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Is posterior epistaxis really ‘posterior’?

In absence of any clear bleeding points seen on the septum, it is generally presumed that the epistaxis is posterior, especially when simple cauterisation of the septum does not help and may progress to sphenopalatine ligation. In this publication, the...

Salivary pepsin – a simple test for LPR?

A diagnosis of laryngopharyngeal reflux (LPR) can be made on the basis of characteristic symptoms and nasendoscopy findings. Objective tests exist for this condition; for example, 24-hour dual-channel pH-metry which is considered to be the gold standard. Such tests are,...

Do parents sleep better after paediatric adenotonsillectomy?

Paediatric adenotonsillectomy for sleep disordered breathing (SDB) is amongst the commonest surgical procedures performed in ENT. In the outpatient clinic, parents routinely express their concern about their child’s breathing but the impact of sleep disordered breathing on the parent is...

More than words: looking at all the evidence

Evidence based practice (EBP) is a three-pillared approach whereby information on the research evidence, factors relating to the patient and clinical experience are all considered to inform a care decision. Unfortunately, there is frequently very little research evidence to inform...

Is the greater auricular nerve important in parotid surgery?

The greater auricular nerve (GAN) is often partially or totally sacrificed during parotidectomy procedures. This was a retrospective study comparing auricular sensation and quality of life in patients that either had their GAN preserved or sacrificed. In the shortterm, patients...

Surviving oropharyngeal squamous cell carcinoma – does subsite matter?

Human papilloma virus (HPV) status is a known prognostic factor in oropharyngeal squamous cell carcinoma (OPSCC). The eighth edition of American Joint Cancer Committee (AJCC) has modified the TNM staging to reflect this. However, subsite as an independent prognostic factor...

The search for the holy grail of rhinosinusitis: another step towards phenotyping in CRS wNP?

For many years, scientists and clinicians have been trying to understand the infinite variability within the term ‘rhinosinusitis’ using radiology, basic science, epidemiology and then using their insights to solve the riddle of management: how to explain why some patients...

Choline PET-CT: an accurate diagnostic tool for the detection of parathyroid adenoma?

Hyperparathyroidism (HPT) is an endocrine disorder characterised by an increase in the secretion of parathyroid hormone (PTH), with a resulting increase in calcium plasma levels, which can cause renal lithiasis, fractures, and osteoporosis, the most frequent symptoms of the disease....

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...

Sinus implants to treat recalcitrant polyps

It is well established that the burden of chronic rhinosinusitis on healthcare costs and patients’ quality of life is high, and that current mainstream treatment options of oral or topical steroids are not without problems. This paper compares two RCTSs...

SNOT-25 to assess CRS - a new tool

The SNOT-22 is a well-established validated instrument, designed to evaluate the rhinosinusitis-specific health status and health-related QOL, however makes only one broad reference to productivity. The objective of this paper is to evaluate a modified SNOT-25 created to better assess...

Acute ENT activity in a teaching hospital

This Belgian prospective audit attempted to provide justification for the provision of a 24-hour emergency service at a large 1038-bed teaching hospital (with 31 ENT consultants). The authors looked at a one-month period during which 190 patients were admitted. They...