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A bittersweet finding

This is an elegant study, documenting the role of, and activation of, nitrous oxide in chronic sinusitis. Bitter taste receptors (TR2) have recently been identified as novel ‘players’ in sinonasal innate immunity and in chronic rhinosinusitis. The receptors are triggered...

Metaplasia of the concave septum

This group conducted a one year prospective study and sampled mucosa from 42 randomly selected patients with septal deviation at a single centre. They found significantly higher rate of squamous metaplasia and lymphocytic infiltration in septal mucosa on the concave...

Laser for active mucosal chronic otitis media

Active mucosal chronic otitis media (COM) is a condition characterised by otorrhoea secondary to chronic inflammation of the middle ear and mastoid mucosa associated with granulations and a tympanic membrane perforation. Surgical intervention is often required, but concurrent mastoidectomy with...

Treating middle ear conditions in developing countries

This month’s journal issue discussed global health in otolaryngology with this paper focusing on the management of chronic middle ear disease in the developing world. Chronic suppurative otitis media (CSOM) is more common in developing countries. The reason for this...

Laryngeal disorders associated with HIV infection

Following the introduction, and now widespread availability, of combined antiretroviral therapy, HIV has become a chronic disease with minimal or indeed no negative impact on life expectancy. As a result, there is a growing public health interest in establishing the...

A systematic review of adjunctive probiotic therapy in the management of chronic rhinosinusitis

It is generally understood that administering substances containing live microbiologically active micro-organisms (probiotics) enhances the treatment of chronic rhinosinusitis. Probiotics manipulate and rebalance the alterations occurring in the local microbiome in chronic rhinosinusitis patients. This results in propagation of healthy...

Persistent postural-perceptual dizziness: a functional neuro-otologic disorder

Persistent postural-perceptual dizziness (PPPD) is a neuro-otological disorder that is the most common cause of chronic vestibular syndrome. It is not a purely structural or psychiatric disease but a functional disorder. The authors reviewed the literature to summarise the diagnostic...

Non-absorbable synthetic material for middle fossa repair using a combined transmastoid/middle fossa approach

Repair of CSF leaks can be a challenging technical undertaking. In this article, the authors describe their use of a synthetic material to help with the successful repair of these leaks from the middle cranial fossa. Erosion of the middle...

Precision medicine in allergic rhinitis and chronic rhinosinusitis

Precision medicine (PM) with its ‘four Ps’ (personalised, predictive, preventive and participatory) is about appreciating differences between individuals when offering management options for health problems. Multiple groups interested in rhinology such as EPOS and ARIA supported a review of the...

Does endoscopic tympanoplasty give better results than a conventional approach?

This is a retrospective review looking at two groups of patients who had undergone middle ear surgery for chronic otitis media (perforation, retraction pocket/cholesteatoma) either open or endoscopic. Four hundred and five patients underwent open ear surgery and 501 endoscopic,...

Cough no more?

The challenge of the ‘unexplained chronic cough’ that just will not go away is a challenge that frustrates many of us. Often patients have seen respiratory, upper GI and eventually they see you as the last resort! Is behavioural therapy...

Microbiome changes after endoscopic sinus surgery: all is not what it seems

As we keep fighting a losing battle with bacteria and antibiotics, it becomes clear that it is not about killing bacteria, not even diminishing the bacterial load, but rather about shifting the different types of bacteria that colonise and live...