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Perioperative management of the head and neck cancer patient

The perioperative care of patients with head and neck cancer is complex and requires significant preoperative planning and patient education. The issues include analgesia, antibiotics, stoma and wound care, general and chest physiotherapy, thromboprophylaxis and nutrition. This article provides a...

Chronic rhinitis endotypes

Chronic rhinitis (CR) is common with up to 30% of the population affected, with a significant impact on quality of life. CR includes several phenotypes with different pathogenesis including allergy, autoimmune, age, occupation, pregnancy, neurogenic and drugs. Such variation means...

Diagnosing complications of acute mastoiditis in emergency situations

In many cases, acute mastoiditis is manageable with intravenous antibiotics and hospitalised care. However, the decision whether to intervene surgically remains crucial and reliance is based on radiological findings – CT scans for bony changes and MRI for possible intra-cerebral...

Can we avoid FESS in patients with true isolated odontogenic sinusitis?

This is a useful study looking at how best to manage patients with odontogenic sinusitis and if FESS can be safely avoided. The authors treated patients by removing the odontogenic cause of the rhinosinusitis by extracting the offending tooth and...

When to operate on a patient without chronic disease?

As ENT surgeons, we spend a lot of time managing chronic rhinosinusitis, so a review and update on the management of the acute disease is always helpful. The standard medical treatment of antibiotics, nasal steroids and nasal decongestants are reported...

Early DCR may be better than delayed in acute dacrocystitis?

Traditionally, acute dacrocystitis has been treated conservatively with antibiotics, analgesia and warm compresses, with surgery reserved for later when the infection has subsided. This meta-analysis looks at early vs. late endonasal dacrocystorhinostomy (DCR) in the treatment of acute dacrocystitis, looking...

Is there any point giving postoperative oral steroids after a FESS?

It is well accepted that when medical treatment fails for chronic rhinosinusitis (CRS), endoscopic sinus surgery (ESS) is more effective than continuing with medical therapy alone. A variety of postoperative care options are available, including saline irrigation, in office debridement,...

A systematic review of adjunctive probiotic therapy in the management of chronic rhinosinusitis

It is generally understood that administering substances containing live microbiologically active micro-organisms (probiotics) enhances the treatment of chronic rhinosinusitis. Probiotics manipulate and rebalance the alterations occurring in the local microbiome in chronic rhinosinusitis patients. This results in propagation of healthy...

The future of rhinology

Over the last few decades, rhinology has been one of the most dynamic and progressive areas of ENT. Professor Fokkens is perfectly placed to offer insight into the future possibilities that could transform our patients’ care, many of which are...

Sinus surgery effects on asthma patients

Chronic rhinosinusitis (CRS) and asthma are related. The authors identified a gap in the literature and designed this study with a relatively large sample size of 86 patients. They included patients with comorbid asthma and CRS with or without polyps...

AM and the neck

Infections with atypical mycobacteria (AM) are increasing, especially with the decline in BCG immunisation. The most frequent presentation is a lymphadenopathy in an immunocompetent child. This poses a difficult diagnostic challenge if the clinician is not aware of this entity....

Radiofrequency for tonsillectomy

This Turkish study compared the use of radiofrequency (RF) tonsillectomy to the more traditional cold steel dissection (CD) technique. The authors enrolled 114 patients undergoing tonsillectomy for chronic tonsillitis and tonsil hypertrophy (causing upper airway obstruction) over a 4-month period....