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Should we be doing earlier MRIs in sudden sensorineural hearing loss?
There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....Salivary duct clipping for drooling
Drooling can be a challenging problem to manage in paediatric ENT. The variety of medical and surgical treatments suggests that there is no gold standard treatment. Nicola Stobbs and Ravi Thevasagayam describe an approach to ligating the salivary ducts. Drooling...
Oral versus oral and intratympanic corticosteroid treatment for sudden sensorineural hearing loss
The 2012 American Academy of Otolaryngology- Head and Neck Surgery Foundation (AAO-HNSF) clinical practice guidelines on sudden sensorineural hearing loss (SNHL) have two statements that address steroid use. Statement eight indicates an option to offer corticosteroid as initial treatment for...
Sleep Disordered Breathing in Children: A Comprehensive Clinical Guide to Evaluation and Treatment
This book offers a very comprehensive guide to sleep disorders in childhood. It is presented in six sections covering the normal upper airway, sleep during development, diagnostic assessment of sleep and breathing in children, sleep disordered breathing in children, the...
Can junior doctors provide immediate help in airway and other ENT emergencies?
In the present trends for centralisation of ENT emergency services, availability of immediate middle grade or senior help in acute ENT emergencies does not always exist on site and hence the role of junior doctors in handling this is enhanced...
Steroids pre-FESS
This meta-analysis and systematic review from the Netherlands and the UK aims to answer the question of whether corticosteroids inhaled and / or taken orally are beneficial to patients with chronic rhinosinusitis undergoing functional endoscopic sinus surgery. Refreshingly 18 RCTs...
Guidelines for management of orbital infections
Orbital infections predominantly affect the paediatric population and complications can be very serious. The cellulitis can be preseptal or orbital and the abscess can be confined within the periosteum or extend into the orbit. Cavernous sinus thrombosis can complicate the...
Aerosols and polypi
Infection in the operative cavities after endoscopic sinus surgery for sinonasal polyposis leads to recurrence of symptoms and mucopurulent discharge. The usual therapies include systemic antibiotics sometimes with steroids. The authors hypothesised that the use of a topical antimicrobial (tobramycin...
Nasal decongestants don’t improve Eustachian tube function
Prescribing nasal steroids and decongestants. It’s something most of us do routinely, in an effort to reduce chronic middle ear effusion in an adult by trying to improve eustachian tube (ET) patency. This study used clever devices (tube manometry and...
Deep neck infections
This study from Shanghai is a retrospective review of 142 patients presenting to an ENT hospital with deep neck infections (DNIs). The findings of the study are comparable to many of the previous studies, however the authors found tonsillitis and...
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...
