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Do intratympanic injections require local anaesthesia?

Intratympanic injections are becoming increasingly acceptable in the management of Meniere’s disease, tinnitus and sudden hearing loss. This is because they avoid the need for hospitalisation and can be performed as low-cost outpatient procedures. It is traditional to freeze the...

Global health missions – not just for consultants. A guide for trainees.

Lulu Ritchie is a courageous and driven trainee in London, inspired by humanitarian missions but conscious of the usual requests for consultant level doctors. Lulu didn’t let that hold her back. She found a way and has kindly summarised her...

The many uses of human amnion

Human amnion has historically been the focus of much myth and superstition. To be born with the ‘caul’ intact was considered lucky and the caul was often manufactured into clothing. In 1910 foetal membranes were first used in skin transplantation...

Does turbinoplasty outcome vary in the presence of allergic disease?

This well organised study from Australia looks at inferior turbinoplasty outcomes in patients with allergy and non-allergic rhinitis who have become refractory to medical treatment. There were 190 patients undergoing turbinoplasty with or without septoplasty assessed in this case-control study...

Modified subciliary approach to the orbital floor

Fractures involving the lateral midface and orbital floor are routinely treated by maxillofacial surgeons. The surgical management requires access to the facial skeleton to reposition and free the soft tissues. There are three main approaches to the orbital floor: infraorbital;...

Precautions to be taken in cosmetic facial surgery

In this comprehensive write-up on precautionary measures to be taken when doing cosmetic surgery on our patients, the authors begin by emphasising that facial plastic surgery is no longer limited to celebrities and the privileged. It has extended into everyday...

Anaesthesia for free-flap surgery

Adel Hutchinson is one of those calm and controlled anaesthetists for whom nothing seems too difficult. In this article, she describes the key perioperative factors for one of the highest complexity operations in ENT; free-flap surgery. It makes good reading...

Enhancing the pure-tone average calculation method for reporting hearing outcomes: the need for a transition to the logarithmic mean

Comparing studies requires common approaches. Ali Faramarzi takes a moment to consider how to tackle the presentation of audiometric data in publications. Uniformity in reporting hearing outcomes is paramount for accurate evaluation and comparison of hearing-related research. Standardised guidelines are...

Intranasal steroids in COVID-19

COVID-19 in patients with allergic conditions does not seem to take more severe course. The Global Initiative for Asthma recommended that asthmatic patients who are on prescribed inhaled or oral steroids should continue to take them. Contradictions between guidelines in...

One airway, one disease - not for everyone!

While 85% of asthmatic patients have rhinitis, only 20-30% with rhinitis have asthma. Together with atopic dermatitis (AD), rhinitis and asthma form a triad that tend to co-exist in patients (multimorbidity). This co-existence raises the possibility of genetic mechanism. Authors...

An overview of human factors in ENT and anaesthesia

James Bates and Chris Frerk are both passionate about how human factors science can improve safety in healthcare and have co-authored this article describing how communication, ergonomics and other non-technical skills are making operating theatres safer. There is no doubt...

Rhinology and 3D printing

3D printing has increasing applications in rhinology, for instance to create patient-specific preoperative models for procedure planning, including designing a template for reconstruction planning following tumour resection, patient consultation and customised prostheses. The authors focused their review on the role...