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1683 results found

Surgery or medicine: when should we stop trying to be conservative?

Although most otolaryngologists would agree that surgery improves the outcomes of patients with CRS when medical treatment has failed, both Cochrane reviews state that there is no proof of improved efficacy of surgery over medicine – however, that was after...

FESS for recurrent acute rhinosinusitis: at last, some data

As noted in both the EPOS 2012 and in the (more recent) ICARS 2016, there is a paucity of evidence on the effectiveness of surgery for recurrent acute rhinosinusitis (RARS). The authors used a control group of patients with CRSsNP,...

Role of the insula and orbitofrontal cortex in tinnitus related distress

It is estimated that 5% of the population suffer from chronic tinnitus with 17% of those suffering emotional distress. The authors attempted to study the neural correlates of tinnitus-related distress using functional magnetic resonance imaging (fMRI) during an Emotional Stroop...

A review of endoscopic sinus surgery outcomes

This review discusses the outcome measures that may be considered in the assessment of patients with chronic rhinosinusitis (CRS) as well as the outcomes of endoscopic sinus surgery (ESS) published so far. The authors also discuss the role of peri-operative...

Classification and assessment of midfacial fractures; no more Le Fort facial fractures

There is some evidence that severe or complex midfacial or orbital fractures have declined over the last decade. Interestingly there is also evidence of an increase in road traffic accidents but a decrease in facial injuries. This is possibly attributed...

Changes in airway dimensions after orthognathic surgery

This is a systematic review of meta-analysis evaluating the effect of different types of orthognathic surgery on the cross sectional area and volume of the upper airway as assessed using CT or MRI. They found 28 articles of which only...

Paediatric lymphadenopathy – helpful decision making

The authors present a very helpful algorithm to manage cervical lymphadenopathy in children. The goal of managing children with inflamed lymph glands is to identify the rare malignant case and not over-investigate the vast majority of benign reactive swellings –...

How best to manage single-sided deafness?

Nowadays there is a plethora of options for patients with single-sided deafness (SSD) including: Bluetooth contralateral routing of signal (CROS) aids; in-the-ear bone conduction hearing aids (TransEar); intra-oral bone conduction aids (SoundBite) and bone-anchored technologies (BAHA). Unilateral cochlear implantation is...

Long-term outcomes after (adeno) tonsillectomy

Patient-reported outcome measures (PROMs) are used increasingly to fill an ‘evidence gap’ where healthcare rationing threatens particular treatments. Tonsillectomy is a long-established and effective treatment for recurrent tonsillitis and obstructive sleep apnoea (OSA) in children. The T-14 outcome measure examines...

No difference upper or lower lip

This is a retrospective review from the Netherlands over a 20-year period to 2009 of squamous cell carcinoma (SCC) of the lip. In total, 979 cases of the lower lip were identified and 126 of the upper lip, with men...

Benefits of combined antiviral and corticosteroid therapy in Bell’s palsy and the role of decompression surgery

Early use of steroids has been established as standard management in Bell’s palsy but simultaneous use of antiviral agents has variable acceptance. This review article analyses statistically based evidence to settle the issue. High quality evidence from a 2009 Cochrane...

Not so innocent, after all: a meta-analysis of the effects of intranasal corticosteroids on growth

The use of intranasal corticosteroids has revolutionised the management of allergic rhinitis and rhinosinusitis and there is now significant evidence of their safety. The problem with side-effects is that clinical studies are designed to demonstrate efficacy, but are underpowered to...