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Transnasal endoscopic repair of CSF leaks

This Italian study was a retrospective review of 110 consecutive patients who underwent repair of their CSF leak via the transnasal endoscopic approach from 2003 to 2013. All surgery was performed by the same primary surgeon and patients with a...

What is the evidence for contralateral tonsillectomy in TORS for known unilateral tonsil malignancy?

The concept of field changes by carcinogens within the upper aerodigestive tract is well established with reported rates of synchronous tumours of 4% and second primaries of 36%. The tonsil in particular has the highest rate of synchronous tumours, postulated...

A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth

It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...

Method of delivery: all topical nasal corticosteroids are not made equal

There is an increasing body of evidence that the role of surgery for chronic rhinosinusitis is to facilitate the delivery of topical medical treatment – most notably, topical corticosteroids. Two recent studies, one using flow dynamics and another one examining...

Compress to suppress the venous tinnitus

This interesting retrospective case series analyses the effectiveness of a modified surgical technique with retromastoid reconstruction of the sigmoid sinus by mechanical compression with Surgicel and bone wax packing under local anaesthesia for patients with venous pulsatile tinnitus related to...

Diagnostic features of acute invasive fungal sinusitis

Acute invasive fungal sinusitis (AIFS) is a rare but frequently lethal condition, commonly associated with a high morbidity among those that survive. It has gained recent media attention on account of its increased incidence following infection with (and treatment for)...

Gadolinium enhanced MRI and the diagnosis of Ménière’s disease

Despite various criteria applied over the years to diagnose Ménière’s disease since the concept of endolymphatic hydrops was first observed in postmortem examinations of patients in 1938, the diagnosis still remains mainly clinical. To visualise endolymphatic hydrops in MRI imaging,...

Parapharyngeal space tumours – is the transoral approach effective?

Several approaches are described to the parapharyngeal space to permit resection of tumours in this region, with the most commonly employed approach being the transcervical route. The transoral approach remains somewhat controversial as it is felt that this approach can...

Choosing instrumental assessments of swallowing for children

Swallowing disorders in children are increasingly common due to advances in medical care allowing them to survive prematurity or complex health conditions. Careful assessment of eating and drinking is necessary to ensure that children are managed both safely and with...

Intra orbital treatment to save the eye!

Invasive fungal sinusitis can be a devastating condition, and accepted management is surgical debridement of infected tissue, systemic antifungal treatment and reversal of immunosuppression. Orbital involvement is common, affecting up to 75% of cases, and in advanced disease orbital exenteration...

Not the answer yet, but it may be in the future

AI is certainly a topical issue these days and radiomics refers to techniques which allow the extraction of quantitative features from medical imaging to produce large data sets for clinical problem solving. This paper looks at CT imaging of the...

Sniffing out the evidence – COVID-19 and loss of sense of smell and taste

Louis Pasteur once observed: “In the fields of observation chance favors only the prepared mind.” Professor Hopkins was certainly prepared when a few anecdotes of smell problems started to accumulate early in the pandemic’s course. Post-viral olfactory loss is nothing...