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Supplementing intranasal cortical steroids with montelukast: does it help?

Intranasal steroids are widely used in the treatment of allergic rhinitis. Whether or not the addition of montelukast helps was assessed in this study. This was a single centre prospective randomised double-blind placebo-controlled trial of two groups of patients, one...

Lower respiratory involvement in allergic rhinitis and chronic sinusitis

The recent ARIA (Allergic Rhinitis and its Impact on Asthma) project has generated interest in simultaneous involvement of the lower respiratory airway in cases of chronic rhinosinusitis and allergic rhinitis. This study takes into account the extent of pulmonary function...

CT and intraoperative nerve monitoring to identify non-recurrent laryngeal nerve during thyroid surgery

A non-recurrent laryngeal nerve (NRLN) is a rare (incidence 0.3% to 1.3%) anatomical variant that results in a higher rate of vocal cord palsy following thyroid surgery. This team from China examined the utility of preoperative CT and intraoperative nerve...

Vascularised tissue in salvage total laryngectomy

Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...

Post tonsillectomy recovery in thermal welding method compared with recovery in cold steel method

Many different methods for tonsillectomy have emerged but whether they provide an improvement over the traditional cold steel tonsillectomy is another matter. Thermal welding is a recent method of tonsillectomy in which the tissues are simultaneously coagulated and divided. In...

Bones, stones and surgical moans: rethinking PTH dynamics in parathyroid surgery

Intraoperative parathyroid hormone (IOPTH) testing has revolutionised minimally invasive unilateral parathyroidectomy (MIP) as the gold standard treatment for primary hyperparathyroidism, replacing old-timey four-gland exploration. IOPTH testing ensures reliable excision of all hypersecreting glands, including those pesky hard-to-find ones, without relying...

Measuring radiation fibrosis in patients with head and neck cancer

People treated with radiotherapy for head and neck cancer experience several acute and chronic effects of this treatment, of which fibrosis is perhaps the most common. Fibrosis occurs as a wound healing response and leads to scarring and reduced range...

Swallowing the risk: managing dysphagia in aged care

The risk of dysphagia increases with age and the prevalence of dysphagia in aged care facilities is 41–52%. Dysphagia increases the risk of aspiration, asphyxiation, malnutrition, pneumonia and ultimately death. Modifying food and fluids, by providing mashed or pureed foods...

How good is secondary intention healing post nasal cutaneous tumour excision?

The variation in size and site of nasal cutaneous tumours allows the surgeon to propose various methods to close the resulting defect post-tumour excision. This prospective multicentre cohort study executed in China encompassed 150 patients, comparing wound healing times and...

Hear me out – tiny steroid implants for fighting meningitis-induced deafness

Sensorineural hearing loss is the most common neurological complication of pneumococcal meningitis. Bacterial infiltration into the inner ear triggers inflammation, leading to cochlear fibrosis and sclerosis – damage that, in over a third of cases, affects both ears. Current Infectious...

Auditory processing disorder (APD): knowledge and practice in hearing healthcare

Awareness and practice for children and adults presenting with APD is variable across healthcare practice. Recently reported experiences of individuals and their families affected by APD show difficulty accessing referral and overall lack of recognition, and note that audiologists show...

Machine learning to support audiology

Jessica Monaghan and David Allen discuss how machine learning, using a wealth of data provided by hearing devices, can be used to streamline their functionality and fitting. They report on how it has been used to support clinicians to maximise...