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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...

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...

Transoral endoscopic thyroidectomy / parathyroidectomy – a new approach

Historically, scarless surgery has been popular in certain cultures. But is it gaining traction around the world? A UK team tell us more. Background Alternative, remote access approaches to thyroidectomy and parathyroidectomy are increasing in popularity, the newest of these...

The EU Medical Device Regulation (MDR)

Back in May 2017, the EU Medical Device Regulation (MDR 2017/745) entered into force, replacing existing directives: Active Implantable Medical Devices (AIMD) In-vitro Diagnostic Directive (IVDD) Medical Device Directive (MDD) By 26 May 2020, the new regulation will have completed...

How will our grandchildren view COVID-19?

Alan Johnson, known to our readers as the former President of ENT UK, gives us his thoughts on the COVID pandemic, looking at it through the lens of other health crises. As I write, COVID-19 is displacing almost all other...

Transnasal oesophagoscopy (TNO) and balloon dilatation under a local anaesthesia

Many of us are becoming more and more familiar with the use of transnasal oesophagoscopy. It has a number of well-described uses in the outpatient setting and is well tolerated by our patients. Yakubu Karagama describes taking this technique a...

Middle ear muscle disorders: presentation, diagnosis and management

Patients often report symptoms relating to disorders of the middle ear muscles. Prof Bance gives us an overview of the anatomy and function, as well as guides our diagnosis and management. The middle ear muscles (MEMs) are a mystery, both...