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Systemic steroid therapy for reduction of macrophage migration inhibition factor in the control of nasal polyposis

It is believed that macrophage migration inhibitory factor mediates inflammation by stimulating the release of other pro-inflammatory cytokines. The use of systemic steroids in control of nasal polyposis is an established treatment. In this study the authors have aimed at...

Zinc and rhinosinusitis

Patients with chronic rhinosinusitis (CRS) in general, and those with nasal polyps (CRSwNP) in particular, have been shown to have down-regulation of tight junction genes. Zinc, on the other hand, is well-known for its role in immune regulation and deficiency...

Cycle helmets protective against facial injuries?

This is a meta-analysis completed by a maxillofacial unit on the South Coast of England. Nine studies from an initial literature review of 102 were included in the analysis. Cycling has been reported as the cause of 3-20% of facial...

DIY Epley manoeuvre

This is an interesting paper that looks at getting patients to do their own particle repositioning manoeuvre (PRM) after having it done by a clinician (‘Epley’ to you and me although there are some slight differences) once a week for...

Painful temporomandibular joints

This paper is a meta-analysis of randomised controlled trials comparing arthrocentesis with conservative management in painful and restricted mouth opening temporomandibular joint symptoms. Temporomandibular joint dysfunction comprises a spectrum of disorders commonly involving facial pain and loss of oral function...

One anastomosis or two

This is a cumulative meta-analysis from Hong Kong reviewing 27 articles and a total of 7,389 flaps. The authors, at the outset, acknowledge that the number of anastomoses is not the only factor of venous compromise and flap failure. Nonetheless...

Allergen specific subcutaneous immunotherapy helps in prolonged control of allergic rhinitis

One of the commonest allergens involved in perennial allergic rhinitis is house dust mite. A good proportion of these cases prove intractable to treatment with oral and intranasal antihistamines and intranasal steroid sprays. Immunotherapy is considered a useful alternative and...

Obstructive sleep apnoea: Does maxillomandibular advancement work?

This is a paper from the Netherlands reviewing 62 patients who underwent maxillomandibular advancement for moderate to severe obstructive sleep apnoea. The authors observed a 71% success rate with mean apnoea hypopnea index (AHI) reduction of 69%. There was no...

Do nasal septal deviation and septoplasy affect Eustachian tube function?

The authors suggest that nasal septal deviation (NSD) or septoplasty possibly affect Eustachian tube (ET) function. They conclude this from their prospective study on 25 patients who underwent septoplasty for NSD. These patients aged above 14 years had no other...

Surgery for snoring

The prevalence of sleep-disordered breathing is rapidly increasing. There is variable evidence for surgical treatments for snoring currently. This Belgian study was a retrospective review of 84 patients who underwent surgery for snoring between May 2011 and December 2015. A...

Surgery or medicine: when should we stop trying to be conservative?

Although most otolaryngologists would agree that surgery improves the outcomes of patients with CRS when medical treatment has failed, both Cochrane reviews state that there is no proof of improved efficacy of surgery over medicine – however, that was after...

Microbiome changes after endoscopic sinus surgery: all is not what it seems

As we keep fighting a losing battle with bacteria and antibiotics, it becomes clear that it is not about killing bacteria, not even diminishing the bacterial load, but rather about shifting the different types of bacteria that colonise and live...