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Post-operative debridement following FESS

Postoperative treatment pathways for patients following functional endoscopic sinus surgery (FESS) vary widely with the topic of debridement of the nasal cavity a subject of conjecture. This article is the result of two independent reviewers using the consort guidance for...

Stereotactic radiosurgery for pituitary adenomas

Residual and recurrent functioning pituitary adenomas can be difficult to delineate on postoperative MRI scans, making them difficult targets for stereotactic radio surgery. In such cases radiation delivery to the entire sellar has been utilised as a radio surgical equivalent...

Nasal peak inspiratory flow (NPIF) as a diagnostic tool for differentiating decongestable from structural nasal obstruction

Identification of the cause of nasal obstruction is critical before surgical intervention such as septoplasty. This study assesses changes in nasal peak inspiratory flow (NPIF) as a tool for discriminating decongestable versus structural obstruction. A cross-sectional study of 52 patients...

Treatment of olfactory dysfunction

The sense of smell is crucial to our being able to relish food and experience our environment. Olfactory dysfunction has been trivialised or ignored previously, but the negative consequences of the loss of sense of smell are being increasingly highlighted....

Postconcussion syndrome: weighing up the options on balance

Balance problems, dizziness, headaches, nausea, vomiting and sensitivity to light and sound, are a few of the symptoms which may be associated with post concussion syndrome (PCS), concussion symptoms which persist longer than 21 days. This article presents a physical...

The applicability and reliability of SHIMP, a new vestibular test, in adolescents

The video head impulse (now called the head impulse paradigm – HIMP) is now a routine test battery in neuro-otological practice. Few will be familiar with the new suppression head impulse paradigm (SHIMP) test. The key difference is that, in...

Round window niche drilling with intratympanic for ISSHL. A new option for salvage?

This paper from China compares the technique of widening the round window via a posterior tympanotomy approach and steroid-soaked gelatin sponge with intratympanic steroids alone for salvage therapy in severe idiopathic sensorineural hearing loss. Salvage therapy was defined as patients...

Do you feel me? Emotional processing post-traumatic brain injury

Traumatic brain injury (TBI) accounted for just under three million accident and emergency admissions in the US in 2013, with common causes including falls, traffic accidents and assaults. Difficulties processing and expressing affective communication is a common sequela of TBI...

Tramadol soaked nasal packs for post-septoplasty analgesia

Having had a septoplasty a number of years ago for the potential treatment of snoring, I was intrigued by this paper which compared the analgesic effect of tramadol-soaked and lignocaine-soaked nasal packs following septoplasty. In my practice, I have always...

Chronic rhinitis endotypes

Chronic rhinitis (CR) is common with up to 30% of the population affected, with a significant impact on quality of life. CR includes several phenotypes with different pathogenesis including allergy, autoimmune, age, occupation, pregnancy, neurogenic and drugs. Such variation means...

The septum and breathing

The authors compared the improvement in nasal obstructive symptoms in two groups of patients. One group underwent septoplasty alone and the other septoplasty accompanied with compensatory turbinoplasty. They used the Nasal Obstruction Symptom Evaluation (NOSE) [12] and visual analog scale...

Stepwise approach to manage palatal myoclonus successfully

Palatal myoclonic tinnitus (PMT) is a rare condition caused by rhythmic voluntary or involuntary movements of the soft palate, mainly the tensor veli palatini and levator veli palatine muscles. Patients usually present with a ‘clicky’ noise in the ear. Oral...