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The effects of polypharmacy in the elderly

Another pill to cure the ill? Alec Lapira discusses the warning signs of polypharmacy in the elderly population. Polypharmacy in the elderly Polypharmacy – defined as the use of five or more medications – occurs in 20–37% of older people...

Therapeutic ultrasound for tumours

This review article provides details about the potential applications of transcranial focused ultrasound (FUS), its mechanism of action and the studies that have set the basis for its use in neuro-oncology. FUS is an emerging modality of therapy for various...

What we need to know about the new frontier of inner ear therapies

This is an interesting and topical review of the emerging biotechnology and pharmaceutical solutions for hearing loss and related conditions such as tinnitus. This paper suggests we are on the cusp of a very large step-change in the way we...

Describing the most useful OSA assessment?

This article sets out to comprehensibly describe drug induced sleep endoscopy and its role in determining the level of obstruction in patients with OSA. The advantages described include the fact that other techniques, including Muller’s manoeuvre, have significant variation in...

Immunosuppresants and ototoxicity

There is a wide range of immunosuppressant drugs ranging from calcineurin inhibitors (e.g. cyclosporine), anti-folic agents (e.g. methotrexate) to anti-TNF and monoclonal antibodies, many of which could be ototoxic. The authors performed a systematic review assessing ototoxicity secondary to immunosuppressant...

Cartilage myringoplasty to treat patulous eustachian tube dysfunction

Patulous eustachian tube (PET) dysfunction, where the eustachian tube is abnormally opened at rest, is a notoriously difficult condition to treat. Symptoms can mimic symptoms of superior semicircular canal dehiscence: autophony, aural fullness, hyperacusis and breathing synchronous tinnitus. Treatment has...

Omalizumab for CRSwNP: a monoclonal antibody

A prospective study from London, evaluating the response of chronic rhinosinusitis patients with nasal polyposis who were being treated with monoclonal antibody against IgE for severe allergic asthma. Thirteen patients were treated with Omalizumab, according to UK guidelines for their...

Polypharmacy in the vestibular clinic

Polypharmacy is defined as the simultaneous use of five or more medications and its prevalence is increasing. Dizziness or vertigo are common side effects of polypharmacy. Despite advancements in patient data management, there remains limited information on polypharmacy in patients...

A review of DISE classification systems

This article looks at the wide variety of classification systems currently available for interpreting drug induced sleep endoscopy (DISE).The fact that there are so many classification systems, suggests that there is: A) a lot of disagreement about how DISE should...

COOL therapy for cisplatin-induced hearing loss

Cisplatin is a commonly used cancer therapy, with nearly 50% of patients undergoing chemotherapy receiving cisplatin as part of their regimen [1]. Depending on the dose, incidence of hearing loss has been reported as 12-100% in adults, and 37-94% in...

Chronic rhinitis endotypes

Chronic rhinitis (CR) is common with up to 30% of the population affected, with a significant impact on quality of life. CR includes several phenotypes with different pathogenesis including allergy, autoimmune, age, occupation, pregnancy, neurogenic and drugs. Such variation means...

DISE as a rationalising tool for sleep apnoea surgery

This retrospective study on 85 adult obstructive sleep apnoea (OSA) patients provides further interesting information for sleep surgeons. These patients were all investigated with polysomnography (PSG) and drug induced sleep endoscopy (DISE). They all then underwent a simple uvulopalatoplasty with...