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Role of oral and intranasal steroids in the management of otitis media with effusion

Inflammation is considered an important factor in the pathogenesis and continuation of otitis media with effusion. Theoretically, this may support the use of steroids, oral or intranasal in the management of this condition. This study comprised three well matched groups...

Nasal steroids do not cause ocular problems

This excellent, high quality and detailed systematic review from Australia dispels the myth propagated recently by some poorly designed studies that intranasal corticosteroids cause intraocular problems. A 40 year review of the usual databases found 665 articles and 19 were...

THRIVE: redefining airway management in endoscopic oesophageal surgery

Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) is no longer just a tool to help anaesthetists secure a difficult airway. Thanks to the work of authors like Yang and colleagues, it is being revolutionised to provide apnoeic oxygenation during endoscopic...

Transnasal endoscopic repair of CSF leaks

This Italian study was a retrospective review of 110 consecutive patients who underwent repair of their CSF leak via the transnasal endoscopic approach from 2003 to 2013. All surgery was performed by the same primary surgeon and patients with a...

Combined sprays for allergic rhinitis maintenance

This meta-analysis looked at the reported efficacy for allergic rhinitis control of various topical sprays, particularly comparative studies. There were fewer ‘head to head’ studies than we would have hoped to exist. This review included intranasal anti-histamines, intranasal steroids and...

Nasal packing after septoplasty

This Turkish study aimed to investigate the effects of different types of nasal packings on middle ear pressure in patients undergoing septoplasty. The authors reference several articles that describe eustachian tube dysfunction, temporary ear fullness and mild pain due to...

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...

Intranasal steroids in COVID-19

COVID-19 in patients with allergic conditions does not seem to take more severe course. The Global Initiative for Asthma recommended that asthmatic patients who are on prescribed inhaled or oral steroids should continue to take them. Contradictions between guidelines in...

Nasal septal perforation repair

Nasal septal perforation repair has traditionally been a great challenge. Many surgical techniques are described, however the success rate of closure has often been poor. Experience from the use of pedicled vascularised mucosal flaps in skull base surgery has been...

Endoscopic ‘syringe and cutdown’ technique for nasolacrimal duct obstruction in children

This article presents a novel yet simple technique to help in the management of congenital NLDO. The authors propose it as a valuable addition to existing standard procedures. Congenital nasolacrimal duct obstruction (NLDO) is a condition encountered within the first...

Covid-19 Tips and insights

The following blog articles have been kindly provided by Eric Levi. For more from Eric Levi, visit https://ericlevi.com/blog/ COVID19 affects everyone Posted on 01/04/2020 by Eric Levi Here’s a report from the Center for Disease Control and Prevention looking at...

People with language-led dementia in India

Primary Progressive Aphasia (PPA) is a language led dementia characterised by slowly worsening speech and language. It is associated with atrophy of the dominant temporal-parietal lobe regions and is commonly caused by frontotemporal or Alzheimer’s pathologies. There are three PPA...