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Use of topical steroids and antibiotics, compared to systemic antibiotics in the treatment of acute rhinusinusitis

Acute rhinusinusitis is mainly initiated by viral infections. Bacterial infection is usually superadded. The inflammatory cascade upregulates the pro-inflammatory mediators resulting in pain, nasal obstruction and nasal discharge. Local application of steroids and antibiotics could provide a higher concentration of...

The role of imaging in differentiating rare temporal bone neoplasms

This paper provides a useful tool to assist in determining the diagnosis of benign neoplasms of the temporal bone using readily available imaging modalities. Specifically, this group have looked at chondrosarcoma, an expansile hypermetabolic mass lesion usually found in the...

Retained surgical cottonoids in the nose

his is an interesting group of case reports essentially documenting the presence and characteristics of retained surgical packing (non-resorbable) post sinus surgery. Paranasal gossypiboma refers to surgical foreign objects such as sponge or patties that are left in the nose;...

CT-scan instead of rigid bronchoscopy in paediatric foreign body aspiration?

Many centres would still use rigid bronchoscopy as the gold standard for possible foreign body aspiration (FBA) in children. Evidence is growing that CT scanning in these situations is a reliable alternative, especially as rigid bronchoscopy (RB) still carries a...

Posturography in persistent postural-perceptual dizziness (PPPD)

Those in neuro-otology practice will be familiar with PPPD now appearing in the forthcoming beta edition of ICD-11. This condition combines the symptoms of phobic postural vertigo and chronic subjective dizziness in which anxiety plays a part. The underlying hypothesis...

Reactive lesions of the contralateral vocal cord – excise or leave?

It is well recognised that benign lesions of one vocal cord can give rise to reactive lesions of the contralateral vocal cord directly opposite to the primary lesion. These contralateral reactive lesions (CRLs) are thought to arise due to impact...

Advances in diagnosis and management of allergic rhinitis

This article reviews advances in the diagnosis and management of allergic rhinitis. Recent advances in the diagnosis of allergic rhinitis include testing of local immunoglobulin E (IgE), urinary test to diagnose aspirin hypersensitivity and optical rhinometry to assess degree of...

Persistent dysphonia due to cricothyroid muscle dystonia – should we be requesting laryngeal EMGs for non-resolving ‘functional’ dysphonia?

This article is an interesting report of a case of persistent voice problems affecting a 43-year-old physician that significantly compromised her ability to converse and communicate at work. Specifically, she had a fluctuating voice quality that would ‘choke off’, combined...

New MRI technique assesses treatment response in skull base osteomyelitis

This paper describes another useful imaging technique to monitor Necrotising Otitis Externa (NOE). Echoplanar diffusion weighted magnetic resonance (DW MR) shows high signal on the ‘ADC map’ with active disease and this reduces in signal intensity as symptoms improve. This...

Botulinum toxin injection for bilateral recurrent laryngeal nerve paralysis

All traditional surgical treatments for bilateral recurrent laryngeal nerve (RLN) paralysis are essentially a balance between maximising airway patency and ensuring adequate phonation / airway protection. This paper highlights the potential role of botulinum toxin (Botox) injection into the cricothyroid...

Adenotonsillectomy can improve ADHD and nocturnal enuresis

The link between chronic adenotonsillar hypertrophy (CAH) and behavioural disturbance is well recognised. Several studies have found that CAH has been associated with attention deficit hyperactivity disorder (ADHD) and treatment of CAH may diminish symptoms of ADHD in a subset...

Can laryngeal sensitivity testing predict aspiration and pneumonia in dysphagic patients?

The laryngeal adductor reflex (LAR) is characterised by brief vocal cord closure in response to laryngeal stimulation. It is important in swallowing physiology as it represents a mechanism for airway protection. The authors of this study examined whether the absence...