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Experience on the front line

21st January 2021 Back to basics Yesterday I went right back to where my medical career began. I grew up in Germany, bilingual. A prerequisite to studying medicine in Germany is that applicants have to spend two months working as...

Retrograde cricopharyngeal dysfunction (RCPD) - inability to burp: treatment with Botox injection

As unusual as it may sound, some people have great difficulty burping. We hear of one approach to tackling this problem. Retrograde cricopharyngeal dysfunction (RCPD) is a condition presenting with inability to burp, resulting in gaseous distension of the digestive...

Cocaine detection hours after FESS

This is a very interesting article from Australia regarding the bioavailability of cocaine following atomised application prior to endoscopic sinus surgery. The well-established practice of preparing the nasal mucosa for sinus surgery involves the placement of a usually modified Moffett’s...

Does middle turbinate resection affect olfaction in endoscopic transsphenoidal surgery?

The middle turbinates (MT) are sometimes partially resected during endoscopic transnasal transsphenoidal pituitary surgery to improve surgical access. Some outfracture the middle turbinates instead. This article presents results of the first prospective randomised study, investigating the effects of such surgery...

Drug eluting stent vs INCS for CRS

A prospective, randomised study from Finland to compare a drug eluting stent (DES) and intranasal corticosteroids (INCS) in 63 patients as assessed by SNOT-22, VAS, endoscopy, CT and rhinometry pre-treatment, at three and six months post treatment. Recruitment was over...

Metformin, the magical solution!

Both noise-induced hearing loss (NIHL) and vestibular schwannomas (VSs) pose a challenge in terms of management. Metformin was suggested as a potential therapeutic drug for NIHL when the drug-target interaction data was investigated. Additionally, there are studies which demonstrate reduction...

Managing CRS in pregnancy

An International team of experts from both sides of the Atlantic set out to perform a systematic review of the management of chronic rhinosinusitis in pregnancy. Despite a thorough search no scientific evidence was found that could form the basis...

Asymmetrical hearing loss following prolonged occupational noise exposure

Noise-induced hearing loss (NIHL) is one of the commonest occupational conditions and has been linked with increased risk of work-related injuries. Noise-induced hearing loss is traditionally associated with bilateral symmetrical sensorineural hearing loss unless they are exposed to unilateral noises,...

Dental implant rehabilitation in fibula free flaps

The fibula free flap was first described in 1975 and since then has gone on to become the gold standard technique for reconstruction of longer spans in the mandible or maxilla. It is a reliable flap that affords good quality...

Type 2 diabetes and BPPV

Previous research has shown an association between BPPV and certain medical conditions such as hypertension, hyperlipidaemia and type 1 diabetes. The authors in this retrospective observational study investigated the interaction between BPPV and type 2 diabetes by examining the ‘role...

Functional Endoscopic Sinus Surgery (FESS) - Part 1

In the first of a two-part series, Martyn Barnes and colleagues discuss indications for functional endoscopic sinus surgery (FESS), the surgical objectives and techniques, patient expectations and the risks of surgery. In part two, the authors will discuss how to...

Staying safe during endoscopic ear surgery

There is growing interest in using rigid endoscopes rather than traditional operative microscopes to perform transcanal middle ear surgery. Rigid endoscopy provides a high resolution, wide-angle view of the tympanic cavity through minimally invasive surgical portals. In this article, Elliott...