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Adult Rhinosinusitis Clinical Practice Guideline update
This is a summary of the ‘Clinical Practice Guideline: Adult Sinusitis’ from the American Academy of Otolaryngology-Head and Neck Surgery Foundation. This is an update of the 2015 version. Evidenc-based statements: 1a. Differential diagnosis of acute rhinosinusitis: Clinicians should distinguish...
Risk of malignancy in non-diagnostic thyroid FNACs
Thyroid nodules are present in between 21-68% of the general population. The evaluation of these nodules to exclude thyroid carcinoma includes fine-needle aspiration cytology (FNAC) and a non-diagnostic cytology result occurs between 8-20% of the time. This retrospective cohort study...
Salivary pepsin – a simple test for LPR?
A diagnosis of laryngopharyngeal reflux (LPR) can be made on the basis of characteristic symptoms and nasendoscopy findings. Objective tests exist for this condition; for example, 24-hour dual-channel pH-metry which is considered to be the gold standard. Such tests are,...
Videofluoroscopic swallowing studies: balancing risks and benefits
Videofluoroscopic swallow studies (VFSS) are an important part of the diagnostic toolkit and arguably the current gold-standard for assessing swallow biomechanics and diagnosing dysphagia. However, the procedure does involve exposure to radiation, and any clinician requesting this should be able...Recalcitrant chronic rhinosinusitis: What to do next?
Whilst the majority of patients with chronic rhinosinusitis (CRS) will significantly improve with treatment, we are sometimes left with a ‘hard-core’ of nasal cripples who fail to improve despite our best efforts. How can we deal with these patients? Valerie...Developments in diagnostic approaches for acutely dizzy patients
The acutely dizzy patient can be a diagnostic and management dilemma for emergency departments and general practitioners, with many patients consequently having delayed access to specialised assessment and treatment. David Jay tells us about HINTS, a bedside test that can...
Elevated intracranial pressure versus migraines versus sinusitis?
This narrative review discusses the challenges faced by an otolaryngologist to differentiate elevated intracranial pressure (eICP), migraines and chronic rhinosinusitis (CRS). Facial pain, pressure, aural fullness, muffled hearing and tinnitus are often common symptoms described by patients with all three...
Laryngeal disorders associated with HIV infection
Following the introduction, and now widespread availability, of combined antiretroviral therapy, HIV has become a chronic disease with minimal or indeed no negative impact on life expectancy. As a result, there is a growing public health interest in establishing the...In conversation with De Wet Swanepoel
A revolutionary new otoscope is using artificial intelligence to dramatically improve access to ear and hearing care in South African outreach communities. Carolina Leal, spoke to Professor De Wet Swanepoel of the University of Pretoria about how his team developed...The hearScope
A revolutionary new otoscope is using artificial intelligence to dramatically improve access to ear and hearing care in South African outreach communities. Carolina Leal, spoke to Professor De Wet Swanepoel of the University of Pretoria about how his team developed...Decreased sound tolerance in autism: understanding and distinguishing between hyperacusis, misophonia, and phonophobia
Decreased sound tolerance (DST) affects a significant proportion of autistic people throughout their lifetime and, as Zachary J Williams explains, it is important that clinicians are aware of the three distinct subtypes of DST when making a diagnosis. Autism spectrum...
