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Balloons – more complicated than first thought?

This study describes the complications seen after balloon sinuplasty (BSP) - a commonly performed procedure (particularly in the USA where it is often performed as an office procedure) versus traditional functional endoscopic sinus surgery (FESS). The data source was a...

A novel way to reduce postoperative nausea and vomiting

This is an interesting RCT which evaluates the prophylactic effect of bilateral endoscopic injection of local anaesthetic in the sphenopalatine ganglion (SPG) on postoperative nausea and vomiting (PONV). It has a robust design, and is sufficiently powered and blinded, with...

Rhoton’s Atlas of Head, Neck, and Brain

Albert Rhoton was a renowned American neurosurgeon with an intense interest in anatomy. This book was published after his death in 2016 and aims to continue Rhoton’s philosophy of patients benefit deriving from surgeons’ knowledge and understanding of complex anatomy....

3D is the future?

This is an interesting take on yet another way to incorporate modern technology into medical practice, and the novel use of a 3D printer to create a custom-made prosthesis for large and irregular nasal septal perforations. These prostheses have the...

Balloon dilatation is an effective adjunct

This is a good study design, sufficiently powered, comparing medical management to balloon sinus dilatation. All patients had failed medical management and were thoroughly assessed preoperatively with Lund-Mackay score confirming abnormal CT findings, SNOT 20 index score, chronic sinusitis score...

Does trainee participation in cochlear implant surgery affect operative times?

The role of surgical education is a very sensitive issue in spite of the obvious need and the obligation of doctors to pass on their knowledge and experience to the next generation. This study is very interesting as it assesses...

Investigations in the management of OSA in children

The purpose of this study was to pick up variation of practice across the UK in the assessment and management of children with suspected OSA, particularly with reference to pulse oximetry and polysomnography. A questionnaire-based survey revealed that preoperative pulse...

The microbiological environment of the paranasal sinuses

This article reviews the ecology of the sinuses and tries to make sense of the confusing literature on the subject. This covers the details of molecular studies, particularly those which attempt to differentiate normal sinuses from those in patients with...

Olfactory neuronal damage in sinusitis

So many patients with nasal disorders have poor olfactory function, yet sometimes the nose may seem comparatively clear of conductive problems. This study postulated that neuronal damage in the olfactory apparatus would lead to a leakage of neuron specific enolase...

A spoonful of sugar… helps the operated sinuses calm down?

Ottoviano et al. present a prospective double-blinded RCT to assess the effect of a nasal gel containing silver sucrose octasulfate (Silsos Gel) on wound healing after endoscopic sinus surgery. The placebo used was a glycol gel. Thirty-four consecutive patients were...

No soup for you…! Early identification of postoperative perforation increases the success of conservative management

Iatrogenic perforation of the hypopharynx or cervical oesophagus is a well-recognised life-threatening complication. Previous studies have demonstrated that conservative management with broad-spectrum antibiotics and withholding oral feeding may avoid morbidity associated with surgical repair. This study addresses when conservative management...

The theory of everything (tonsil)?

Tonsil sepsis can manifest as acute tonsillitis, a peritonsillar abscess (PTA) or rarely as an intra-tonsillar (ITA) abscess. Whilst the management of these conditions is familiar to ENT surgeons from early in training, perhaps little attention has been paid to...