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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...

Indication and timing of electrodiagnostic tests in facial palsy

This excellent review describes the benefits and limitations of electrodiagnostic testing for patients with facial paralysis. Tests such as Schirmer, stapedial reflex and electrogustometry have been largely replaced by neurophysiologic tests like nerve excitability test (NET), electroneuronography (ENoG), surface electromyography...

All about velopharyngeal dysfunction

The velopharynx functionally separates the oral from the nasal cavities. Inadequate or abnormal function of this muscular valve affects speech and swallow. Velopharyngeal dysfunction can be subdivided into insufficiency, incompetence and mislearning. This is a review paper and indeed a...

The evidence for various treatments of autoimmune ear disease

The difficulty with this disease entity is that it is a heterogeneous group of conditions affecting the ear and a widely accepted diagnostic criteria does not exist. It is therefore difficult to conduct a well controlled trial and this systematic...

Righting the paralysed lip

Many surgical procedures that otolaryngologists perform put the facial nerve at risk of injury, a complication that the surgeon and patient fear alike. Unfortunately, injuries to the nerve can and do happen despite adequate precautions, and facial paralysis may be...

Back to basics: nasendoscopy beats CT, again!

There are few otolaryngologists (or patients) who have not been confronted with a computed tomography scan referring to a deviated septum. In a very similar way to the accidental findings of sinus mucosal thickening, the clinician is left in a...