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Reducing readmission rates after transsphenoidal pituitary surgery

This retrospective study provides an outpatient care pathway to screen and manage delayed hyponatremia which the study identified as the primary cause of readmission following transsphenoidal pituitary surgery. Of the 303 patients who were studied, 27 were readmitted within 30...

The increasingly favourable outcomes from endoscopic endonasal approaches for the management of pituitary adenomas

Historically, pituitary tumours have been surgically managed with an open, transcranial approach. Although this approach still has its merits in large intracranial adenomas, technological advancement has allowed smaller tumours to be debulked via a transseptal microscopic technique. These days, the...

Surgery for hypopharyngeal obstruction causing OSA

Surgical treatments for OSA are evolving with improved diagnostic accuracy of the level(s) involved. Where the collapsing segment lies below the soft palate, a variety of surgical techniques to correct the affected segment(s) are emerging. This article concentrates on one...

Diagnosis of osteonecrosis of the jaw

Although the management of osteonecrosis of the jaw is usually provided by colleagues in maxillofacial surgery, it is essential for ENT surgeons to effectively diagnose the various presentations of this condition. Affected bone that is exposed and necrotic may remain...

Velopharyngeal insufficiency after adenotonsillectomy

The authors retrospectively reviewed the clinical records of 320 paediatric patients who underwent either tonsillectomy, adenoidectomy or adenotonsillectomy, under a single paediatric ENT surgeon. Patients with pre-existing velopharyngeal insufficiency (VPI) were excluded, as assessed by preoperative testing for nasal air...

Thalidomide in HHT

An interesting paper from a specialist centre in the Netherlands regarding the use of thalidomide in HHT patients. The St Antonius hospital has 1238 patients with HHT and 1% of these use thalidomide. The aim was to assess the benefits,...

Balloon compared to FESS – long-term patient satisfaction

Balloon compared to FESS – long-term patient satisfaction This paper is the first controlled study of balloon sinoplasty’s long-term efficacy, with a follow-up extending over five years. There were 208 patients analysed and 88 recruited. Exclusions were nasal polyps grade...

Puberty and rhinitis

While asthma and rhinitis are more common in boys compared to girls in childhood, whether this trend persists after puberty or not is not yet clear. Authors inspected the European Commission funded MeDALL (Mechanisms of the Development of ALLergy) to...

Inspiratory peak flow and tracheostomy

The evaluation of the degree of laryngeal obstruction to indicate a tracheostomy has always been a subjective decision. The authors correlated the visual laryngeal obstruction by flexible nasolaryngoscopy and the peak inspiratory flow using a pocket peak inspiratory flowmeter. Twenty-two...

Should all patients with BPPV have an MRI?

This paper describes an interesting series of 500 patients over a 10-year period with posterior canal BPPV, who had been investigated with MRI. The female to male ratio was 1.6:1 with a mean age of 56. There was a right...

Synchronous bilateral tonsil cancer

There is a long-standing debate regarding either unilateral or bilateral tonsillectomy for histological confirmation of tonsil cancer. Bilateral tonsillectomy is the standard of care in Denmark for proven or suspected tonsil carcinoma, and in the diagnostic work-up of the unknown...

Useful algorithm to manage adults with branchial cysts

Managing a solitary cystic lateral neck mass, specifically differentiating between a simple second branchial cyst and a metastatic cyst poses a challenge. Often the diagnosis only becomes apparent on the final histology. This paper analysed 28 adults that presented to...