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Deep space neck infections and their management

This article explores the approach to managing patients with deep space neck infections. Clearly, an understanding of the fascial planes within the neck is required which then provides an understanding of the route of spread in these cases. The authors...

History of innovation in ENT

Innovation seems to have been in the strapline of every meeting, conference and course for the last few years. You would be forgiven for thinking it is a new a concept, but as Neil Weir beautifully details, innovation has been...

A systematic review of adjunctive probiotic therapy in the management of chronic rhinosinusitis

It is generally understood that administering substances containing live microbiologically active micro-organisms (probiotics) enhances the treatment of chronic rhinosinusitis. Probiotics manipulate and rebalance the alterations occurring in the local microbiome in chronic rhinosinusitis patients. This results in propagation of healthy...

Temporal bone trauma

Introduction Temporal bone injuries represent one of the more complex management problems presenting to the otolaryngologist. This is largely due to difficulties in assessment and the frequent delays in referral, often as a result of other injuries demanding more immediate...

Managing spontaneous CSF leaks secondary to benign intracranial hypertension

Spontaneous CSF leaks are a rare entity. In this paper, a Spanish group report their experience managing the condition using endoscopic surgery in 35 patients over an eight year period. Leak locations included the cribriform plate (18/35), ethmoid roof (15/35)...

Surgery or medicine: when should we stop trying to be conservative?

Although most otolaryngologists would agree that surgery improves the outcomes of patients with CRS when medical treatment has failed, both Cochrane reviews state that there is no proof of improved efficacy of surgery over medicine – however, that was after...

An overview of cranioplasty

This article provides a summary of the indications, materials and current techniques available in cranioplasty. Cranioplasty is performed to restore the normal architecture of the skull following craniectomy for many reasons including intracranial infection, trauma and neoplasm. The timing of...

Microbiome changes after endoscopic sinus surgery: all is not what it seems

As we keep fighting a losing battle with bacteria and antibiotics, it becomes clear that it is not about killing bacteria, not even diminishing the bacterial load, but rather about shifting the different types of bacteria that colonise and live...

CSOM in Mwanza, Tanzania

This is a prospective, cross-sectional study involving 301 patients consisting of farmers, students and employed professionals attending an ENT clinic in Mwanza, Tanzania. Of the 301 patients, 13 were HIV positive; 37.9% had some degree of conductive / sensorineural /...

No soup for you…! Early identification of postoperative perforation increases the success of conservative management

Iatrogenic perforation of the hypopharynx or cervical oesophagus is a well-recognised life-threatening complication. Previous studies have demonstrated that conservative management with broad-spectrum antibiotics and withholding oral feeding may avoid morbidity associated with surgical repair. This study addresses when conservative management...

Guidelines for management of orbital infections

Orbital infections predominantly affect the paediatric population and complications can be very serious. The cellulitis can be preseptal or orbital and the abscess can be confined within the periosteum or extend into the orbit. Cavernous sinus thrombosis can complicate the...

Perioperative management of the head and neck cancer patient

The perioperative care of patients with head and neck cancer is complex and requires significant preoperative planning and patient education. The issues include analgesia, antibiotics, stoma and wound care, general and chest physiotherapy, thromboprophylaxis and nutrition. This article provides a...