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Time to professionalise medical leadership

For a profession proud of its adherence to an evidence base, medicine has been remarkably slow to acknowledge and to act on the evidence which underpins the value of good leadership to patients and the healthcare system. Mr Robert Francis...

Anaesthesia under fire

Kate Prior is an anaesthetist who has, quite literally, been there, done that. In this article she manages to use words on a page to bring to life some of the conditions and challenges she faced as a member of...

A spoonful of sugar… helps the operated sinuses calm down?

Ottoviano et al. present a prospective double-blinded RCT to assess the effect of a nasal gel containing silver sucrose octasulfate (Silsos Gel) on wound healing after endoscopic sinus surgery. The placebo used was a glycol gel. Thirty-four consecutive patients were...

A bittersweet finding

This is an elegant study, documenting the role of, and activation of, nitrous oxide in chronic sinusitis. Bitter taste receptors (TR2) have recently been identified as novel ‘players’ in sinonasal innate immunity and in chronic rhinosinusitis. The receptors are triggered...

Minimally invasive techniques for benign salivary gland obstruction

Salivary gland obstruction is a common condition – it is recognised by a complaint of intermittent meal-time swelling of the affected salivary gland and can be accompanied by recurrent infections. Imaging can identify the nature and location of an obstruction...

Useful algorithm to manage adults with branchial cysts

Managing a solitary cystic lateral neck mass, specifically differentiating between a simple second branchial cyst and a metastatic cyst poses a challenge. Often the diagnosis only becomes apparent on the final histology. This paper analysed 28 adults that presented to...

Prioritisation of surgery for pituitary tumours

This study is based on the findings of internationally renowned skull base surgeons who convened to recommend this stratification scheme. The study authors report that incidental diagnosis of pituitary tumours during routine imaging as well as early identification of visual...

The increasingly favourable outcomes from endoscopic endonasal approaches for the management of pituitary adenomas

Historically, pituitary tumours have been surgically managed with an open, transcranial approach. Although this approach still has its merits in large intracranial adenomas, technological advancement has allowed smaller tumours to be debulked via a transseptal microscopic technique. These days, the...

Long-term outcomes after endoscopic pituitary macroadenomas resection

In this retrospective study the authors attempted to find out long-term outcomes after pituitary macroadenoma resection via the endonasal endoscopic transsphenoidal route. Eighty of the 162 patients operated on met the study criteria of clinical and radiological follow-up for at...

Paediatric versus adult pituitary adenomas

This retrospective study compares paediatric with adult patients undergoing pituitary adenoma surgery over a period of 26 years at a single institution. All surgeries were performed via a sublabial approach using the operating microscope. An endoscope was used occasionally for...

Identifying clinically useful salivary substitutes

This in vitro study analysed the efficacy of salivary substitutes used in the treatment of xerostomia following head neck irradiation. The researchers applied the products under evaluation onto a synthetic surface and onto cellular gingival models. The products were then...

We should all use ultrasound-guided core needle biopsy when investigating salivary gland lesions

Ultrasound core needle biopsy of salivary glands is an excellent diagnostic tool in terms of accuracy (both sensitivity and specificity), technical performance, and safety profile. This paper provided an update of the previous meta-analysis of the same question, which found...