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Does minimally invasive surgery under local anaesthesia have a role in the management of chronic rhinusinusitis?

A formal FESS procedure usually done under local anaesthesia is considered as gold standard in the management of chronic rhinusinusitis. However, success is hampered by a significant recurrence rate of polyps requiring revision surgery, long waiting lists, reluctance of elderly...

Can we predict how much benefit patients will get from ESS with a novel monoclonal antibody

Mepolizumab (Nucala) is a humanised IgG1 monoclonal antibody that acts as an IL-5 antagonist. It has been shown to be highly effective in treating severe asthma. It is hypothesised that it will be effective for patients with recalcitrant CRSwNP. This...

A new era in the treatment of recalcitrant nasal polyps?

Chronic rhinosinusitis with nasal polyps (CRSwNP) can be difficult to treat effectively in patients with aggressive or recalcitrant disease. Omalizumab (Xolair) is a monoclonal anti-IgE antibody with proven benefits for patients with moderate/severe asthma and CRSwNP, but this study looks...

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...

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...

Helmets make a difference in bicycle injuries

This is a meta-analysis of maxillofacial injuries arising from riding a bicycle. The incidence of maxillofacial fractures in cycling accidents varies from 3-20% and, whilst the effectiveness of helmets in preventing traumatic brain injuries is well known, their protective effect...

Tympanometry with cochlear implants

Multifrequency and multicomponent tympanometry enables evaluation of minute changes in the middle ear system as well as changes in resonant frequency. Change in resonant frequency would indicate a change in the natural characteristics of the middle ear, such as mass...

Posterior nasal neurectomy – long-term data shows tailing off of benefits but still improvement after three years

It is well understood that allergic rhinitis has a very detrimental effect on quality of life for afflicted patients. This study looks at patients with allergic rhinitis but no other associated sinonasal or respiratory diagnoses. Patients with a history of...

Balance Function Assessment and Management – Second Edition

This is the second edition of this reference work which was first published in 2008. Vestibular assessment and management has moved on in the intervening seven years and this new edition reflects this. This aims to be a comprehensive reference...

International classification of bilateral vestibulopathy (BVP)

In the past few years the Bárány Society have been standardising the diagnostic criteria for various vestibular disorders – International Classification of Vestibular Disorders (ICVD). Diagnosis of BVP relies on history, bedside clinical assessment and objective vestibular tests. The authors...

aVOR – An Educational Tool

As anyone who has tried to learn the anatomy and physiology of the vestibular system can attest, understanding and visualising the structures and their functions can be quite challenging. Thankfully, there is now a free app called aVOR (iOS, iTunes...

From the editor September/October 2023

Declan Costello, MA, MBBS, FRCS(ORL-HNS),Consultant Ear, Nose and Throat Surgeon, Wexham Park Hospital, Slough, Berkshire, UK. E: d.costello@nhs.netTw: @Voicedoctor_uk Who do you think you are? And – perhaps equally important – how do you come across to other people? For...