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Drooling: what is it like to be unable to manage your own saliva?

Drooling in Parkinson’s is associated with less frequent and inefficient swallowing, resulting in a build-up of saliva in the mouth that then moves beyond the lips. It often causes discomfort as the skin becomes sore, and results in embarrassment. The...

Influence of smoking on vocal fold polyps

A vocal fold polyp is a benign lesion related to phonotrauma which induces upregulation of inflammatory processes and histological changes can occur in the epithelium and lamina propria. Whether smoking produces additional or enhanced changes is the subject of this...

An algorithm to distinguish between distant metastases and metachronous lung primary in patients with HPV-related oropharyngeal cancer

Distinguishing between distant metastases of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) and metachronous primary lung squamous cell carcinoma (SCC) is important as it has implications for treatment, prognosis counselling, and registry data. Although p16 immunohistochemistry (p16 IHC) is widely accepted...

Salivary pepsin – a simple test for LPR?

A diagnosis of laryngopharyngeal reflux (LPR) can be made on the basis of characteristic symptoms and nasendoscopy findings. Objective tests exist for this condition; for example, 24-hour dual-channel pH-metry which is considered to be the gold standard. Such tests are,...

Retrograde cricopharyngeal dysfunction (RCPD) - inability to burp: treatment with Botox injection

As unusual as it may sound, some people have great difficulty burping. We hear of one approach to tackling this problem. Retrograde cricopharyngeal dysfunction (RCPD) is a condition presenting with inability to burp, resulting in gaseous distension of the digestive...

Drug eluting stent vs INCS for CRS

A prospective, randomised study from Finland to compare a drug eluting stent (DES) and intranasal corticosteroids (INCS) in 63 patients as assessed by SNOT-22, VAS, endoscopy, CT and rhinometry pre-treatment, at three and six months post treatment. Recruitment was over...

Managing CRS in pregnancy

An International team of experts from both sides of the Atlantic set out to perform a systematic review of the management of chronic rhinosinusitis in pregnancy. Despite a thorough search no scientific evidence was found that could form the basis...

Cocaine detection hours after FESS

This is a very interesting article from Australia regarding the bioavailability of cocaine following atomised application prior to endoscopic sinus surgery. The well-established practice of preparing the nasal mucosa for sinus surgery involves the placement of a usually modified Moffett’s...

Does middle turbinate resection affect olfaction in endoscopic transsphenoidal surgery?

The middle turbinates (MT) are sometimes partially resected during endoscopic transnasal transsphenoidal pituitary surgery to improve surgical access. Some outfracture the middle turbinates instead. This article presents results of the first prospective randomised study, investigating the effects of such surgery...

Metformin, the magical solution!

Both noise-induced hearing loss (NIHL) and vestibular schwannomas (VSs) pose a challenge in terms of management. Metformin was suggested as a potential therapeutic drug for NIHL when the drug-target interaction data was investigated. Additionally, there are studies which demonstrate reduction...

Management of peritonsillar abscesses – should we be offering a hot tonsillectomy?

Peritonsillar abscesses (PTAs) are one of the most common reasons for patients being referred to ENT services on an emergent basis worldwide. The conventional treatment for adult patients with a PTA in the UK involves needle aspiration or incision and...

Diagnosing and managing somatic tinnitus

Interactions between auditory and somatosensory pathways can lead to interesting tinnitus experiences which can be very bothersome. Dr Sarah Michiels describes her pioneering work in this area, and the possibilities of physiotherapy based therapy. Background Somatic (also called somatosensory) tinnitus...