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Surgery or medicine: when should we stop trying to be conservative?
Although most otolaryngologists would agree that surgery improves the outcomes of patients with CRS when medical treatment has failed, both Cochrane reviews state that there is no proof of improved efficacy of surgery over medicine – however, that was after...
An overview of cranioplasty
This article provides a summary of the indications, materials and current techniques available in cranioplasty. Cranioplasty is performed to restore the normal architecture of the skull following craniectomy for many reasons including intracranial infection, trauma and neoplasm. The timing of...
Microbiome changes after endoscopic sinus surgery: all is not what it seems
As we keep fighting a losing battle with bacteria and antibiotics, it becomes clear that it is not about killing bacteria, not even diminishing the bacterial load, but rather about shifting the different types of bacteria that colonise and live...
IV dexamethasone versus LA infiltration during paediatric tonsillectomy
Postoperative nausea and vomiting following tonsillectomy is important to control for improved oral intake and satisfaction following surgery. Optimal management is still debated. This team from Beirut conducted a randomised double blind clinical trial comparing the effect of intravenous dexamethasone...Rhinology: what does the future hold?
David Kennedy surveys the past, the present and the future of rhinology practice and research. An evolution of understanding in rhinology The dramatic growth of clinical and translational research within the field of rhinology in recent years is illustrated by...
Biofilms in Otitis
If you haven’t already heard of biofilms, this book will tell you that they are multicellular networks of bacteria encased in a matrix, a complex multidimensional biologic fortress that protects bacteria against changes in the environment, host immune responses and...
Experience of the Sophono transcutaneous bone conduction system
This article is a frank discussion of the authors’ experience implanting these devices. The principle of the device is surgical implantation of a bilobed magnet within a bony well in the cranium (similar position to BAHA). The implant is a...
Management of necrotising otitis externa
Although uncommon, necrotising (previously malignant) otitis externa (nOE) can be very aggressive, particularly if not managed appropriately. In this study the authors perform a retrospective review of 25 patients admitted with nOE over a four year period at a tertiary...
Are quinsies worth draining?
Recent data is providing accumulating evidence that treatment failure in the management of peritonsillar abscesses (PTAs, aka ‘quinsies’) is similar when these are managed with medical treatment (MT) alone versus MT plus surgical drainage (M+ST). However, in the absence of...
Role of maxillary sinus irrigation as an adjuvant to current management of chronic rhinusitis without polyposis
Several decades have passed since irrigation of maxillary sinuses generally became a treatment of the past. A more recent concept of biofilms may have evoked new interest in this past procedure, fraught with its own issues. In this study, the...
The hippo and the nose
Chronic rhinosinusitis with nasal polyps (CRSwNP) leads to histological changes including thickening of the basilar membrane and epithelial proliferation. Molecular mechanisms underlying these changes are still not fully clear. A signalling pathway called the hippo with Yes‐associated protein (YAP) as...
