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Choosing Wisely!
This article focuses on the prickly topic of healthcare costs and specifically on reducing spending on neuroimaging for headaches. Epidemiological studies indicate that the prevalence of lifetime headaches is 93 to 99% and accounts for 1.5% of all primary care...
Argh! Facial pain! What to do??
We often come across patients with presentation of facial pain, but unless this is sinugenic in origin, our understanding and management of it can often be found wanting. Craniofacial pain is in fact highly complex and encompasses a wide range...
Deep neck infections
This study from Shanghai is a retrospective review of 142 patients presenting to an ENT hospital with deep neck infections (DNIs). The findings of the study are comparable to many of the previous studies, however the authors found tonsillitis and...
Day care or admission for aesthetic nasal surgery?
Day-care surgery is gaining in popularity throughout the surgical specialities due to economical constraints and patient convenience. However this is not without risk and a careful procedure by procedure evaluation should be performed to prove the suitability of this type...
Use of tranexamic acid in ENT surgery
Postoperative bleeding in otolaryngologic procedures causes delayed discharge, requires re-admission and adds considerably to the cost of patient care. Whether the anti-fibrinolytic activity of tranexamic acid should be used routinely to prevent haemorrhagic complications after ENT operations is speculation but...
Stereotactic radiosurgery for pituitary adenomas
Residual and recurrent functioning pituitary adenomas can be difficult to delineate on postoperative MRI scans, making them difficult targets for stereotactic radio surgery. In such cases radiation delivery to the entire sellar has been utilised as a radio surgical equivalent...
Controlling tinnitus
The absence of sufficient evidence for the use of integrated sound generators for the management of tinnitus led the authors to conduct a randomised blind clinical trial in which they compared the use of a conventional hearing aid with a...
Transnasal oesophagoscopy: prospective cohort review
This paper looked at 257 patients undergoing the procedure in a tertiary otolaryngology department. In light of the morbidity of upper GI endoscopy associated with the sedation required, the safety profile of transnasal oesophagoscopy is a clear advantage. This cohort...
Chronic rhinosinusitis, are we treating the same disease?
Chronic rhinosinusitis (CRS) is a heterogenic disease. The effects of heterogeneity on treatment outcome are not very clear. Authors used clinical features such as endoscopic findings scores and full blood count findings in addition to analysis of 35 molecular markers....
When to treat a fractured mandible?
This is a prospective study from Brisbane of 215 patients with a total of 359 fractures of the mandible. Nine outcome variables were analysed with a further 19 included to adjust for potential confounding. Treatment delay was found not to...
Delirium post-op
This is a retrospective study from Japan analysing 102 patients who underwent oral cancer resection and free flap reconstruction. Postoperative delirium occurred in a third of these patients. An increased risk was identified in those with high preoperative albumin, postoperative...
