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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...
Vitamin C, a possible remedy for seasickness?
The internet is full of devices and medicines vying for superiority over which one is the best for preventing seasickness. This study was based on the following observations: elevated histamine levels trigger seasickness; blockade on histidine decarboxylase prevents seasickness while...
Chronic phase of concussion and stability of gaze
It has been known that vestibular symptoms can persist for several months after concussion. The authors designed this study to assess the effect of chronic concussion (more than one year) on gaze stability and the relationship between deficits in gaze...
Persistent imbalance after traumatic brain injury is central in origin
Several residual symptoms, including dizziness and imbalance, can follow traumatic brain injury, no matter how mild. This study focused on the mechanisms, peripheral and central, underlying the complaint of persistent imbalance in patients with chronic mild traumatic brain injury (mTBI)....
Neuro-Ophthalmology and Neuro-Otology: A Case-Based Guide for Clinicians and Scientists
As Daniel Gold points out in his preface, the idea for this title was borne from the observation that, despite the considerable overlap between the fields of neuro-ophthalmology and vestibular neurology, there is no single text that marries these two...
Chronic rhinosinusitis update
There is still a lack of awareness of chronic rhinosinusitis (CRS) despite its burden, calling for events such as the recent Global Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) Awareness Day. Research findings from recent publications by Backaert et al have...Endolymphatic sac surgery: controversial procedure for the treatment of Ménière’s disease
Landmark Paper: Thomsen J, Bretlau P, Tos M, Johnsen NJ. Ménière’s disease: endolymphatic sac decompression compared with sham (placebo) decompression. Ann N Y Acad Sci 1981;374:820-30. Of all of the chapters in the Landmark Papers book, the chapter that discussed...
Associated findings in MRI used for detecting acoustic neuroma
Presently, gadolinium enhanced magnetic resonance imaging is the ‘gold standard’ for investigating acoustic neuroma. There are often ‘incidental’ findings that may or may not be significant. In this study of 109 scans, the authors noted an uptake of 0.9% for...
Prostaglandin versus leukotriene receptor-antagonists in treatment of seasonal allergic rhinitis RCT phase II
Seasonal allergic rhinitis is very common. Failure to control the disease with mono-therapy leads to dual therapy treatment with less compliance and reduced quality of life. A prostaglandin receptor antagonist (ONO-4053) showed some efficacy in controlling allergic rhinitis in animal...
Time to endoscopic sinus surgery and outcomes
A well written prospective study, which demonstrates that patients who require endoscopic sinus surgery, should be operated on without long delay since this achieves better and more sustained outcomes. There were 1493 patients undergoing primary nasal surgery who had completed...
Should we be doing earlier MRIs in sudden sensorineural hearing loss?
There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....
