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Can we predict how much benefit patients will get from ESS with a novel monoclonal antibody

Mepolizumab (Nucala) is a humanised IgG1 monoclonal antibody that acts as an IL-5 antagonist. It has been shown to be highly effective in treating severe asthma. It is hypothesised that it will be effective for patients with recalcitrant CRSwNP. This...

The nice therapist effect: does the therapeutic relationship matter?

Quality of relationships is considered a core component of all speech and language therapy work, yet there is little agreement of what constitutes a therapeutic relationship. This study describes a scoping review to map existing evidence that has investigated this...

Hearing preservation in cochlear implantation – an American cocktail

There has been an increase in hearing preservation cochlear implant (HPCI) surgery over the last decade. Both steroid and L-N-acetylcysteine (NAC) were used and investigated respectively in the past in HPCI surgery. Authors investigated the role of perioperative NAC and...

Migration and training: a British-Nigerian surgeon’s perspective

Less than 4% of doctors on the UK’s medical register describe their ethnicity as African or part African, yet there are myriad driving forces behind the migration of medical trainees from Africa to the UK and other developed countries. Ekpemi...

What is Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE)?

THRIVE is a physiological mechanism for oxygenating and ventilating patients who are under general anaesthesia and who have diminished or absent respiratory effort [1]. Classical ventilation requires bulk flow of gases into and out of the lungs driven by chest...

Screening for hearing aid fittings – an approach for primary care

Introduction The communication difficulties related to hearing loss can lead to ‘depression, social withdrawal and problems with employment and access to information sources’ [1]. Furthermore, unmanaged hearing loss is associated with dementia, a poorer quality of life, depression, anxiety and...

Facial filler danger zones

Non-surgical facial rejuvenation techniques are increasing and are now undertaken by plastic, maxillofacial and ENT surgeons as well as non-surgeon technicians in the private sector. Although the technique of using fillers is less invasive than surgical options, it is not...

How do you solve a problem like Dysphagia?

When a patient is referred to a speech and language therapist for the management of swallowing difficulties, multiple options are available to address these issues. The choice is based on a detailed assessment of the patient’s swallowing physiology and function....

Allergen immunotherapy and allergic rhinitis – EAACI guideline 2017

Allergic rhinitis (AR) is a common chronic childhood disease with considerable social burden and impact on quality of life, frequently necessitating treatment with various combinations of antihistamines and corticosteroids. The allergen immunotherapy (AIT), sometimes known as desensitisation therapy, can modify...

Discharge planning

For a specialty such as ENT in which so many procedures are performed as day case surgery, there is a pressing need for objective discharge criteria to facilitate safe decision making post-op. This review strikes a good balance between prescriptive...

‘Close’ surgical margin in oral tongue redefined, 2.3mm is as good as 5mm

Gold standard treatment of squamous cell carcinoma (SCC) of the oral tongue remains surgical resection of the primary tumour with negative margins. The primary goal is the complete excision of the tumour with no residual cancer cells left behind. A...

BAHAs in single-sided deafness doesn’t improve sound localisation

This systematic review from South Korea nicely summarises what we know about SSD (single-sided deafness) and hearing rehabilitation with BAHAs (Bone Anchored Hearing Aids). SSD was defined as a PTA greater than 90 dB and a normal hearing opposite ear...