marginal or insignificant with probiotic use. However, when the SNOT subscale breakdown analysis was analysed, this appeared to show significant improvements in the sleep (5.5 per cent reduction; p = 0.02), psychological (4.0 per cent reduction; p = 0.03) and rhinological (5.0 per cent improvement; p = 0.03) symptom subscales. The authors call for future trials, to fully determine the utility of probiotics in chronic rhinosinusitis.Reference Fong, Lim, Gnanam and Charn1
The scientific literature appears to show that the prevalence of olfactory dysfunction as a result of coronavirus disease 2019 (Covid-19) infection has decreased over time, from over 50 per cent in the early pandemic waves, to 1–30 per cent in those with Covid-19 caused by the omicron variant.Reference Vaira, Lechien, Deiana, Salzano, Maglitto and Piombino2–Reference Fernandez, Molinari, Federici, Silvestri, De Corso and Presutti6 However, to date, no studies have assessed whether this lower prevalence corresponds to a lower frequency of persistent olfactory dysfunction. Vaira et al., in this month's issue of The Journal, evaluate the recovery of olfactory function at six months in individuals infected with the Covid-19 omicron variant, compared with healthy controls, using psychophysical tests.Reference Vaira, Boscolo-Rizzo, Lechien, Mayo-Yáñez, Petrocelli and Pistidda7 In this study, omicron variant infection was associated with a significantly lower persistent olfactory dysfunction rate than previous Covid-19 variants, and, at six months, the prevalence of olfactory dysfunction in infected patients did not differ significantly from that in the general population. It has been hypothesised that the omicron variant is less destructive to the olfactory neuroepithelium and less neuroinvasive.Reference Iravani, Malekpour, Rasekhi, Faramarzi, Soltaniesmaeili and Golkhar8 Moreover, high concentrations of nasal immunoglobulins (e.g. from prior vaccination and/or previous infection) are protective.
From a historical perspective, Agnelli and King research the history surrounding aural myiasis, with the earliest case being reported by Celsus in the first century.Reference Agnelli and King9
The Senior Editors would like to take this opportunity to thank all those who have contributed to this year's journal, including all the authors, Assistant Editors, reviewers, advisers, production staff, our publishing partners at Cambridge University Press and all other colleagues at The Journal. Finally, we wish all of our readers a happy and successful 2024.
