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Location, location, location: How to get the steroid where you need it, in chronic rhinosinusitis

What almost all current guidelines on chronic rhinosinusitis have in common is the importance of intranasal steroid (INCS) use. However, it is increasingly understood that the efficacy of INCS depends on their efficient delivery to the point of need, i.e....

Effects of nasal sprays on ciliary function

What do topical nasal sprays do to the nasal mucosa in the long term? This study reports the effect of corticosteroids, antihistamines and common preservatives in nasal sprays, benzalkonium chloride (BKC) and potassium sorbate (PS), on an in-vitro model of...

An app to help display hearing results

Vestibular neuronitis (VN) is a common condition that we treat. Despite this, many of us lack the in-depth knowledge and scientific reasons for doing what we do. Granted, the evidence is lacking in some areas but this paper is worth...

Botulinum toxin and drooling – how much, how often and where?

This was an incredibly useful article covering all aspects of the use of botulinum toxin as a treatment modality in sialorrhoea. The article starts by outlining why treating sialorrhoea is important and describes the non-pharmacological and pharmacological options, highlighting that...

Assessment and management of dysphagia in the elderly

This article covers dysphagia in older patients, which is an important topic due to an ageing population, and a relatively common symptom that we see in clinic. Dysphagia could be due to presbyphagia secondary to changes in head and neck...

Speculating on saliva during endoscopy

It has been noted that the presence of saliva in the pharynx and larynx during flexible endoscopic evaluation of swallowing (FEES) can be an indicator of increased risk of aspiration and consequent pneumonia, as well as weight loss and malnutrition....

Resolving dysphagia – can we distinguish mild dysphagia from no dysphagia?

Many patients with dysphagia following neurological events can and do experience a resolution of their swallowing difficulties, sometimes without any intervention. However, it is challenging for clinicians to distinguish mild dysphagia from no dysphagia. The question of where to draw...

Do easier-to-swallow tablets improve medication adherence in people with dysphagia?

Swallowing tablets can be challenging for many people, but particularly so for those with a diagnosis of dysphagia. As a result, many medications are prepared in alternate formats including liquid, dissolvable or orally disintegrating tablets that dissolve on contact with...