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Early recognition aiding better prognosis?

As we are all aware, acute invasive fungal rhinosinusitis (AIFR) is a life-threatening disease which typically affects immunocompromised patients. It is diagnosed via typical signs, symptoms and presentation but gold standard is by biopsy of tissues demonstrating infiltration fungal hyphae....

Metformin, the magical solution!

Both noise-induced hearing loss (NIHL) and vestibular schwannomas (VSs) pose a challenge in terms of management. Metformin was suggested as a potential therapeutic drug for NIHL when the drug-target interaction data was investigated. Additionally, there are studies which demonstrate reduction...

Vestibular schwannoma surgery and inner ear injuries

Iatrogenic inner ear injury during vestibular schwannoma (VS) surgery ranges between 20% and 30% in the literature. However, there is no up-to-date quantification of such injuries, hence this study. The authors conducted a US-multicentre database search looking for patients who...

Hearing preservation in cochlear implantation – an American cocktail

There has been an increase in hearing preservation cochlear implant (HPCI) surgery over the last decade. Both steroid and L-N-acetylcysteine (NAC) were used and investigated respectively in the past in HPCI surgery. Authors investigated the role of perioperative NAC and...

Cochlear implantation in inner ear schwannoma patients

Inner ear schwannomas (IES) are rare. Patients with IES tend to lose their hearing. Surgery is a treatment option, but it leads to complete loss of hearing. Other treatment options include stereotactic radiosurgery (SRS) and watchful waiting (WW). The authors...

Endolymphatic duct, a bit more than what meets the eye

It is theorised that the endolymphatic duct (ED) and the endolymphatic sac (ES) system play a role in both the production and absorption of endolymph. This system could be responsible for development of endolymphatic hydrops (EH). Recently, the presence of...

To pack or not to pack!

Ear packing is thought to support grafts, control bleeding and facilitate healing. However, it is not without complications such as fibrosis and infection. The authors aimed at investigating the effect of middle ear packing on graft success rate in myringoplasty...

Mastoid surgery for cholesteatoma

Landmark Paper: Toner JG, Smyth GDL. Surgical Treatment of Cholesteatoma: a comparison of three techniques. Am J Otol 1990;11(4):247-9. Canal wall up or canal wall down? Chris Aldren discusses the landmark paper that attempted to provide a definitive answer for...

Cochlear implant – should we follow the curve?

Slimmer electrodes were developed by cochlear implant companies under the premise of hearing preservation (HP). Electrode types included stylet-curved electrodes sheath-curved electrodes, and straight-flexible electrodes. Previous reviews did not compare sheath and straight electrodes. A systematic review and meta-analysis were...

COVID-19: UCT-Africa Virtual ENT transcends academic silos

The COVID-19 pandemic has been a global catastrophe with far-reaching consequences felt across many fronts around the world. One such aspect is the training of the future generation of ENT surgeons. With routine elective activity curtailed, academic conferences cancelled, and...

Prominauris: Which surgical technique to use?

Otoplasty accounted for 3.2% of all plastic surgical interventions, and 2.6% worldwide in 2015. Patient satisfaction ranges above 95% for prominent ear correction despite the myriad of available techniques in the literature associated with highly variable outcomes. The authors split...

Corticosteroid prescribing in ENT - are we at risk of being sued?

Of medications leading to malpractice claims, corticosteroids comprise the third most common. They are used widely and have a significant side-effect profile: hypertension, lipodystrophy, diabetes, avascular necrosis of the femoral head, peptic ulceration and psychiatric reactions to name but a...