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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...

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]....

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...

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...

The MACRO Trial: defining best management of chronic rhinosinusitis

A major UK trial in The Lancet finds ESS provides greater symptom relief than long-term macrolides for adults with CRS, supporting earlier surgery and fewer antibiotics. The MACRO Programme was established in 2016 when the UK National Institute of Health...

IL-25 and nasal polyps, another target

Immune response in chronic rhinosinusitis with nasal polyps (CRSwNP) is mainly via type 2 T-helper (Th2) cells while Th1 cells characterise chronic rhinosinusitis without nasal polyps (CRSsNP) immune response. CRSwNP is heterogeneous on a cytological level causing a varied response...

Recovery rates in sudden sensorineural hearing loss

Sudden sensorineural hearing loss (SSNHL) is most commonly idiopathic, and is seen relatively frequently in ENT practice. Recovery spans a period of around 1-2 months, and ultimate outcomes are highly variable, from complete recovery to no detectable hearing. Although the...

Allergen specific subcutaneous immunotherapy helps in prolonged control of allergic rhinitis

One of the commonest allergens involved in perennial allergic rhinitis is house dust mite. A good proportion of these cases prove intractable to treatment with oral and intranasal antihistamines and intranasal steroid sprays. Immunotherapy is considered a useful alternative and...

Effects of nasal sprays on ciliary function

What do topical nasal sprays do to the nasal mucosa in the long term? This study reports the effect of corticosteroids, antihistamines and common preservatives in nasal sprays, benzalkonium chloride (BKC) and potassium sorbate (PS), on an in-vitro model of...

Evidence and nasal polyp treatments

The change in the routine management of nasal polyps in the past 2-3 decades has been fascinating and this review from Charleston covers the topics of systemic treatment, local treatment, perioperative treatment and immunotherapy and touches on the lower airway...

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....