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An alternative device for obstructive sleep apnoea
Continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnoea (OSA), primarily due to the vast amount of short-term evidence in the medical literature it has accrued. The enduring obstacle to CPAP from becoming a treatment option...
Allergic rhinitis, the usual suspects
Allergic rhinitis (AR) is characterised by allergen binding to IgE on mast cells and basophils and subsequent histamine, prostaglandine D2 (PGD2) and cysteinyl leukotrienes (cysLTs) release causing early-phase response. This is followed by late-phase response mediated by eosinophils. Other cells,...
Does balloon tuboplasty work in the long term, and how can we measure outcomes?
There is much interest and debate at ENT conferences and within current literature about the role of balloon dilatation techniques for Eustachian tube dysfunction (ETD), a condition which we still only have limited understanding of, and which can be challenging...
How can we improve outcomes for patients with acute vestibular neuritis?
Vestibular neuritis is a common disorder that can leave up to 50% of patients with persistent vertigo symptoms for months to years following the acute insult. Often their first contact with ENT or balance specialists is many months after the...
Bespoke is best for children with communication difficulties
Children with communication difficulties can benefit from augmentative alternative communication (AAC) aids to support them in daily interaction, as well as in developing milestones. One of the most difficult aspects of choosing a device is not only meeting the child’s...
Active smoking predicts poor outcome in HPV positive oropharyngeal squamous cell carcinoma
Tobacco smoking is a well-known risk factor in human papilloma virus (HPV)-negative head and neck squamous cell cancer. Its effects include increased risk of treatment failure, distant metastases and reduced overall survival. HPV has been increasingly implicated as a causative...
Future practice: tele-rehabilitation in speech and language therapy
It is known that our population is ageing, resulting in an increase in the number of people living with progressive neurological conditions such as Parkinson’s disease. Health services endeavour to deliver specialist and personalised care to all these people, often...
Do we need contrast MRI when screening for vestibular schwannoma?
Gadolinium contrast enhanced T1-weighted (gT1w) MRI images of the internal acoustic meati have long been considered the gold standard in the diagnosis of vestibular schwannoma (VS). However, the addition of contrast to the MRI examination increases the cost and time...
Neuromodulation in drug resistant epilepsy
Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...
Is flexible nasendoscopy really aerosol generating?
Amid the COVID-19 pandemic, the safety of office-based laryngoscopy has been a source of considerable concern, speculation and debate. Flexible nasendoscopy is a key diagnostic tool in the assessment of the ENT patient, however most healthcare providers consider this to...
Compress to suppress the venous tinnitus
This interesting retrospective case series analyses the effectiveness of a modified surgical technique with retromastoid reconstruction of the sigmoid sinus by mechanical compression with Surgicel and bone wax packing under local anaesthesia for patients with venous pulsatile tinnitus related to...
