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Sellar surgery – when to prepare for repair

Endoscopic sellar surgery, especially for adenomas, is a relatively safe, straightforward surgery with (mostly) reproducible results and few complications. One of the commonest complications is the creation of a CSF leak with the subsequent need for repair (there is usually...

The increasingly favourable outcomes from endoscopic endonasal approaches for the management of pituitary adenomas

Historically, pituitary tumours have been surgically managed with an open, transcranial approach. Although this approach still has its merits in large intracranial adenomas, technological advancement has allowed smaller tumours to be debulked via a transseptal microscopic technique. These days, the...

Allergen specific subcutaneous immunotherapy helps in prolonged control of allergic rhinitis

One of the commonest allergens involved in perennial allergic rhinitis is house dust mite. A good proportion of these cases prove intractable to treatment with oral and intranasal antihistamines and intranasal steroid sprays. Immunotherapy is considered a useful alternative and...

How should I excise sinonasal tumours, open or endoscopic? En bloc or piecemeal?

Sinonasal tumours often present late because initial symptoms mimic benign disease. They tend to produce more unilateral nasal symptoms, and patients with advance disease often describe paraesthesia and other cranial neuropathies. They only account for approximately 3% of upper aerodigestive...

Aerosols and polypi

Infection in the operative cavities after endoscopic sinus surgery for sinonasal polyposis leads to recurrence of symptoms and mucopurulent discharge. The usual therapies include systemic antibiotics sometimes with steroids. The authors hypothesised that the use of a topical antimicrobial (tobramycin...

Paediatric salivary gland tumours

This is a review article of a rare group of neoplasms that frequently present as painless preauricular mass in older children. There is a wide differential including first branchial arch abnormalities, inflammatory and granulomatous processes. Those masses that are painless,...

Postinfectious olfactory disorders

Recovery of olfactory function following URTI is frequent, even many years after the infectious insult. Upper respiratory tract infection is the commonest cause of olfactory loss. Many treatment options exist including topical steroids, vitamin B, acupuncture, and zinc, which can...

Thyroid nodule update

This excellent article summarises the current diagnostic difficulties with an endocrine gland that frequently produces nodules, some of which may harbour malignancy. At 50 years of age and over there is about a 50% chance of having a nodule; at...

An analysis of 60 treated cystic lesions in children

This is a retrospective single-centre study of 60 consecutive cases in children. Children aged four months to 14-years-old underwent intervention under general anaesthetic from 2000 to 2012. As one might expect, most of these cysts were mucoceles and ranulas. Of...

Viral induced hearing loss

Viruses are a common cause of hearing loss both in children and adults. This article provides a good review of the viral causes of hearing loss and can be regarded as an essential read. The authors divide the viruses into...

Death related to epistaxis

One of the commonest emergencies presenting in ENT is epistaxis. The presentation can be through accident and emergency or through ward referrals. In this national audit of epistaxis management involving 113 centres, it was noted that 33 of the 985...

Algorithm for malignant otitis externa

Timely detection and effective management of this potentially fatal condition cannot be overemphasised. This study presents 16 cases over 12 months in a tertiary referral centre. Most patients had diabetes and others were immunocompromised due to radiotherapy, immunosuppressive medication or...