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The debate: endoscopic vs microscopic ear surgery – meta-analysis of outcomes

Although the endoscopic approach to ear surgery has become more common in clinical practice, the debate about its role versus the traditional microscopic approach continues in many ENT units. This meta-analysis from the Mount Sinai ENT department in New York...

Rhinotillexomania - how bad can nose picking get?

This is a fascinating first case report of rhinotillexomania associated with empty nose syndrome (ENS). Rhinotillexomania encompasses compulsive, pathological nose picking and is a variant of self-harm. Tranchito and Chhabra describe an elderly patient presenting with longstanding symptoms of nasal...

Updates on current evidence for biologics in chronic rhinosinusitis

For a comparatively short piece, this article manages to pack in a lot of important information about a complex emerging area of rhinology – immunologically targeted therapy (biologics). Immunologically targeted therapy is a rapidly progressing and expanding domain which is...

Enhanced recovery following surgery for head and neck cancer – the current evidence

Enhanced recovery after surgery (ERAS) programmes are now well established in many surgical specialities as a means of reducing postoperative complications and length of stay in hospital. Whilst many head and neck teams have interventions used to aid postoperative recovery,...

Laryngopharyngeal reflux - would mucolytics help?

With laryngopharyngeal reflux (LPR) being such a common presenting complaint to ENT clinics, who would not want to have more, effective treatment options for patients suffering with this annoying condition? In their small randomised, controlled trial, Chae et al put...

Do we need contrast MRI when screening for vestibular schwannoma?

Gadolinium contrast enhanced T1-weighted (gT1w) MRI images of the internal acoustic meati have long been considered the gold standard in the diagnosis of vestibular schwannoma (VS). However, the addition of contrast to the MRI examination increases the cost and time...

Otosclerosis - to scan or not to scan?

In an era of insidiously reducing thresholds for investigating patients, Maxwell and colleagues pose an important question: is high-resolution computed tomography (HRCT) prior to stapes surgery for otosclerosis worthwhile? Their practice typically considers HRCT for cases of suspected otosclerosis presenting...

RCT: tongue retaining devices vs CPAP for OSA

This study compared the effect of a tongue retaining device versus the use of CPAP in 27 patients within a crossover RCT design. Tongue retaining devices (also known as tongue stabilising devices), are similar in appearance to a plastic tongue-sized...

How common are swallowing problems in a general adult population?

This paper reports on the largest cross-continent study to date, looking at the prevalence of swallowing problems reported by adults in the community aged 18-65 years old. The authors used the Eating Assessment Tool (EAT-10) distributed via an online survey...

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...

Long-term effectiveness of sleep surgery for obstructive sleep apnoea

n this study, 39 patients from Turkey with obstructive sleep apnoea (of varying severity) underwent an expansion sphincter pharyngoplasty. This operation was devised by Prof Kenny Pang in Singapore and involves using the palatopharyngeus muscle and partly relocating it laterally...

An advance in imaging for sinonasal tumours?

Benign sinonasal growths are incredibly common, and malignant sinonasal growths thankfully rare. We know that malignant tumours often present late, and the imaging can sometimes be misleading, so the authors here compare using diffusion weighted imaging (DWI), dynamic contrast enhanced...