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Is benign intracranial hypertension underdiagnosed in patients with spontaneous CSF leaks?

In ENT practice we come across spontaneous CSF leaks. Patients present either as unilateral watery rhinorrhoea or otorrhoea, or sometimes as hearing loss with a watery middle ear effusion. Clinicians, after confirming the diagnosis of CSF leak with beta 2...

Dacryocystorhinostomy revisited

In this technical variant, instead of seeking the lacrimal sac, the authors describe a retrograde technique. They first identify the nasolacrimal duct at the level of the most anterior insertion of the inferior turbinate in the lateral nasal wall. The...

Transverse venous sinus stenosis – a risk factor for CSF leak in patients with idiopathic intracranial hypertension

This was a multicentre (six French tertiary hospitals) retrospective case-controlled study aiming to investigate the rate of transverse venous sinus stenosis (TVSS) in patients with idiopathic intracranial hypertension (IIH) with nasal cerebrospinal fluid (CSF) leaks. They compared the preoperative MRI...

A comparison between biologic and surgical treatment (FESS) for chronic rhinosinusitis with polyposis

In recent years, it is being increasingly recognised that chronic rhinosinusitis with nasal polyps (CRSwP) is a type 2 chronic inflammation based on IL-4 and IL-13, and the novel monoclonal antibody, such as dupilumab, is likely to have a major...

Factor favouring the need for revision FESS in chronic sinusitis with polyps – a multivariate analysis including phenotypes

Chronic rhinosinusitis with polyposis is a type 2 inflammation with risks of recurrence and need for revision operations. This is known to depend on the endotype and phenotype factors. This is a retrospective study of 212 patients. Of these, 112...

A useful adjuvant treatment for SNAC or IP

5-Fluorouracil (5FU) is a topical preparation used in the treatment of various dermatological, ocular and gynaecologic malignant and pre-malignant conditions, and this literature review looks at the efficacy of 5FU in treating inverted papilloma and sinonasal tumours. The authors cite...

Update on cholesteatoma

Surgery for cholesteatoma should be tailored to individual patients, considering patient and disease factors, to obtain a dry, safe and functional ear. In this article, the authors discuss the current definitions and classification system of middle ear cholesteatoma, as well...

How I do it Issue I

To skip directly to features, click the links below: Welcome from the editor - by Miles Bannister KTP laser in the office - by Markus Hess and Susanne Fleischer The surgical management of rhinophyma using a microdebrider - by Andrew...

Timing of surgery in chronic rhinosinusitis: does it matter?

While many patients with chronic rhinosinusitis respond to medical treatment, some do not. The next step for these patients is surgery, but how soon should this be offered? Sooner rather than later seems to be the answer, as Claire Hopkins...

A small company’s perspective

In this article, we hear from Alan McNulty, Director from Sheffmed, an SME (Small – Medium Enterprise), who have supplied surgical instruments, consumables and video systems to ENT clinicians for over 12 years. Alan outlines some of the choices and...

Middle ear reconstruction in children: why, when and how

Every ear in every child is different. Rob Nash discusses the rationale behind reconstructive ear surgery in children and his philosophy on timing and techniques of reconstruction. It is rare for middle ear pathologies to be life threatening. Indeed, it...

Head and neck robotic surgery – considerations for the surgical trainee

In 2021, training in head and neck cancer surgery would be incomplete without some robotic resections under the belt. Henry Zhang explains how he did it and outlines the options available. With a wide range of applications in both benign...