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Functional Endoscopic Sinus Surgery (FESS) - Part 2

In the first of this two-part series, Martyn Barnes and colleagues discussed indications for functional endoscopic sinus surgery (FESS), the surgical objectives and techniques, patient expectations and the risks of surgery [1]. In this second and final part, the authors...

Dupilumab prospective RCT for CRSwNP, a multinational trial of 60 patients with a 16-week CT follow-up

This transcontinental work describes a randomised, double blind, placebo controlled parallel group study over a 16-week period, assessing 60 patients with CRSwNP by CT scan scores. All patients had a four-week period of intranasal corticosteroids followed by randomisation to add...

Can diet alone be used to treat laryngopharyngeal reflux?

In this crossover observational study, a low-fat, low-quick-release sugar, high-protein, alkaline, and plant-based diet was investigated as a single treatment for laryngopharyngeal reflux (LPR). Authors recruited 50 participants with demonstrated LPR on hypopharyngeal-oesophageal multichannel intraluminal impedance-pH-monitoring (HEMII-pH), off acid suppressive...

Laryngology: past, present and future

Two laryngological authorities trace the history of laryngology, from ancient Rome to the modern day. The structure of the vocal folds was a matter of conjecture until the renaissance when anatomists such as Andreas Vesalius and Julius Casserius demonstrated the...

Review of surgical treatments of intractable Meniere’s disease

This is a nice summary of the evidence available for the surgical treatments for intractable Meniere’s disease. To summarise, in five-10 years, over 90% of vestibular neurectomy cases, more than 80% of intratympanic gentamycin treatment, and 70-80% of endolymphatic sac...

Budesonide irrigation in polyposis

It is very well known through many RCTs and now meta-analyses that saline-based irrigation is beneficial in patients after sinus surgery. It is also demonstrated that intranasal steroids are beneficial postoperatively but there is also a trend for steroid based...

Location, location, location: How to get the steroid where you need it, in chronic rhinosinusitis

What almost all current guidelines on chronic rhinosinusitis have in common is the importance of intranasal steroid (INCS) use. However, it is increasingly understood that the efficacy of INCS depends on their efficient delivery to the point of need, i.e....

Still not smelling

Post-Covid anosmia/hyposmia is a troublesome persistent symptom for lots of patients. Management is still elusive. This was a nationwide survey of ENT practitioners. Of the 715 surveyed members, only 7.4% responded. Most performed a nasal endoscopy, 60% ordered an MRI...

Factor favouring the need for revision FESS in chronic sinusitis with polyps – a multivariate analysis including phenotypes

Chronic rhinosinusitis with polyposis is a type 2 inflammation with risks of recurrence and need for revision operations. This is known to depend on the endotype and phenotype factors. This is a retrospective study of 212 patients. Of these, 112...

Minimally invasive techniques for benign salivary gland obstruction

Salivary gland obstruction is a common condition – it is recognised by a complaint of intermittent meal-time swelling of the affected salivary gland and can be accompanied by recurrent infections. Imaging can identify the nature and location of an obstruction...

Intratympanic treatments for subjective idiopathic tinnitus

Direct application of medication into the ear is long established, going back as far as written records. In the modern era, greater understanding of aural anatomy revealed that drugs instilled in the middle ear could potentially diffuse into the cochlea...

Endoscopic airway interventions in children

Open surgery for paediatric airway pathologies such as subglottic stenosis was hailed as revolutionary when many of today’s paediatric ORL specialists were in training. Equipment, facilities and training has moved on and the high-quality optics in modern endoscopes, coupled with...