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Recalcitrant chronic rhinosinusitis: What to do next?

Whilst the majority of patients with chronic rhinosinusitis (CRS) will significantly improve with treatment, we are sometimes left with a ‘hard-core’ of nasal cripples who fail to improve despite our best efforts. How can we deal with these patients? Valerie...

The future of inner ear drug delivery

The techniques for delivering drugs to the inner ear system are evolving. Jeffrey Harris considers the myths, the facts and the potential for drug delivery innovations and how they can improve tomorrow’s hearing outcomes. The inner ear’s delicate membranous structure,...

Margin control using optical techniques in head and neck surgery

Emerging optical techniques such as high-resolution microendoscopy (HRME) are currently being examined for their reliability in discriminating benign from neoplastic epithelium. These techniques may offer the potential to detect the margin of an upper aerodigestive tract tumour in a non-invasive...

The stubborn polyp cases are ‘different’

The widely different behaviour of nasal polyp disease between patients is a major feature of rhinology practice and makes counselling of patients difficult when approaching their first operative intervention. Setting aside aspirin sensitivity (Samter’s triad), which is known to be...

Eosinophilic or not eosinophilic: dupilumab seems to work

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammation with interleukin (IL)-4, IL-13, and IL-5. Tissue eosinophilia in nasal polyps dramatically increased over a 10-20-year period. Classification of the severity of eosinophil status is expected to lead to...

Medication and its effect on the larynx

This article summarises different medications and their effect on the voice. A growing number of patients we see in clinic are on multiple medications that could affect vocal cord function. The author summarises different classes of medications and their potential...

Platelet-rich plasma to reduce post-tonsillectomy haemorrhage and pain

Minimising haemorrhage and promoting healing of raw areas are cornerstones for uneventful and speedy recovery after tonsillectomy. In this single-blinded prospective experimental study, application of platelet-rich plasma to one side tonsillar bed has been compared to the other side in...

Nasal disease and quality of life in athletes

Rhinitis is a nasal condition which is generally underappreciated in primary care and even less in athletes. In this study, the authors specify nasal symptoms constituting rhinitis as nasal blockage, sneezing bouts, rhinorrhoea and itching and compare their prevalence in...

A new criterion for diagnosing chronic tonsillitis?

It is essential to establish the diagnosis of recurrent tonsillitis in patients undergoing tonsillectomy. This is based mainly on history which itself can be inaccurate and is supported by clinical findings which are not truly specific. There seems to be...

Steroids for vocal cord mucus retention cysts

This is an interesting paper that describes the use of intralesional steroid injections to treat vocal cord mucus retention cysts. The gold standard is microlaryngoscopy and excision of the lesion. In patients who may be unable to undergo surgery, this...

Globus – benign when the sole symptom

This is a prospective cohort study of Danish patients that presented to an otolaryngologist’s office with globus over the course of a year. They accounted for 4% of new patients, amounting to 122 patients in this study (57 patients were...

Are cardiovascular risk factors associated with hearing loss?

Cardiovascular disease (CVD) risk factors are associated with microvascular damage that can impair molecular transport across capillary walls and cause inflammation and oxidative stress that may damage cochlear structure and function. This study determined, among a population-based sample of Canadian...