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The MACRO Trial: defining best management of chronic rhinosinusitis

A major UK trial in The Lancet finds ESS provides greater symptom relief than long-term macrolides for adults with CRS, supporting earlier surgery and fewer antibiotics. The MACRO Programme was established in 2016 when the UK National Institute of Health...

Greener pastures? Reflections from UK ENT surgeons now practising abroad

Ever considered practising ENT abroad? Here are some experiences of previously UK-based ENT surgeons who took the plunge and are now plying their trade in distant lands. Andrew McCombe ENT ConsultantDate of migration: December 2015Place of work: Mediclinic City Hospital,...

Research ethics and otolaryngology

The aim of this review was to assess the frequency of reporting of informed consent and regional ethical committee (REC) approval in all reports of trials published in the three major European otolaryngology journals in 2012 (including Clinical Otolaryngology itself!)....

What do SLTs do in palliative care?

The authors of this article highlight that the number of older people has increased significantly in the last two decades, and the number of people over 85 has doubled in Australia since 1996. They attribute this to improved lifestyle factors...

The right to choose: stories from the rare dementias

People with primary progressive aphasia (PPA) experience an insidious onset and gradual decline in language on a background of lesser or no cognitive impairment, hence a language-led dementia. There are three different PPA variants that correspond with three different clinical...

Quo vadis FESS? Future directions in functional endoscopic sinus surgery

Endoscopic sinus surgery is now so ubiquitous that it is hard to imagine a time when it was not part of our clinical practice. Valentin Tomazic takes a look at its early development and looks ahead to endoscopic sinus surgery...

Temporal bone trauma

Introduction Temporal bone injuries represent one of the more complex management problems presenting to the otolaryngologist. This is largely due to difficulties in assessment and the frequent delays in referral, often as a result of other injuries demanding more immediate...

Botulinum toxin injection for bilateral recurrent laryngeal nerve paralysis

All traditional surgical treatments for bilateral recurrent laryngeal nerve (RLN) paralysis are essentially a balance between maximising airway patency and ensuring adequate phonation / airway protection. This paper highlights the potential role of botulinum toxin (Botox) injection into the cricothyroid...

Suspect the unsuspecting in thyroid cancer

This article reminds readers of how often invasive thyroid disease can appear, as the symptomatology is minimal. Noticeable airway symptoms appear after 50% of the airway is involved and surgeons can often fall in the unsuspecting trap of discovering locally...

Inter-aural hearing preservation in cochlear implantation

Hearing preservation during cochlear implantation is becoming increasingly important, although results can be unpredictable. NICE are in the process of updating their guidance in the UK and it is possible that those with better hearing than the current candidates will...

Minimally invasive surgery vs. linear incision for BAHA – outcomes compared at six months

The postoperative outcomes which are clinically relevant now in bone anchored hearing device surgery have come a long way over the past decade. The newer techniques have meant that previous concerns with skin numbness and cosmesis are now such rare...

Diurnal and monthly variations in secondary post-tonsillectomy haemorrhage rates

Several studies have looked into variable haemorrhagic rates with different methods of surgery and clinical backgrounds. Few have looked into non-clinical factors such as environment and diurnal influence on occurrence of post-tonsillectomy bleeding. This extensive study comprises 5357 tonsillectomy patients...