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Argh! Facial pain! What to do??
We often come across patients with presentation of facial pain, but unless this is sinugenic in origin, our understanding and management of it can often be found wanting. Craniofacial pain is in fact highly complex and encompasses a wide range...
The stubborn polyp cases are ‘different’
The widely different behaviour of nasal polyp disease between patients is a major feature of rhinology practice and makes counselling of patients difficult when approaching their first operative intervention. Setting aside aspirin sensitivity (Samter’s triad), which is known to be...
ENT emergencies
This Belgian paper reports the epidemiology of 1296 patients attending the emergency department with ENT problems over a five-year period. As expected the most common presentation was epistaxis, but interestingly vertigo seemed to be the second most common presentation to...
Comparing patient and surgeon concerns in sinus surgery
This prospective observational study had a total of 180 patients undergoing endoscopic sinus surgery for chronic rhinosinusitis with or without polyposis. Data was analysed using descriptive statistics and analysis of variance. Subjects felt the greatest level of concern regarding potential...
Use of tranexamic acid in ENT surgery
Postoperative bleeding in otolaryngologic procedures causes delayed discharge, requires re-admission and adds considerably to the cost of patient care. Whether the anti-fibrinolytic activity of tranexamic acid should be used routinely to prevent haemorrhagic complications after ENT operations is speculation but...
Stereotactic radiosurgery for pituitary adenomas
Residual and recurrent functioning pituitary adenomas can be difficult to delineate on postoperative MRI scans, making them difficult targets for stereotactic radio surgery. In such cases radiation delivery to the entire sellar has been utilised as a radio surgical equivalent...
Risk factors for post tonsillectomy bleeds
This paper reviews post-tonsillectomy bleeding in 692 patients and attempts to tease out risk factors. The overall bleed rate of 11.6% seems very high. The return to theatre rate was 2.6%. The paper identifies male patients and adult patients as...
Ideal terminology for unexplained paediatric language problems
This paper aims to open a discussion about the different labels being used to refer to children’s unexplained language impairments. A wide range of terminology has been applied creating confusion, impeding progress of research and access to appropriate services. For...
Chronic rhinosinusitis, are we treating the same disease?
Chronic rhinosinusitis (CRS) is a heterogenic disease. The effects of heterogeneity on treatment outcome are not very clear. Authors used clinical features such as endoscopic findings scores and full blood count findings in addition to analysis of 35 molecular markers....
Interleukins, cilia and polyps
Interleukins (ILs) including IL13 (Th2 cytokine) are inflammatory mediators and their role in asthma has been detailed before. This study explores IL13 receptor expression in chronic rhinosinusitis with nasal polyps (CRSwNP). The authors investigate protein and mRNA expression levels of...
Is a chest x-ray necessary in making urgent referrals for suspected head and neck cancer?
The article presents an audit on urgent referrals for suspected head and neck cancer in 2144 patients. Only 8.6% of cases proved positive for head and neck cancer. The Scottish Referral Guidelines were adhered only in 55.1% of cases. Interestingly,...
