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Time to endoscopic sinus surgery and outcomes
A well written prospective study, which demonstrates that patients who require endoscopic sinus surgery, should be operated on without long delay since this achieves better and more sustained outcomes. There were 1493 patients undergoing primary nasal surgery who had completed...
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...
When should that child’s wet ear be operated on?
The team from Birmingham have provided a meta-analysis to answer the question of when to perform a type 1 tympanoplasty on chronic paediatric perforations (under 18 year olds). Forty-five studies were included which resulted in 2609 cases. Closure rate at...
Postoperative radiation in early stage oropharyngeal squamous cell cancer (OPSCC)
There is significant variation in treatment strategies for OPSCC between units. This is largely due to unanswered questions which continue to exist beyond the published literature. We know that human papilloma virus status has a significant influence on prognosis but...
Local dexamethasone infiltration in tonsillectomy
Intravenous dexamethasone is routinely given during tonsillectomy for its effects on postoperative pain and nausea. This Chinese randomised study divided 240 children undergoing tonsillectomy into three groups, receiving either no steroid, intravenous dexamethasone, or the same amount of dexamethasone infiltrated...
The effect of sleep deprivation on auditory processing
This article caught my eye for personal and professional reasons. As a full time ENT trainee working 24-hour on-calls, I also have young children who have never slept through the night and don’t respect weekends or days off. My FRCS...
Waiting for smell to recover after post-viral hyposmia
The patient with post-viral anosmia will always want to know how long they must wait to reach a plateau. This study from South Korea of a comparatively small group (20 controls and 63 patients) tells us that favourable prognostic indicators...
Vascularised tissue in salvage total laryngectomy
Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...
The lateral neck cystic mass – diagnostic dilemma. Can HPV status help?
Solitary cystic masses in the lateral neck can present a significant diagnostic dilemma as they can be metastases from tumours of the oro or nasopharynx. This retrospective paper detailed all patients presenting to a university hospital in Germany, from September...
The snotty child?
This article is interesting for those of us who see children regularly in secondary care but rarely see them with chronic rhinosinusitis. The authors remind the reader of the EPOS guidelines for diagnosis of CRS in children: two or more...
How effective and safe is audiologist-led screening of acoustic neuroma in patients with asymmetrical hearing loss and unilateral tinnitus?
About two out of 100 patients presenting with asymmetric hearing and unilateral tinnitus have acoustic neuroma. The traditional method in which these patients first attend a clinician and then undergo screening through an MRI, can be expensive and prolong the...
