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A more comprehensive management for eosinophilic chronic rhinosinusitis after FESS

In recent years there has been increasing recognition of eosinophilic chronic rhinosinusitis which, in particular, results in persistent symptoms and recurrence of nasal polyps, even after FESS surgery. It therefore calls for measures adjuvant to FESS to stop persistence of...

Use of topical steroids and antibiotics, compared to systemic antibiotics in the treatment of acute rhinusinusitis

Acute rhinusinusitis is mainly initiated by viral infections. Bacterial infection is usually superadded. The inflammatory cascade upregulates the pro-inflammatory mediators resulting in pain, nasal obstruction and nasal discharge. Local application of steroids and antibiotics could provide a higher concentration of...

Should intratympanic steroids be the first line treatment for sudden sensorineural hearing loss?

This article looked at whether intratympanic steroids (ITS) provide more benefits over systemic steroid therapy (SST) as initial therapy in patients with idiopathic sudden sensorineural hearing loss (ISSHL). This meta-analysis study, based on published RCTs, concluded that ITS treatment exhibited...

Endoscopic arytenoid abduction lateropexy for bilateral vocal cord paralysis in neonates

We are delighted to publish a further update on the use of the technique for vocal fold lateralisation in neonates from Laszlo Rovo and Shahram Madani, who have previously informed us of this new technique [1]. These cases are rare...

Does salvage treatment in sudden sensorineural hearing loss work?

Many treatment strategies for sudden sensorineural hearing loss (SSNHL) have been discussed, but the high spontaneous recovery rate (32-65%) of idiopathic SSNHL and differing treatment guidelines make comparing outcomes difficult. Systemic steroids are the most common first-line therapy with significant...

Monitoring the mouth in ALS

Amyotrophic lateral sclerosis (ALS; or motor neurone disease) is characterised by gradual loss of function in the speech muscles resulting in a progressive deterioration in a person’s ability to communicate. The aim of this study was to investigate the use...

Evidence-based practice: management of sudden sensorineural hearing loss

What is the current evidence for medical management of sudden sensorineural hearing loss? Jessica Choong and Stephen O’Leary present a review of the current evidence of treatments options. Sudden sensorineural hearing loss (SSNHL) causes significant distress and, in many cases,...

Sinus implants to treat recalcitrant polyps

It is well established that the burden of chronic rhinosinusitis on healthcare costs and patients’ quality of life is high, and that current mainstream treatment options of oral or topical steroids are not without problems. This paper compares two RCTSs...

Role of intranasal steroids after radiotherapy for nasopharyngeal carcinoma

Rhinosinusitis often follows radiotherapy in the treatment of carcinoma of the nasopharynx. The interval and severity may vary with the dose of radiation and stage of the carcinoma. In this randomised, controlled study, patients who developed rhinosinusitis after radiotherapy treatment...

Benefits of combined antiviral and corticosteroid therapy in Bell’s palsy and the role of decompression surgery

Early use of steroids has been established as standard management in Bell’s palsy but simultaneous use of antiviral agents has variable acceptance. This review article analyses statistically based evidence to settle the issue. High quality evidence from a 2009 Cochrane...

The common frontal sinusotomy (Lothrop) and chronic rhinosinusitis

As our understanding of the pathophysiology of CRS evolves, so do our treatment strategies. It is accepted that in many cases, the main role of surgery is to allow better penetration of topical therapies to the sinus cavities. What, then,...

Hear me out – tiny steroid implants for fighting meningitis-induced deafness

Sensorineural hearing loss is the most common neurological complication of pneumococcal meningitis. Bacterial infiltration into the inner ear triggers inflammation, leading to cochlear fibrosis and sclerosis – damage that, in over a third of cases, affects both ears. Current Infectious...