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Predicting CSF leaks pre FESS: Gera classification - a new tool?

An interesting study from Italy looking at an anterior skull base classification that may be useful in predicting risk of intraoperative CSF leak during FESS surgery. Traditionally we have used the Keros classification system, developed in 1962 to categorise olfactory...

CRSwNP, another monoclonal antibody

Interleukins 4, 5 and 13 were shown to be important factors in type 2 inflammation, which characterises chronic rhinosinusitis with nasal polyposis (CRSwNP). In CRSwNP non-responders and those who recur short after-surgery monoclonal antibodies might be an answer. Examples include...

A single blinded RCT comparing triamcinolone with 5-FU treatment for keloid scars

This single blinded RCT compared 43 patients with 50 symptomatic keloids that were randomised to two matched groups of 25 scars, receiving either 5-fluorouracil (5-FU) or current first line treatment, triamcinolone (TAC). The surgeon administering the injectable treatments was unblinded,...

Nasal physiology and septal perforations

This interesting article from North Carolina and New York aims to assess the impact of anterior septal perforations on nasal physiology, using computational fluid dynamics and computer simulation. A computerised 3D model was constructed of a normal patient aged 37,...

Can amplification preserve auditory function?

Hearing loss is a noted modifiable risk factor for dementia, and is also associated with depression, decreased quality of life and isolation. Hearing aids are the main intervention for presbycusis and a 2017 Cochrane Review showed that they have a...

Reduction in recurrent cholesteatoma rates with bony obliteration tympanoplasty technique

This large retrospective study from the Erasmus Medical Centre in Rotterdam compares outcomes in traditional canal wall up (CWU) and canal wall down (CWD +/- partial obliteration of mastoid bowl) mastoid surgery for cholesteatoma with bony obliteration tympanoplasty (BOT, which...

Blood-sampling prognostic predictors for Bell’s palsy

Bell’s palsy is generally defined as an acute-onset unilateral idiopathic mononeuropathy in the facial nerve. It is of unknown aetiology, however, inflammation is considered a major cause. Electroneurography assessing nerve excitability is the most reliable examination for predicting prognosis of...

AI in ENT practice

Artificial intelligence (AI) technologies are becoming increasingly prevalent in our lives and there has been both enthusiasm and caution for using AI in healthcare. A recent article in the Journal of the American Medical Association reported on a trial examining...

Case study suggesting mtDNA mutation as a tinnitus factor: ND1:m.3394T>C

Konadath et al report a genetic case study of a 24-year-old female experiencing reduced hearing sensitivity and tinnitus along with a blocked sensation in her right ear, sudden onset one year prior with no other otological complaints. Standard audiometry along...

Management of post-tonsillectomy bleeding with nebulised TXA

In the last 20 years, rates of adult tonsillectomy have fallen in the order of 50%. The flipside to this, is that the number of admissions of patients with acute tonsilitis is more than double the reduction in tonsillectomy rates....