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Botulinum toxin injection in spasmodic dysphonia

Spasmodic dysphonia is a rare neurological voice disorder, which is often missed by the inexperienced ear. There is no laboratory test or investigation to diagnose this condition therefore, it is best diagnosed by listening to the patient’s voice. Laryngeal endoscopy...

Timing of surgery in chronic rhinosinusitis: does it matter?

While many patients with chronic rhinosinusitis respond to medical treatment, some do not. The next step for these patients is surgery, but how soon should this be offered? Sooner rather than later seems to be the answer, as Claire Hopkins...

Olfaction in CRS

Conventional teaching tells us that hyposmia in chronic rhinosinusitis is due to mechanical obstruction of the olfactory cleft. But it might be that the story is slightly more complicated than that. Olfactory dysfunction is a common feature of chronic rhinosinusitis...

Endotypes in chronic rhinosinusitis: clinical relevance

Identifying endotypes enables personalised therapies that target specific pathophysiological processes, potentially resulting in better treatment outcomes for patients. The contemporary model of chronic rhinosinusitis (CRS) pathogenesis revolving around endotype, in combination with an expanding toolbox of diagnostics and therapeutics, enables...

Running a post-COVID smell clinic

Over the past year, much of our effort as a speciality has been directed towards crisis management and keeping services afloat. Our practice has changed in untold ways, but unprecedented numbers of patients with smell disorders will increasingly require our...

The future of inner ear drug delivery

The techniques for delivering drugs to the inner ear system are evolving. Jeffrey Harris considers the myths, the facts and the potential for drug delivery innovations and how they can improve tomorrow’s hearing outcomes. The inner ear’s delicate membranous structure,...

Chronic cough hypersensitivity syndrome

We all have patients who give us a ‘heartsink’ feeling; for many of us, the coughing patient is exactly such a situation. In this overview, Bhaskar Ram and Sangeeta Maini outline their approach to diagnosis. Declan Costello, Editor. Introduction Chronic...

Bipolar microdebrider turbinoplasty

There are a variety of ways to reduce the bulk of hypertrophied turbinates. Kimberley Lau and Showkat Mirza describe their technique which can be used in difficult cases and with minimal morbidity. As ever, one aim should be to avoid...

Targeting the microbiome in chronic rhinosinusitis

Researchers at St Paul’s Sinus Centre and UBC in Vancouver are testing a novel treatment for CRS: transferring mucus from a healthy donor into a patient’s sinuses. Chronic rhinosinusitis (CRS) is one of the most common diseases managed by otolaryngologists...

Aetiology, investigation and acute management of sudden sensorineural hearing loss

The cause of a single sided sensorineural hearing loss has a wide variety of aetiologies. This review, by Edwin Halliday, looks specifically at the differential diagnostic causes of a sudden sensorineural hearing loss, the relevant investigations and the management should...

Beware of GPA as a cause of subglottic stenosis

Up to 92% of patients with granulomatosis with polyangiitis (GPA) have concurrent ENT manifestations of the disease. Whilst we are familiar with sinonasal and middle ear presentations of GPA, subglottic stenosis (SGS) is another important and potentially life threatening manifestation....

Voice change after total thyroidectomy with intact laryngeal nerves – a common but temporary problem

It has been reported that up to 87% of patients have a degree of voice dysfunction after thyroidectomy, even when the laryngeal nerves are preserved. Postoperative inflammation, laryngeal oedema due to vascular congestion, direct damage to the cricothyroid muscles and...