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Precision medicine in allergic rhinitis and chronic rhinosinusitis

Precision medicine (PM) with its ‘four Ps’ (personalised, predictive, preventive and participatory) is about appreciating differences between individuals when offering management options for health problems. Multiple groups interested in rhinology such as EPOS and ARIA supported a review of the...

What can we tell about swallow physiology from a bedside clinical assessment?

Knowledge about swallowing physiology has greatly increased with the use of instrumental assessments such as videofluoroscopy (VFS). The authors of this paper performed an analysis of data obtained from 60 stroke patients who were assessed via a clinical swallow examination...

Previous radiotherapy does not cause worse outcomes in patients with differentiated thyroid cancer

Radiation exposure from nuclear incidents, especially in childhood, is known to increase the risk of thyroid cancer. This large retrospective study from the Memorial Sloan Kettering Cancer Centre sought to determine if thyroid cancers in patients with prior exposure to...

Laryngeal Manifestations of Systemic Diseases

Laryngeal Manifestations of Systemic Diseases is a unique reference manual which will cater to a wide potential audience. It would represent a good text for laryngologists coming across patients with known comorbidities or as new diagnoses of underlying pathologies, but...

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...

Measuring is understanding: an unsupervised PROM clustering of CRS patients

It has been clear for quite some years, at least for anyone dealing daily with chronic rhinosinusitis (CRS) patients, that CRS is an ‘umbrella’ diagnosis. There are significant differences between patients, including different demographic data, different endoscopic and radiographic images,...

What to do if adenotonsillectomy does not cure sleep apnoea in children?

This article reviews the management of children with persistent obstructive sleep apnoea (OSA) following adenotonsillectomy (AT). Risk factors for patients to have persistent disease include obesity, being Afro-Caribbean and existing co-morbidities such as craniofacial and neuromuscular disorders. Initial assessment of...

Pain control for patients with chronic pain following surgery

There is an increasing number of patients with a background of chronic pain presenting to the otolaryngologist. Patients with chronic pain require extra consideration in postoperative pain control due to risk of tolerance and dependence. This article summarises postoperative management...

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)...

Persistent postural-perceptual dizziness: a functional neuro-otologic disorder

Persistent postural-perceptual dizziness (PPPD) is a neuro-otological disorder that is the most common cause of chronic vestibular syndrome. It is not a purely structural or psychiatric disease but a functional disorder. The authors reviewed the literature to summarise the diagnostic...

The curse of Sports Illustrated

“Not a supernatural curse, but a basic statistical concept of blinding simplicity.” What is ‘regression to the mean’? I am reliably informed that our former North American colonies publish a periodical known as Sports Illustrated (note, incidentally, the characteristically incorrect...