Significance of abnormal retropharyngeal nodes in head and neck cancer

Abnormal retropharyngeal lymph nodes (RLN) have prognostic relevance for patients with oral, oropharyngeal or nasopharyngeal squamous cell carcinoma (SCC). However, consensus on the evaluation and management of abnormal RLN in these patients is lacking. The authors of this paper provided...

Tramadol soaked nasal packs for post-septoplasty analgesia

Having had a septoplasty a number of years ago for the potential treatment of snoring, I was intrigued by this paper which compared the analgesic effect of tramadol-soaked and lignocaine-soaked nasal packs following septoplasty. In my practice, I have always...

Diagnostic criteria for haemodynamic orthostatic dizziness

Over the past several years, the Bárány Society has been developing an International Classification of Vestibular Disorders (ICVD) in order to standardise diagnosis and nomenclature for both clinical and research purposes. Many in vestibular practice would be familiar with the...

The debate: endoscopic vs microscopic ear surgery – meta-analysis of outcomes

Although the endoscopic approach to ear surgery has become more common in clinical practice, the debate about its role versus the traditional microscopic approach continues in many ENT units. This meta-analysis from the Mount Sinai ENT department in New York...

Outcomes of temporal bone-resurfacing for pulsatile tinnitus associated with vascular wall anomalies

This month’s Ed’s choice is an interesting systematic review into the management of pulsatile tinnitus. There are impressive results from resurfacing of symptomatic anatomical abnormalities of the temporal bone and I suspect that referrals for further imaging and otology clinic...

Peripheral nerve stimulation for chronic refractory pain

Peripheral nerve stimulation (PNS) plays an important role in treating chronic refractory pain syndromes that manifest in limited distributions and overlap with areas of neurologic innervation. The process is generally thought to capitalise on the inhibition and activation of pain-related...

Sphenopalatine ganglion block in endoscopic sinus surgery reduces intra and post-operative morbidity

The authors present results of a meta-analysis to investigate the role of sphenopalatine ganglion block (SPGB) in reducing postoperative pain in endoscopic sinus surgery (ESS). An electronic database search (Pubmed, SCOPUS, Google Scholar, Embase, and the Cochrane Register of Controlled...

Cocaine detection hours after FESS

This is a very interesting article from Australia regarding the bioavailability of cocaine following atomised application prior to endoscopic sinus surgery. The well-established practice of preparing the nasal mucosa for sinus surgery involves the placement of a usually modified Moffett’s...

Nasal physiology and septal perforations

This interesting article from North Carolina and New York aims to assess the impact of anterior septal perforations on nasal physiology, using computational fluid dynamics and computer simulation. A computerised 3D model was constructed of a normal patient aged 37,...

Death related to epistaxis

One of the commonest emergencies presenting in ENT is epistaxis. The presentation can be through accident and emergency or through ward referrals. In this national audit of epistaxis management involving 113 centres, it was noted that 33 of the 985...

Recovery room cortisol to predict long-term glucocorticoid supplementation

The authors report the results of using recovery room (RR) cortisol to predict the need for long-term glucocorticoids in patients who underwent transsphenoidal surgery (TSS). They conducted a retrospective study of preoperative morning serum cortisol (MSC), RR cortisol and day...

CRSwNP, another monoclonal antibody

Interleukins 4, 5 and 13 were shown to be important factors in type 2 inflammation, which characterises chronic rhinosinusitis with nasal polyposis (CRSwNP). In CRSwNP non-responders and those who recur short after-surgery monoclonal antibodies might be an answer. Examples include...