Journal Reviews
Still not smelling
Post-Covid anosmia/hyposmia is a troublesome persistent symptom for lots of patients. Management is still elusive. This was a nationwide survey of ENT practitioners. Of the 715 surveyed members, only 7.4% responded. Most performed a nasal endoscopy, 60% ordered an MRI...
Corticosteroid prescribing in ENT - are we at risk of being sued?
Of medications leading to malpractice claims, corticosteroids comprise the third most common. They are used widely and have a significant side-effect profile: hypertension, lipodystrophy, diabetes, avascular necrosis of the femoral head, peptic ulceration and psychiatric reactions to name but a...
Patients with auto-immune Meniere’s disease more likely to respond to intratympanic steroids
The authors retrospectively reviewed the duration of symptom control after intratympanic dexamethasone (IT) injections in 27 patients with Meniere’s disease (MD) over a six-year period. The patients received two IT injections of 3.3mg/ml of dexamethasone one-to-two weeks apart. Eleven patients...
Role of intratympanic corticosteroid for treatment of Bell’s palsy and Ramsay Hunt syndrome
Acute peripheral facial palsy occurs annually in 30 in 1,000,000 individuals in the general population. Bell’s palsy and Ramsay Hunt syndrome account for about 70% of cases of peripheral facial palsy. They are believed to be caused by viral reactivation...
Treatment options for vestibular neuritis: systematic review and meta-analysis
Vestibular neuritis (VN) is the third most common cause of peripheral vertigo. VN has been postulated to have viral aetiology and historically it was treated with steroids, until 2011 when a Cochrane review demonstrated lack of robust evidence behind this...
Intratympanic steroids - to give or not to give?
The treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) is controversial and different modes of steroids have been tried without any universal consensus. Various authors have reported combined oral and intratympanic steroid therapy in SSNHL, with consistent results in several...
Do steroids improve outcome in acute vestibular neuritis?
The role of steroids in short and long-term recovery from acute vestibular neuritis has been a subject of debate for several years. The authors reported findings of a prospective randomised trial in 60 adult patients. Inclusion criteria were acute vertigo...
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...
Review of surgical treatments of intractable Meniere’s disease
This is a nice summary of the evidence available for the surgical treatments for intractable Meniere’s disease. To summarise, in five-10 years, over 90% of vestibular neurectomy cases, more than 80% of intratympanic gentamycin treatment, and 70-80% of endolymphatic sac...
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...
Not so innocent, after all: a meta-analysis of the effects of intranasal corticosteroids on growth
The use of intranasal corticosteroids has revolutionised the management of allergic rhinitis and rhinosinusitis and there is now significant evidence of their safety. The problem with side-effects is that clinical studies are designed to demonstrate efficacy, but are underpowered to...
