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No soup for you…! Early identification of postoperative perforation increases the success of conservative management
Iatrogenic perforation of the hypopharynx or cervical oesophagus is a well-recognised life-threatening complication. Previous studies have demonstrated that conservative management with broad-spectrum antibiotics and withholding oral feeding may avoid morbidity associated with surgical repair. This study addresses when conservative management...
The theory of everything (tonsil)?
Tonsil sepsis can manifest as acute tonsillitis, a peritonsillar abscess (PTA) or rarely as an intra-tonsillar (ITA) abscess. Whilst the management of these conditions is familiar to ENT surgeons from early in training, perhaps little attention has been paid to...
Smell and mental health
This national survey from Korea asked questions about many aspects of health and one of these was about sense of smell. The prevalence of olfactory problems was 5% in the adult group surveyed, and other studies would suggest that this...
Combined sprays for allergic rhinitis maintenance
This meta-analysis looked at the reported efficacy for allergic rhinitis control of various topical sprays, particularly comparative studies. There were fewer ‘head to head’ studies than we would have hoped to exist. This review included intranasal anti-histamines, intranasal steroids and...
Choosing Wisely!
This article focuses on the prickly topic of healthcare costs and specifically on reducing spending on neuroimaging for headaches. Epidemiological studies indicate that the prevalence of lifetime headaches is 93 to 99% and accounts for 1.5% of all primary care...
Hearing aid standards and test systems
Hearing aids are the most used management / rehabilitation option for people with hearing loss. Generally, hearing instrument manufacturers perform the hearing aid performance measurements and provide its specification in terms of functionality. However, it is also common for government...
Postoperative complications in OSA patients
This well researched meta-analysis describes the various complications obstructive sleep apnoea (OSA) patients may acquire after surgery. These American reviewers found that OSA patients after non-upper airway operations, were more like to suffer (compared to non-OSA patients), from the following...
Passive smoking and rhinosinusitis
One would expect that subjects exposed to more passive smoke would have a significantly increased level of rhinosinusitis. This study looked at a reasonable number of sinusitis and control subjects (404 and 165) using hair nicotine as an assessment of...
Improving smell outcomes after sinus surgery: impregnated dressings?
There is much we can do to improve the airway of patients with chronic sinus disease, especially those with polyps. However, the olfactory outcomes are usually disappointing and patients miss this important sensory modality, which has an effect on their...
What do we put in our nasal douches? Anything?
The rise of the popularity of saline nasal douches, with several commercial preparations available, may be a rediscovery of an age-old tradition, but it has been shown to benefit patients. The question then arises as to whether this can be...
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...
