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THRIVE: redefining airway management in endoscopic oesophageal surgery
Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) is no longer just a tool to help anaesthetists secure a difficult airway. Thanks to the work of authors like Yang and colleagues, it is being revolutionised to provide apnoeic oxygenation during endoscopic...
Role of oral and intranasal steroids in the management of otitis media with effusion
Inflammation is considered an important factor in the pathogenesis and continuation of otitis media with effusion. Theoretically, this may support the use of steroids, oral or intranasal in the management of this condition. This study comprised three well matched groups...
Nasal steroids do not cause ocular problems
This excellent, high quality and detailed systematic review from Australia dispels the myth propagated recently by some poorly designed studies that intranasal corticosteroids cause intraocular problems. A 40 year review of the usual databases found 665 articles and 19 were...
Transnasal oesophagoscopy: prospective cohort review
This paper looked at 257 patients undergoing the procedure in a tertiary otolaryngology department. In light of the morbidity of upper GI endoscopy associated with the sedation required, the safety profile of transnasal oesophagoscopy is a clear advantage. This cohort...Superior semicircular canal dehiscence: transmastoid obliteration
Sometimes patients with dizziness turn out to have slightly more unusual causes of their problem. Thomas Milner and Georgios Kontorinis describe their technique for managing patients who have a diagnosis of superior canal dehiscence as an identified cause of their...
Nasal packing after septoplasty
This Turkish study aimed to investigate the effects of different types of nasal packings on middle ear pressure in patients undergoing septoplasty. The authors reference several articles that describe eustachian tube dysfunction, temporary ear fullness and mild pain due to...
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...
Intranasal steroids in COVID-19
COVID-19 in patients with allergic conditions does not seem to take more severe course. The Global Initiative for Asthma recommended that asthmatic patients who are on prescribed inhaled or oral steroids should continue to take them. Contradictions between guidelines in...
Combined sprays for allergic rhinitis maintenance
This meta-analysis looked at the reported efficacy for allergic rhinitis control of various topical sprays, particularly comparative studies. There were fewer ‘head to head’ studies than we would have hoped to exist. This review included intranasal anti-histamines, intranasal steroids and...Covid-19 Tips and insights
The following blog articles have been kindly provided by Eric Levi. For more from Eric Levi, visit https://ericlevi.com/blog/ COVID19 affects everyone Posted on 01/04/2020 by Eric Levi Here’s a report from the Center for Disease Control and Prevention looking at...
Paediatric versus adult pituitary adenomas
This retrospective study compares paediatric with adult patients undergoing pituitary adenoma surgery over a period of 26 years at a single institution. All surgeries were performed via a sublabial approach using the operating microscope. An endoscope was used occasionally for...
