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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...

Radiation-induced dysphagia in head and neck cancer

This is a helpful reference paper that provides an overview of the biomolecular effects of radiation on the tissues of the upper aero-digestive tract. The authors explain that radiation injuries occur in a repetitive and accruing manner over the duration...

A beginner’s guide to endoscopic ear surgery (EES)

For some, this article will not provide them with anything new with respect to EES – in particular, the advantages of the technique and how to achieve them. However, for those surgeons who are debating whether to embark on the...

CT-scan instead of rigid bronchoscopy in paediatric foreign body aspiration?

Many centres would still use rigid bronchoscopy as the gold standard for possible foreign body aspiration (FBA) in children. Evidence is growing that CT scanning in these situations is a reliable alternative, especially as rigid bronchoscopy (RB) still carries a...

Titanium bobbins are prone to water penetration

There is limited evidence that swimming with grommets increases ear infections and most clinicians advise swimming with ventilation tubes is acceptable. Concerns may persist especially among parents. This paper evaluates the amount of different liquids (soapy water, sea water, chlorinated...