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A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth

It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...

Method of delivery: all topical nasal corticosteroids are not made equal

There is an increasing body of evidence that the role of surgery for chronic rhinosinusitis is to facilitate the delivery of topical medical treatment – most notably, topical corticosteroids. Two recent studies, one using flow dynamics and another one examining...

Cochlear implantation in children with congenital long QT syndrome

Jervell and Lange-Neilsen syndrome is a condition where sensorineural deafness coincides with inherited abnormalities of the heart, resulting in prolonged ventricular repolarisation, frequently shown on an ECG with a prolonged QT interval. These children can present at implant centres for...

What to do if adenotonsillectomy does not cure sleep apnoea in children?

This article reviews the management of children with persistent obstructive sleep apnoea (OSA) following adenotonsillectomy (AT). Risk factors for patients to have persistent disease include obesity, being Afro-Caribbean and existing co-morbidities such as craniofacial and neuromuscular disorders. Initial assessment of...

Pain control for patients with chronic pain following surgery

There is an increasing number of patients with a background of chronic pain presenting to the otolaryngologist. Patients with chronic pain require extra consideration in postoperative pain control due to risk of tolerance and dependence. This article summarises postoperative management...

Diagnostic features of acute invasive fungal sinusitis

Acute invasive fungal sinusitis (AIFS) is a rare but frequently lethal condition, commonly associated with a high morbidity among those that survive. It has gained recent media attention on account of its increased incidence following infection with (and treatment for)...

Newborn sensorineural hearing loss – what is the incidence?

In the last two decades, the introduction of newborn screening for hearing loss has dramatically lowered the average age of newborn hearing loss diagnosis to around two to three months of age. The benefits of early diagnosis are manifold, enabling...

Do easier-to-swallow tablets improve medication adherence in people with dysphagia?

Swallowing tablets can be challenging for many people, but particularly so for those with a diagnosis of dysphagia. As a result, many medications are prepared in alternate formats including liquid, dissolvable or orally disintegrating tablets that dissolve on contact with...