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Are upper respiratory symptoms and macroscopic changes in children always due to gastro-oesphageal reflux?
In children, symptoms such as chronic cough, wheezing, stridor, voice changes, persistent asthma and dental erosion are often presumed to be due to gastro-oesophageal reflux and empirical treatment with PPIs is offered. Usual investigations, such as a barium meal, gastroscopy...
Hereditary haemorrhagic telangiectasia
This is a very nicely written overview of this difficult condition by two expert rhinologists with a tertiary practice. The genetic basis, pathophysiology, diagnosis, natural history and available management options are all discussed. Clearly there is a large spectrum of...
Nasal decongestants don’t improve Eustachian tube function
Prescribing nasal steroids and decongestants. It’s something most of us do routinely, in an effort to reduce chronic middle ear effusion in an adult by trying to improve eustachian tube (ET) patency. This study used clever devices (tube manometry and...
Evidence and nasal polyp treatments
The change in the routine management of nasal polyps in the past 2-3 decades has been fascinating and this review from Charleston covers the topics of systemic treatment, local treatment, perioperative treatment and immunotherapy and touches on the lower airway...
Location, location, location: How to get the steroid where you need it, in chronic rhinosinusitis
What almost all current guidelines on chronic rhinosinusitis have in common is the importance of intranasal steroid (INCS) use. However, it is increasingly understood that the efficacy of INCS depends on their efficient delivery to the point of need, i.e....
Nothing about us without us: a how-to guide
Participatory design is an approach that is built around collaboration with users through a process of coproduction, design and creation. Most interventions are designed with the expert clinician researcher as the starting point, who looks at theory, evidence and their...
It is all so COSI…
Something which we have realised for a long time in the UK is the importance of the clinician in the assessment and long-term adoption of hearing aids. This common sense article outlines the need for more individualised patient pathways, thinking...
