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Management of post-tonsillectomy bleeding with nebulised TXA

In the last 20 years, rates of adult tonsillectomy have fallen in the order of 50%. The flipside to this, is that the number of admissions of patients with acute tonsilitis is more than double the reduction in tonsillectomy rates....

Helicobacter pylori and chronic tonsillitis

Helicobacter pylori infection in the stomach has long been associated with chronic gastritis, duodenal and peptic ulceration and even gastric cancer. Whether laryngopharyngeal reflux (LPR) brings up these organisms and induces chronic tonsillitis is an interesting concept, which the authors...

Risk factors for TORS treatment failure in HPV-related oropharyngeal cancers

HPV-related squamous cell cancers are an increasingly common cause of malignancy in the oropharynx. There is evidence that these cancers are associated with a significantly improved overall survival compared to conventional HPV-negative tumours. The optimal treatment for such cancers is...

Botulinum toxin in ENT

This comprehensive review neatly summarises non-cosmetic uses of botulinum toxin within otorhinolaryngology, it is perhaps easy to forget the medical use of botulinum toxin has now been approved for the last thirty years. Its overall safety profile places it as...

Occurrence of cancer in asymmetrical tonsillar enlargement in adults

With significant increase in head and neck cancer in the last decade, attributed to HPV, fast-track referrals from primary care have markedly increased, adding further to the burden on the NHS. Whether or not unilateral tonsillar enlargement alone, without red...

Recalcitrant chronic rhinosinusitis: What to do next?

Whilst the majority of patients with chronic rhinosinusitis (CRS) will significantly improve with treatment, we are sometimes left with a ‘hard-core’ of nasal cripples who fail to improve despite our best efforts. How can we deal with these patients? Valerie...

Ear wax removal: should anyone and everyone perform it?

Earwax removal is a controversial and much-debated issue in audiology. Risks and public safety call for reforms, sparking discussion on professional standards. Earwax is a natural secretion produced by the ear. It is an amalgamation of desquamous epithelial skin cells,...

Global audiology during COVID-19

The COVID-19 pandemic has affected, and in some areas, put a complete hold on, audiology practice around the world. In April 2020, during the peak of the pandemic for many regions, our audiology Global Ambassadors provided their reports from their...

Unexplained dizziness in elderly patients

How do we explain unexplained dizziness in elderly patients? How far should we go with investigations? And most importantly, how should we manage this challenging and expanding group of patients whose balance affects their safety? Richard Ibitoye and Diego Kaski...

Diagnosis and treatment of snoring in adults – S2k Guideline of the German Society of Otorhinolaryngology, Head and Neck Surgery

This article summarises the work done by the German Society of Otorhinolaryngology, who have developed guidelines for the management of snoring. ‘S2k’ is German nomenclature for a consensus based guideline, which (for those of you interested in such things), is...

On-call in ENT Surgery

The On-call in ENT Surgery, as part of the On-call Series, is written explicitly as the “survival guide” for all junior doctors starting out in ENT or as “a tool to aid consolidation of knowledge gathered by more senior ENT...

What blood tests should be requested to investigate vocal cord paralysis?

Patients who are discovered to have a vocal cord palsy with no obvious cause on history or examination routinely undergo investigations to exclude an underlying pathology. Cross-sectional imaging of the relevant recurrent laryngeal nerve is required, but considerable variability has...