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Gastro-oesophageal reflux and cricopharyngeal dysfunction – how do they link?

It has been hypothesised that cricopharyngeal muscle hypertrophy develops as a response to chronic gastro-oesophageal reflux disease. The cricopharyngeus muscle is an important component and contributor to the upper oesophageal sphincter that creates a barrier between the pharynx and oesophagus....

Radiological diagnosis of mastoiditis in patients screened for acoustic neuroma

Magnetic resonance imaging is the ‘gold standard’ for screening patients suspected to have acoustic neuroma. Various abnormalities are picked up through this investigation, one of which, not uncommonly reported, is mastoiditis. This requires referral to otolaryngology and further evaluation. In...

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...

The right to choose: the how-to of practicable supports

Providing all practicable supports to enable a person to participate in decision-making is one of the five key principles of the English and Welsh Mental Capacity Act 2005. This article (set in the Canadian legal framework, which has many similarities...

COVID-19 in patients with chronic rhinosinusitis with polyps. Are they at risk?

COVID-19 entry factors are highly present in nasal epithelial cells. These factors include ACE2 and TMPRSS2. Their presence in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) was not investigated before. Authors investigated expression of ACE2 and TMPRSS2 in two...

Molecular and genetic nature of skull base tumours drives management

This article reviews the molecular basis and paradigm shift in the diagnosis and management of skull base tumours. It is now known that the phenotype of meningiomas is influenced by their genotype. Endolymphatic sac tumours are observed in up to...

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...

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...

Falls and ASL users

A mixed-method pilot study was carried out to assess the cognitive load of sign language among users and, consequently, the possible risk of injurious falls. The study specifically investigated the possible risk of falls due to the simultaneous activity of...

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...

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...

Bell’s palsy – antivirals and steroids for all?

The role of antiviral medications in the treatment of Bell’s palsy remains somewhat controversial. Antivirals alone do not appear to be helpful, whereas numerous studies have shown that corticosteroids improve the chance of a full recovery compared to placebo. What...