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Laser for active mucosal chronic otitis media

Active mucosal chronic otitis media (COM) is a condition characterised by otorrhoea secondary to chronic inflammation of the middle ear and mastoid mucosa associated with granulations and a tympanic membrane perforation. Surgical intervention is often required, but concurrent mastoidectomy with...

What is the evidence for duration of antibiotic prophylaxis in head and neck free-flap cases?

The topic of this systematic review is one which is commonly heard in discussions between microbiologists and head and neck surgeons – what is the evidence for antibiotic prophylaxis in clean-contaminated free-flap cases, and crucially, how long should antibiotics be...

Measuring the ‘impact’ of preoperative immunonutrition

Using preoperative nutritional supplements as part of ‘enhanced recovery’ in surgical patients is not a new concept. This interesting paper looks at the latest development in optimising patients undergoing head and neck oncological surgery. Immunonutrition (Nestle’s ‘Oral Impact’ in this...

Combined endoscopic and transcutaneous approach for removal of parotid stones

The authors describe a small case series (n=8) of patients with obstructive symptoms from sialolithiasis of the parotid gland. A combined endoscopic and transcutaneous approach was used. The position of the stone in Stensen’s duct was identified by endoscopic transillumination....

Gardasil vaccination – an effective adjuvant therapy for RRP?

The clinical manifestations of recurrent respiratory papillomatosis (RRP) can vary hugely from individual to individual. Whilst some affected children will outgrow the disease, a subset of patients will experience frequent recurrences and require multiple surgical procedures over the course of...

Consider PCR testing in culture negative necrotising otitis externa

Necrotising otitis externa (NOE) often does not yield identification of a causative organism to treat although in 90% of cases it is a member of the pseudomonas species. The incidence of fungal NOE is not to be forgotten and this...

Loss of smell in the age of COVID-19

Loss of smell (LOS) is a debilitating symptom with increasing interest for the medical community due to its high prevalence in COVID-19. In the present paper, a team of 15 experts provide recommendations for the investigation and management of patients...

Are quinsies worth draining?

Recent data is providing accumulating evidence that treatment failure in the management of peritonsillar abscesses (PTAs, aka ‘quinsies’) is similar when these are managed with medical treatment (MT) alone versus MT plus surgical drainage (M+ST). However, in the absence of...

A diagnosis-based scoring system to predict outcomes in necrotising otitis externa

Patients admitted with necrotising otitis externa have increased six-fold in the last 10 years. The prognosis is variable and dependent on co-existing morbidities. Charlston Comorbidity Index (CCI) is a weighted comorbidity scoring method, based on the presence or absence of...

Make food thy medicine!

This is a useful paper emphasising how diet affects health and various ENT conditions. We have known for many years the power of food as medicine. We also know that what we eat can affect our bodies in multiple ways...

Chronic rhinosinusitis – a pre-malignant condition?

Nasopharyngeal carcinoma (NPC) is a relatively uncommon diagnosis in the West but is prevalent in Southeast Asia. Several factors have been established to be associated with a higher risk of developing NPC, including salted fish consumption, smoking, alcohol, and Epstein...