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Persistent dysphonia due to cricothyroid muscle dystonia – should we be requesting laryngeal EMGs for non-resolving ‘functional’ dysphonia?
This article is an interesting report of a case of persistent voice problems affecting a 43-year-old physician that significantly compromised her ability to converse and communicate at work. Specifically, she had a fluctuating voice quality that would ‘choke off’, combined...
Patient reported outcomes improve if antibiotic choice is directed from endoscopic culture results in chronic rhinosinusitis
The use of antibiotics in chronic rhinosinusitis (CRS) has been established as part of the EPOS guidelines, as has the role of taking swabs for microbiology culture. There has not been much literature however on whether tailoring antibiotics in response...
When should we decompress the facial nerve in Bell’s Palsy?
It has been over three decades since Fisch popularised facial nerve (FN) decompression for Bell’s Palsy. Studies further exploring this have been few since, partly due to the major complications that can occur following this type of surgery. The current...
Is there a role for facial nerve decompression in Ramsay Hunt syndrome?
This is an interesting paper. The authors recommend a transmastoid facial decompression for patients with complete facial nerve paralysis with House Brackman HB 5/6 who do not show any sign of recovery after two weeks of treatment following a diagnosis...
The hippo and the nose
Chronic rhinosinusitis with nasal polyps (CRSwNP) leads to histological changes including thickening of the basilar membrane and epithelial proliferation. Molecular mechanisms underlying these changes are still not fully clear. A signalling pathway called the hippo with Yes‐associated protein (YAP) as...
What to do if adenotonsillectomy does not cure sleep apnoea in children?
This article reviews the management of children with persistent obstructive sleep apnoea (OSA) following adenotonsillectomy (AT). Risk factors for patients to have persistent disease include obesity, being Afro-Caribbean and existing co-morbidities such as craniofacial and neuromuscular disorders. Initial assessment of...
Are quinsies worth draining?
Recent data is providing accumulating evidence that treatment failure in the management of peritonsillar abscesses (PTAs, aka ‘quinsies’) is similar when these are managed with medical treatment (MT) alone versus MT plus surgical drainage (M+ST). However, in the absence of...
Management of patulous eustachian tube dysfunction
Idiopathic sudden sensorineural hearing loss (iSSNHL) is defined as a hearing loss of 30 dB or more at three contiguous frequencies within 72 hours, with acute low-tone hearing loss (ALHL) excluded from this category. Despite standard treatment, outcomes vary: one-third...
Hyoid bone interposition graft in treatment of laryngotracheal stenosis
Laryngotracheal stenosis remains a challenging condition to manage, with treatment options plagued by either high rates of recurrence or excessive morbidity. The authors describe two cases of adult laryngotracheal stenosis treated by a hyoid interposition composite graft. A two-step procedure...Surgical management of congenital nasal pyriform aperture stenosis
Introduction Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of neonatal upper airway obstruction which was first described by Douglas in 1952 [1]. The first radiological description of CNPAS was described by Ey et al in 1988 [2]....Adolescence, drug use and body image
Teenagers are notoriously conscious of how they are perceived by others. Dr Saraiva and colleagues explain how this can lead to problems with substance abuse for both boys and girls, and discuss the different substances they may encounter. Adolescence is...
