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Intra orbital treatment to save the eye!

Invasive fungal sinusitis can be a devastating condition, and accepted management is surgical debridement of infected tissue, systemic antifungal treatment and reversal of immunosuppression. Orbital involvement is common, affecting up to 75% of cases, and in advanced disease orbital exenteration...

Earlier intervention to correct anosmia?

This is an interesting study aimed to determine the timing for successful surgical intervention in improving the sense of smell in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). A total of 86 CRSwNP patients with loss of smell and...

Aerosols and polypi

Infection in the operative cavities after endoscopic sinus surgery for sinonasal polyposis leads to recurrence of symptoms and mucopurulent discharge. The usual therapies include systemic antibiotics sometimes with steroids. The authors hypothesised that the use of a topical antimicrobial (tobramycin...

Techniques of Botulinum Toxin Injections in the Head and Neck

The foreword begins with a saying by George Bernard Shaw, “all great truths begin as blasphemies”. This certainly was the case with medical application of Botox initially, however, botulinum toxin now has an accepted role and is widely used in...

Medical training initiative (MTI): stepping outside the box

Medical training initiative (MTI) scheme in the UK are becoming increasingly available and are actively supported by ENT UK. Despite this, knowledge of them is limited and there can be a mismatch between supervisors and potential candidates. Our authors, Manuela...

Audiology in this issue... Paediatric Audiology Gamechangers (NovDec18)

Fifty years ago, the National Conference on Education of the Deaf followed up on the Babbidge Report of 1965, recognising the failure of oralism in deaf education. Because young, deaf children at that time did not have access to sound, they could not develop speech and language. Further, because children were identified at two years or later, early intervention was only a dream.

Nasal polyps, does size matter?

This study from Germany investigates the correlation between nasal polyp size and return of olfactory function following endoscopic sinus surgery. Olfaction is affected more in patients with CRSwNP than with CRSsNP and the best chance of smell recovery occurs in...

Algorithm for malignant otitis externa

Timely detection and effective management of this potentially fatal condition cannot be overemphasised. This study presents 16 cases over 12 months in a tertiary referral centre. Most patients had diabetes and others were immunocompromised due to radiotherapy, immunosuppressive medication or...

The experience of being a new ENT SHO

In this article, Matt Donachie shares insights on the daunting yet enjoyable experience of starting as an ENT junior doctor, offering valuable advice. Starting your first job as a junior doctor in any specialty in the UK can be a...

Ear wax: the good, the bad, and the ugly

With ear wax removal being a core part of ENT and audiology services, Seth Schwartz gives us his dos and don’ts. We have all seen cartoons where a character pulls enough wax out of their ears to make a candle....

Ethanol ablation for benign cystic neck lesions

Benign cystic head and neck lesions have traditionally been managed conservatively or with surgical excision. Ethanol ablation (EA) has now established a role in the management of benign thyroid cysts, and its use has also been expanded to non-thyroid cysts....

The emergence of in-office ventilation tubes for the treatment of otitis media in children

In-office tympanostomy tube systems offer a quicker, anaesthesia-free alternative to traditional surgery for children, with promising outcomes and reduced costs. Tympanostomy tube or grommet insertion is the most common surgery performed on children worldwide. Whilst a relatively short and straightforward...