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Discovery in the genetics of complex disease: Otitis media

Otitis media (OM), a common disease of childhood, is considered to be a complex trait with multiple genetic and environmental factors expected to contribute to a child’s risk of developing recurrent acute OM (rAOM; ≥3 episodes in 6 months or...

Endoscopic ear surgery in children

The benefits of endoscopes in otologic surgery, which have become increasingly widely appreciated in recent years, are very well suited to the management of paediatric middle ear disease. Although one might imagine that the smaller ear canal of a child...

Is one glass of wine on call safe?

It’s a standard question for those about to sit a Specialist Training (ST) interview; you are on call and you call a senior colleague in to perform an operation. You smell alcohol on the breath of the surgeon, so what...

Outcomes of office-based biopsies for laryngopharyngeal carcinoma – faster diagnoses and equivalent oncological outcomes as compared to biopsies under general anaesthesia

Patients in the UK with head and neck cancers are the most likely to face long waits to treatment in comparison to other cancer sites, with only just over half commencing treatment within 62 days of being referred on a...

A comparison between ultrasonography-guided drainage with open surgical drainage of deep neck space abscesses

A comparison between ultrasonography-guided drainage with open surgical drainage of deep neck space abscesses Neck space abscesses are common; conventional drainage involves intra-oral or extra-oral approaches. The former can compromise the airway and the latter can cause neurovascular injuries, scarring...

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...