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How to tackle the problem of ciprofloxacin-resistant ear infections?

The growing issue of ciprofloxacin-resistant ear organisms is certainly a pertinent one. The situation here in the UK, where ototoxic topical drops are frequently given initially in the presence of pus and a perforation, differs markedly from elsewhere where fluoroquinolones...

A trial of house dust mite sublingual tablet in children with allergic rhinitis

The house dust mite (HDM) is one of the commonest causative agents in allergic rhinitis (AR), affecting patients across all demographics. Recently, sublingual immunotherapy (SLIT) has been shown in clinical trials and meta-analysis to be effective compared to placebo in...

Eustachian tube function before and after FESS

This is a prospective study from the UK looking at Eustachian tube dysfunction (ETD) in patients with chronic rhinosinusitis (CRS) undergoing surgery. Fifty-seven consecutive patients who had failed medical therapy and were scheduled for endoscopic sinus surgery completed SNOT-22 and...

Long-term voice outcomes following transoral laser surgery versus radiotherapy for early laryngeal cancers

The oncological outcomes of transoral laser microsurgery (TOLM) for early laryngeal cancers are well-known to be very similar to radiation therapy (RT). The functional outcomes associated with each treatment modality are therefore of significant interest. This study is reported to...

Is virtual reality the future of vestibular rehabilitation?

The use of virtual reality (VR) in vestibular rehabilitation is gaining some popularity but availability is hampered by cost. One VR system in use in some centres is the Hybrid VR unit which incorporates motion trackers and force platforms. This...

Hypoglossal nerve stimulation for OSA

Hypoglossal nerve stimulation has been lauded as the great new surgical treatment panacea for obstructive sleep apnoea (OSA). This meta-analysis includes 12 studies with a total of 350 patients, including the five-year follow-up data from the STAR trial which was...

Telepractice for the delivery of paediatric feeding services

During the current COVID-19 pandemic, telepractice is being heralded as the safest service delivery mode for the majority of outpatient consultations. Patients are reviewed by their healthcare specialist through video consultations, thus avoiding the need for patients to leave their...

Predicting the need for salvage laryngectomy

The treatment of laryngeal cancer has seen a shift towards organ preservation strategies with non-surgical treatment offering equivalent survival outcomes. Nonetheless, salvage total laryngectomy (SLT) remains an important curative management option in cases of treatment failure or recurrence. The authors...

Speculating on saliva during endoscopy

It has been noted that the presence of saliva in the pharynx and larynx during flexible endoscopic evaluation of swallowing (FEES) can be an indicator of increased risk of aspiration and consequent pneumonia, as well as weight loss and malnutrition....

Neuromodulation in drug resistant epilepsy

Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...

Patient-reported outcome measures: what do the people say?

Patient-reported outcome measures (PROMs) assess and quantify health outcomes from the patient’s perspective. Defining these questionnaires as outcomes indicates that they are psychometrically sensitive to change. This article describes three PROMS: namely the Patient Reported Outcome Measurement Information System (PROMIS),...

Immunosuppresants and ototoxicity

There is a wide range of immunosuppressant drugs ranging from calcineurin inhibitors (e.g. cyclosporine), anti-folic agents (e.g. methotrexate) to anti-TNF and monoclonal antibodies, many of which could be ototoxic. The authors performed a systematic review assessing ototoxicity secondary to immunosuppressant...