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A novel way to reduce postoperative nausea and vomiting
This is an interesting RCT which evaluates the prophylactic effect of bilateral endoscopic injection of local anaesthetic in the sphenopalatine ganglion (SPG) on postoperative nausea and vomiting (PONV). It has a robust design, and is sufficiently powered and blinded, with...
Visual distraction helps patients tolerate flexible laryngoscopy
With the arrival of flexible fibreoptic laryngoscope some 35 years ago, the examination of the laryngopharynx has become remarkably easier and saves immense time and costs since the days of mirror examination when this examination was not truly satisfactory in...
Daflon – a new way to treat idiopathic epistaxis
Epistaxis is a common ENT emergency and most cases are idiopathic. Flavonoids are natural substances with variable phenolic structures that are found in fruit and vegetables and take effect on blood vessels. Daflon is proposed to control epistaxis by “improving...
Gastro-oesophageal reflux and cricopharyngeal dysfunction – how do they link?
It has been hypothesised that cricopharyngeal muscle hypertrophy develops as a response to chronic gastro-oesophageal reflux disease. The cricopharyngeus muscle is an important component and contributor to the upper oesophageal sphincter that creates a barrier between the pharynx and oesophagus....
Deglutition in pharyngolaryngectomy patients
Circular defects after total pharyngolaryngectomy present a reconstructive challenge. In this study, the authors compared the swallowing results after three reconstructive techniques: free forearm flap, free jejunal loop and folded pectoralis major flap. Forty-six patients were included and were evaluated...
How to manage the concha bullosa in FESS
It is an interesting concept to assess how much impact the presence of a large concha bullosa (CB) has on both severity of chronic rhinosinusitis (CRS) and also postoperative outcomes after FESS. The authors accept that the paper has limitations...
Preventing major postoperative haemorrhage following TORS
Transoral robotic surgery (TORS) has become an increasingly utilised treatment modality in the management of oropharyngeal squamous cell carcinoma (OPSCC). Postoperative haemorrhage, although uncommon, is a significant complication. To ameliorate this risk, transcervical ligation of branches of the external carotid...
Hemilaryngopharyngeal Spasm (HeLPS)
The authors report an unusual case of hemilaryngopharyngeal spasm (HeLPS) with glossopharyngeal neuralgia with otalgia in a middle-aged female patient. Her symptoms included left-sided sharp, electric sensation like pain radiating from her left ear to the left side of her...
When to operate on a patient without chronic disease?
As ENT surgeons, we spend a lot of time managing chronic rhinosinusitis, so a review and update on the management of the acute disease is always helpful. The standard medical treatment of antibiotics, nasal steroids and nasal decongestants are reported...
Indication and timing of electrodiagnostic tests in facial palsy
This excellent review describes the benefits and limitations of electrodiagnostic testing for patients with facial paralysis. Tests such as Schirmer, stapedial reflex and electrogustometry have been largely replaced by neurophysiologic tests like nerve excitability test (NET), electroneuronography (ENoG), surface electromyography...
Adenotonsillectomy day-case discharge criteria: a systematic review
In this paper, Gowda et al review the literature aiming to answer a long-standing question regarding the criteria for same-day discharge of paediatric patients post adenoidectomy and/or tonsillectomy performed for treatment of obstructive sleep apnoea (OSA). Following PRISMA consensus, they...
