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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...
Prevention better than cure?
This systematic review looks at methods of ‘barrier protection’ or ‘barrier-enforcing’ to minimise allergic rhinitis symptoms, using 15 RCTs. Whilst the authors admit that patient numbers were small in a number of these studies, generally it seems that barrier techniques...
Biologicals for severe chronic rhinosinusitis with nasal polyps. Any use?
Recent advances and knowledge of inflammatory endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP) led to introduction of biological agents such as monoclonal antibodies targeting IgE (omalizumab) and Interleukins (ILs) such as IL4R alpha (dupilumab) and IL5. The European Academy...
Prognostic value of vascular ultrasonographic findings in patients with idiopathic sudden sensorineural hearing loss
Sudden sensorineural hearing loss is often idiopathic. Although the aetiology of idiopathic sudden sensorineural hearing loss (ISSNHL) is unclear, vascular compromise is one of the frequently proposed hypotheses to explain its pathophysiology. Existing studies have shown an association between ISSNHL...
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...
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...
