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Otolaryngology Head and Neck Surgery: Clinical reference guide - Fourth Edition

This textbook, well known to North American residents, is now in its fourth edition. It has been extensively revised to include more up-to-date topics, such as robotic surgery, sleep medicine and paediatric otolaryngology. Authors Raza Pasha and Justin Golab aim...

Nasal nitric oxide – an inflammatory marker in paediatric allergic rhinitis?

Nasal nitric oxide (nNO) is mainly produced in the paranasal sinus mucosa and was shown in some studies to have increased expression in allergic rhinitis (AR). Although it represents a potential non-invasive tool for AR measurement, there remains no consensus...

Associated findings in MRI used for detecting acoustic neuroma

Presently, gadolinium enhanced magnetic resonance imaging is the ‘gold standard’ for investigating acoustic neuroma. There are often ‘incidental’ findings that may or may not be significant. In this study of 109 scans, the authors noted an uptake of 0.9% for...

CSF leak – endoscopic or open repair?

Cerebrospinal fluid (CSF) rhinorrhoea is well known to the ENT surgeon. It commonly occurs secondary to a predisposing event such as accidental or iatrogenic trauma. When it occurs spontaneously, it can be associated with benign intracranial hypertension. The commonest CSF...

Sphenopalatine ganglion block in endoscopic sinus surgery reduces intra and post-operative morbidity

The authors present results of a meta-analysis to investigate the role of sphenopalatine ganglion block (SPGB) in reducing postoperative pain in endoscopic sinus surgery (ESS). An electronic database search (Pubmed, SCOPUS, Google Scholar, Embase, and the Cochrane Register of Controlled...

QOL studies for anterior skull base surgeries

The Anterior Skull Base Nasal Inventory-12 (ASK Nasal-12) is a standard tool for assessment of quality of life (QOL) in patients who have undergone endonasal transsphenoidal surgery. As nasal trauma and rhinological complications following endonasal transsphenoidal surgery can influence QOL,...

Is benign intracranial hypertension underdiagnosed in patients with spontaneous CSF leaks?

In ENT practice we come across spontaneous CSF leaks. Patients present either as unilateral watery rhinorrhoea or otorrhoea, or sometimes as hearing loss with a watery middle ear effusion. Clinicians, after confirming the diagnosis of CSF leak with beta 2...

Managing spontaneous CSF leaks secondary to benign intracranial hypertension

Spontaneous CSF leaks are a rare entity. In this paper, a Spanish group report their experience managing the condition using endoscopic surgery in 35 patients over an eight year period. Leak locations included the cribriform plate (18/35), ethmoid roof (15/35)...

How should I excise sinonasal tumours, open or endoscopic? En bloc or piecemeal?

Sinonasal tumours often present late because initial symptoms mimic benign disease. They tend to produce more unilateral nasal symptoms, and patients with advance disease often describe paraesthesia and other cranial neuropathies. They only account for approximately 3% of upper aerodigestive...