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Rates of tonsillitis increase as rates of tonsillectomy reduce
This retrospective study sought to determine the effect of reduced rates of tonsillectomy in England and Wales, over a 13-year period, on rate of hospital admissions for the complications of acute tonsil infection (acute tonsillitis and quinsy), and hospital bed-day...
Should intratympanic steroids be the first line treatment for sudden sensorineural hearing loss?
This article looked at whether intratympanic steroids (ITS) provide more benefits over systemic steroid therapy (SST) as initial therapy in patients with idiopathic sudden sensorineural hearing loss (ISSHL). This meta-analysis study, based on published RCTs, concluded that ITS treatment exhibited...
Surgery or medicine: when should we stop trying to be conservative?
Although most otolaryngologists would agree that surgery improves the outcomes of patients with CRS when medical treatment has failed, both Cochrane reviews state that there is no proof of improved efficacy of surgery over medicine – however, that was after...
Microbiome changes after endoscopic sinus surgery: all is not what it seems
As we keep fighting a losing battle with bacteria and antibiotics, it becomes clear that it is not about killing bacteria, not even diminishing the bacterial load, but rather about shifting the different types of bacteria that colonise and live...
Paediatric pituitary surgery - is it lagging behind?
Endoscopic sellar surgery, especially for adenomas, is a relatively safe, straightforward surgery with (mostly) reproducible results and few complications. However, the evolution of pituitary surgery was a long process, starting from open/transfrontal approaches all the way to transsphenoid to the...
FESS for recurrent acute rhinosinusitis: at last, some data
As noted in both the EPOS 2012 and in the (more recent) ICARS 2016, there is a paucity of evidence on the effectiveness of surgery for recurrent acute rhinosinusitis (RARS). The authors used a control group of patients with CRSsNP,...
Sellar surgery – when to prepare for repair
Endoscopic sellar surgery, especially for adenomas, is a relatively safe, straightforward surgery with (mostly) reproducible results and few complications. One of the commonest complications is the creation of a CSF leak with the subsequent need for repair (there is usually...
The microbiological environment of the paranasal sinuses
This article reviews the ecology of the sinuses and tries to make sense of the confusing literature on the subject. This covers the details of molecular studies, particularly those which attempt to differentiate normal sinuses from those in patients with...
“Rhinosweetometry”
An article that elicits a wry smile from the reader is worth drawing attention to particularly in the winter months. This account of brave self-experimentation is unlikely to lead to a future Nobel prize but nonetheless reinforces the important principle...
One anastomosis or two
This is a cumulative meta-analysis from Hong Kong reviewing 27 articles and a total of 7,389 flaps. The authors, at the outset, acknowledge that the number of anastomoses is not the only factor of venous compromise and flap failure. Nonetheless...
Attitudes towards leisure noise
Noise is a very common reason for hearing loss. The question is whether young adults realise the danger of developing a noise related hearing loss. The aim of this study was to evaluate the attitude towards leisure noise and noise...
