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Pre-clinical development of magnetic delivery of therapy to middle and inner ears
Why are we developing this technology? A key problem in drug delivery is getting the therapy to the right place in the body, which is especially challenging for targets that are small, deep and are protected or surrounded by anatomical...
Outcomes of temporal bone-resurfacing for pulsatile tinnitus associated with vascular wall anomalies
This month’s Ed’s choice is an interesting systematic review into the management of pulsatile tinnitus. There are impressive results from resurfacing of symptomatic anatomical abnormalities of the temporal bone and I suspect that referrals for further imaging and otology clinic...The ENT operating theatre viewed down the retrospectoscope
We learn much of our future by looking at our past; Douglas MacMillan provides us with a fascinating glimpse into his years as a junior doctor. The operating theatre was a somewhat alien environment in the late 1960s: theatre sisters...
Effects of nasal sprays on ciliary function
What do topical nasal sprays do to the nasal mucosa in the long term? This study reports the effect of corticosteroids, antihistamines and common preservatives in nasal sprays, benzalkonium chloride (BKC) and potassium sorbate (PS), on an in-vitro model of...
Evidence and nasal polyp treatments
The change in the routine management of nasal polyps in the past 2-3 decades has been fascinating and this review from Charleston covers the topics of systemic treatment, local treatment, perioperative treatment and immunotherapy and touches on the lower airway...
Patients with auto-immune Meniere’s disease more likely to respond to intratympanic steroids
The authors retrospectively reviewed the duration of symptom control after intratympanic dexamethasone (IT) injections in 27 patients with Meniere’s disease (MD) over a six-year period. The patients received two IT injections of 3.3mg/ml of dexamethasone one-to-two weeks apart. Eleven patients...
Location, location, location: How to get the steroid where you need it, in chronic rhinosinusitis
What almost all current guidelines on chronic rhinosinusitis have in common is the importance of intranasal steroid (INCS) use. However, it is increasingly understood that the efficacy of INCS depends on their efficient delivery to the point of need, i.e....
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...
IL-25 and nasal polyps, another target
Immune response in chronic rhinosinusitis with nasal polyps (CRSwNP) is mainly via type 2 T-helper (Th2) cells while Th1 cells characterise chronic rhinosinusitis without nasal polyps (CRSsNP) immune response. CRSwNP is heterogeneous on a cytological level causing a varied response...
