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Silent sinus syndrome: which approach offers the best outcome?
Silent sinus syndrome (SSS) is a rare condition with patients presenting as spontaneous, painless enophthalmos, hypoglobus, orbital asymmetry, and maxillary sinus collapse on the ipsilateral side. The orbital resorption occurs secondary to negative pressure created in the maxillary sinus by...
Rhinotillexomania - how bad can nose picking get?
This is a fascinating first case report of rhinotillexomania associated with empty nose syndrome (ENS). Rhinotillexomania encompasses compulsive, pathological nose picking and is a variant of self-harm. Tranchito and Chhabra describe an elderly patient presenting with longstanding symptoms of nasal...
COVID-19 and medical practice
The pandemic has deeply affected all types of medical and surgical practice and even publications. In this issue, the lead article was on the French consensus on ENT practice during the pandemic. In ENT practice, both patients and health workers...
Vestibular migraine or BPPV?
There are close similarities between benign paroxysmal positional vertigo (BPPV) and vestibular migraine (VM) as both can be presented by positional nystagmus. Though BPPV remains the commonest cause of pure positional vertigo, VM can mimic this condition. This study is...
Laryngopharyngeal reflux - would mucolytics help?
With laryngopharyngeal reflux (LPR) being such a common presenting complaint to ENT clinics, who would not want to have more, effective treatment options for patients suffering with this annoying condition? In their small randomised, controlled trial, Chae et al put...
Multiple surgeries for RRP – does a greater number of operations result in a worse voice outcome?
Recurrent respiratory papillomatosis (RRP) of the larynx remains a challenging condition to treat, with a number of affected patients requiring multiple operations to remove recurrent disease over the course of their lifetime. At the most severe end of the spectrum,...
Combination PPI and intralesional steroid treatment for recurrent laryngeal granuloma
The existence of a wide range of treatments for recurrent laryngeal granulomas (repeat surgery, high-dose proton pump inhibitor (PPIs), surgery with botulinum toxin injection, botulinum toxin injection alone, etc) is a testament to the refractory nature of this condition, with...
Argon plasma coagulation for epistaxis in HHT
In this study from the Czech Republic, the authors looked at the effectiveness of argon plasma coagulation (a non-contact form of monopolar electrocoagulation) in treating recurrent epistaxis in patients with hereditary haemorrhagic telangiectasia (HHT). The advantage of argon plasma coagulation...
Does endoscopic sinus surgery for chronic rhinosinusitis improve COPD?
Chronic rhinosinusitis (CRS) can be associated with asthma, with a reported frequency of asthma in patients with CRS of up to 44%. COPD is another lung condition that can be associated with CRS. This longitudinal study reviewed the nasal and...
Does pollution worsen inflammatory nasal problems?
This ambitious study, conducted over a period of four years, assessed 27,863 patients and compared levels of allergic rhinitis (AR) or chronic rhinosinusitis (CRS) with the levels of air pollution recorded, as assessed by levels of particulate matter (PM10). They...
Which surgical procedure is more effective in treating OSA? Tonsillectomy or modified uvulopalatopharyngoplasty?
Obstructive sleep apnoea (OSA) is a recognised condition that is increasing in prevalence, affecting the quality of life in certain individuals. Although the first line management is non-surgical, this paper highlights the two different surgical procedures offered to patients. The...
