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CRSwNP initiation, not always an interleukin fault

CRSwNP, similar to asthma, is an inflammatory disorder (type II) with eosinophilia and raised IL-5 and IL-13. Inflammation in CRSwNP is thought to be started by IL-25, IL-33 and thymic stromal lymphopoietin (TSLP), all of which form an important part...

Maxillomandibular advancement for sleep apnoea

This is a meta-analysis compiled from India. Of the initial 103 publications, 20 were analysed. Surgical cure was defined as postsurgical AHI of fewer than five events per hour. Of the 251 patients assessed for AHI, 12 were considered normal,...

A new criterion for diagnosing chronic tonsillitis?

It is essential to establish the diagnosis of recurrent tonsillitis in patients undergoing tonsillectomy. This is based mainly on history which itself can be inaccurate and is supported by clinical findings which are not truly specific. There seems to be...

Sinonasal undifferentiated carcinoma – slowly getting there

The rarest of the rare, sinonasal tumours form only a small part of the total number of head and neck tumours and undifferentiated carcinoma (SNUC) is one of the rarest of this group. There is some data (and some expert...

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...

Applying ‘Sal classification’ to parotid cytology to replicate the success of the Thy classification system

The usefulness of the Thy classification in thyroid gland disease has led to attempts to generate a similar cytology classification for parotid lesions. However, the accuracy of fine-needle aspiration cytology in salivary gland disease is more variable because of the...

Inspiratory peak flow and tracheostomy

The evaluation of the degree of laryngeal obstruction to indicate a tracheostomy has always been a subjective decision. The authors correlated the visual laryngeal obstruction by flexible nasolaryngoscopy and the peak inspiratory flow using a pocket peak inspiratory flowmeter. Twenty-two...

A new treatment for chronic rhinitis

The review paper looks at the efficacy of cryoablation of the posterior nasal nerve (PNN) to treat chronic rhinitis, an increasingly popular method of treating a highly prevalent and morbidity-inducing disease. Five studies were included in the meta-analysis, all dating...

SPECT scans not justified in growth of the mandibular condyle

This is a paper from Hong Kong of 200 patients between January 2011 and July 2013 who underwent SPECT bone scintigraphy for assessment of growth causing condylar hyperplasia and subsequent mandibular asymmetry. Thirty-four patients were found to have active growth...

Post-thyroidectomy vocal cord palsy: are there long-term sequelae?

This is a well written paper utilising the Hospital Episode Statistics dataset for all thyroidectomies performed in England between 2004 and 2012. The study had a very impressive 43,515 participants and only included young, fit patients undergoing thyroidectomy once for...

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...

An algorithm to distinguish between distant metastases and metachronous lung primary in patients with HPV-related oropharyngeal cancer

Distinguishing between distant metastases of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) and metachronous primary lung squamous cell carcinoma (SCC) is important as it has implications for treatment, prognosis counselling, and registry data. Although p16 immunohistochemistry (p16 IHC) is widely accepted...