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Does Tranexamic acid reduce intraoperative bleeding during FESS?

Intraoperative bleeding during FESS can reduce visibility and obscure important landmarks. This can result in longer operative times, increase risks of complications and even lead to incomplete surgery. Tranexamic acid is a drug which prevents fibrinolysis and stabilises blood clots....

Assessment and management of dysphagia in the elderly

This article covers dysphagia in older patients, which is an important topic due to an ageing population, and a relatively common symptom that we see in clinic. Dysphagia could be due to presbyphagia secondary to changes in head and neck...

Can and should vestibular schwannoma surgery be carried out via the endoscopic transcanal approach?

The extent and scope of endoscopic ear surgery has rapidly progressed in recent years, and this paper, from one of the leading proponents of this technique, reports on the outcomes of a case series of patients who have had total...

THRIVE: redefining airway management in endoscopic oesophageal surgery

Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) is no longer just a tool to help anaesthetists secure a difficult airway. Thanks to the work of authors like Yang and colleagues, it is being revolutionised to provide apnoeic oxygenation during endoscopic...

Budesonide nasal irrigation for chronic rhinosinusitis: is it effective and safe?

Budesonide respules used in nasal irrigations as part of chronic rhinosinusitis management are usually at a dose of 0.25 mg to 2 mg, which is substantially higher compared to budesonide nasal spray, typically ranging from 64 to 256 micrograms. Hence,...

Minimally invasive techniques for benign salivary gland obstruction

Salivary gland obstruction is a common condition – it is recognised by a complaint of intermittent meal-time swelling of the affected salivary gland and can be accompanied by recurrent infections. Imaging can identify the nature and location of an obstruction...

Salivary pepsin – a simple test for LPR?

A diagnosis of laryngopharyngeal reflux (LPR) can be made on the basis of characteristic symptoms and nasendoscopy findings. Objective tests exist for this condition; for example, 24-hour dual-channel pH-metry which is considered to be the gold standard. Such tests are,...

Patient positioning for transnasal flexible laryngoscopy

The position of a patient’s head during flexible nasendoscopy to visualise the larynx does not usually require much consideration – adequate views are almost always obtained with a patient sitting in a neutral position. Occasionally however, there will be patients...

How best to follow up a sinonasal cancer?

Sinonasal malignancies are rare tumours and, in the UK, are usually treated in tertiary treatment centres but may well be followed up long term in the patient’s local hospital, so advice on how best to manage these patients is invaluable....

ENT in this issue...The Future of ENT (Mar/Apr19)

Chris CoulsonENT Surgeon; Managing Director of endoscope-i E: chris@endoscope-i.com The future, predict it at your peril’, said me – just now. But despite this (rather late) warning, we have managed to commission five articles from futurists within our midst. The...

Bringing space science to balance and tinnitus

Jameel Muzaffar is a specialist registrar in ENT surgery in the West Midlands. His research interests include applications of imaging to ENT. Chris Coulson is a consultant otologist, particularly interested in the development of technological solutions. He is part of...

Cummings Otolaryngology: Head and Neck Surgery: Seventh Edition - Volumes 1-3

It’s no secret Cummings Otolaryngology: Head and Neck Surgery is amongst the most widely recognised international texts on the subject. This edition does not disappoint, and provides a truly comprehensive evidence-based evaluation of topics in general otolaryngology, facial plastic and...