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Can we predict how much benefit patients will get from ESS with a novel monoclonal antibody

Mepolizumab (Nucala) is a humanised IgG1 monoclonal antibody that acts as an IL-5 antagonist. It has been shown to be highly effective in treating severe asthma. It is hypothesised that it will be effective for patients with recalcitrant CRSwNP. This...

Ethanol ablation for benign cystic neck lesions

Benign cystic head and neck lesions have traditionally been managed conservatively or with surgical excision. Ethanol ablation (EA) has now established a role in the management of benign thyroid cysts, and its use has also been expanded to non-thyroid cysts....

Is there a limitation for excising parapharyngeal tumours transorally?

The parapharyngeal space is a complex anatomical space bounded medially by the oropharynx and laterally by the mandible. It is conceptualised as an inverted pyramid extending from base of skull above to the hyoid bone below. The space is divided...

Assessment of temporal bone skills on 3D-printed temporal bones – a useful training curriculum?

The authors contend it is now archaic to follow Halstead’s model of surgical training, namely ‘see one, do one and teach one’. Simulated training is now widely used in many surgical specialities. With every surgical trainee having an individual learning...

Swallowing and breathing: speech and language therapy

Swallowing difficulties are a common comorbidity in just over a quarter of people living with chronic obstructive pulmonary disease (COPD). Given the associated risks of aspiration and exacerbation of COPD symptoms, speech and language therapists (SLTs) can offer valuable guidance...

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...

Does sleep quality improve when we adequately treat CRS?

In addition to the well-known symptoms associated with chronic rhinosinusitis (CRS), patients often suffer with poor sleep quality which is also detrimental to health and wellbeing. This meta-analysis looked at 35 papers reporting outcomes for CRS patients post surgery on...

Inpatient or outpatient thyroidectomy?

This systematic review and meta-analysis discusses the safety of hemithyroidectomy in an outpatient vis-à-vis an inpatient setting. Thyroidectomy has traditionally been performed as an inpatient procedure. Currently, an increasing number of surgeons are performing thyroidectomy in outpatient settings. The main...

Assessment of audiological needs

A thorough assessment of audiological needs is crucial for a successful audiological rehabilitation. This study concentrated on creating the Québec Audiological Assessment Protocol for Younger and Older Adults (QAAP-YOA) that could be easily adopted in audiological clinics. The authors used...

A comparison between trainee and trainer outcomes in mastoid surgery

In this era where training faces restrictions due to theatre time, fewer sessions available to trainees and requirements of consultant-led and consultant-delivered services, one unit confirmed that myringoplasties given to trainees reduced from 34.2% to 16%. This study compares outcomes...

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...

A new treatment for septal perforations?

Nasal septal perorations are notoriously difficult to close surgically and can be extremely symptomatic and debilitating for the patient. This paper describes the use of carvacrol (a monoterpene phenol of the family Lamiacaea which is often found in essential oils)....