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Botulinum toxin and drooling – how much, how often and where?

This was an incredibly useful article covering all aspects of the use of botulinum toxin as a treatment modality in sialorrhoea. The article starts by outlining why treating sialorrhoea is important and describes the non-pharmacological and pharmacological options, highlighting that...

Allergic rhinitis, the usual suspects

Allergic rhinitis (AR) is characterised by allergen binding to IgE on mast cells and basophils and subsequent histamine, prostaglandine D2 (PGD2) and cysteinyl leukotrienes (cysLTs) release causing early-phase response. This is followed by late-phase response mediated by eosinophils. Other cells,...

Scalp reconstruction a new algorithm

Reconstruction of the scalp after acquired defects remains a common challenge for the reconstructive surgeon, especially in light of a history of radiation to the area. Wound healing by secondary intention or with a wound vacuum assisted closure are viable...

The outer ear in the visual arts

The ear is an exceptional organ, and quite rightly takes its place in the visual arts, as described by Albert Mudry, who takes us on a whistle-stop tour of the appearance of the ear and its depictions in art throughout...

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...

Assessment of viral aetiology in the formation of nasal polyps

The exact aetiology of nasal polyposis is not yet established although it is believed that allergic, infectious, mechanical, immunological and biochemical factors may be involved. Using the technique of polymerase chain reaction, this study assesses the role of human adenovirus,...

Does septoplasty improve smell?

This is a study from Barcelona on a very interesting topic: does septoplasty change sense of smell? The theory being that a deviated septum would prevent airflow to the olfactory region and once the anatomical obstruction has been relieved, that...

The role of objective measures and imaging to optimise cochlear implant outcomes

Should we be using new or novel objective measures and imaging to assist with our cochlear implant patients? Debi Vickers and Shak Saeed describe current clinical techniques and present advances that have the potential to optimise outcomes. Introduction It is...

Is one glass of wine on call safe?

It’s a standard question for those about to sit a Specialist Training (ST) interview; you are on call and you call a senior colleague in to perform an operation. You smell alcohol on the breath of the surgeon, so what...

Extranodal extension following surgical resection of HPV-positive oropharyngeal cancer – is adjuvant radiotherapy alone sufficient?

Human papillomavirus (HPV) is a known aetiological factor in oropharyngeal squamous cell carcinoma (OPSCC). HPV-positive OPSCC is recognised to have a more favourable prognosis than HPV-negative disease. Treatment deintensification for HPV+ OPSCC has therefore been an area of research focus...

Relationship between ART and language development

Assisted Reproduction Technology (ART) and especially more invasive techniques of ART may be associated with an increase in neurodevelopmental problems including language delay. Some studies have reported slightly worse perinatal outcomes of IVF babies compared to naturally conceived babies. The...

Foreign object removal from the ear or nose

The range of nasal and aural foreign bodies that present to accident and emergency (A&E) departments, emergency rooms and minor injury units is limited only by the imagination. Aetiology and epidemiology statistics point to patients being predominantly children in the...