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Risk factors for post tonsillectomy bleeds

This paper reviews post-tonsillectomy bleeding in 692 patients and attempts to tease out risk factors. The overall bleed rate of 11.6% seems very high. The return to theatre rate was 2.6%. The paper identifies male patients and adult patients as...

Occlusal splint, injections or arthrocentesis in myofascial pain

Facial pain is a fairly common complaint and may present in a myriad of symptoms. These patients present to both dentists and general practitioners and could end up referred to a number of specialists. Temporomandibular disorders may originate from either...

Building sound: from Stonehenge to a Symphony Hall

Modern architecture can use scientific techniques to shape room acoustics and create great sounding places. Professor Trevor Cox discusses our ancestors’ understanding of the importance of building techniques to enhance acoustics from Stonehenge to a Symphony Hall. Going to an...

What do we put in our nasal douches? Anything?

The rise of the popularity of saline nasal douches, with several commercial preparations available, may be a rediscovery of an age-old tradition, but it has been shown to benefit patients. The question then arises as to whether this can be...

Intranasal steroids in COVID-19

COVID-19 in patients with allergic conditions does not seem to take more severe course. The Global Initiative for Asthma recommended that asthmatic patients who are on prescribed inhaled or oral steroids should continue to take them. Contradictions between guidelines in...

Managing the most common branchial arch anomaly

This article is a well written, helpful summary of the management of the most common branchial anomaly in children – the second. These are characterised as cysts, sinuses or tracts between the anterior border of sternocleidomastoid, coursing between the internal...

Vitamin C analgesia for UPPP

Postoperative pain management after uvulopharyngopalatoplasty is a common clinical problem. This well-designed study from Iran describes the novel use of vitamin C as an analgesic. The precise mechanism of action is not clearly defined, but appears to be related to...

European position paper on drug induced sedation endoscopy (DISE)

DISE is a controversial topic but a practice that is largely accepted in the UK. There has been much variation about the technique, and how to interpret the results. For this reason, a collection of European DISE bigwigs aimed for...

Adjuvant intratympanic steroid therapy in sudden sensorineural hearing loss

Sudden sensorineural hearing loss (SNHL) means abrupt hearing loss by 30dB affecting three consecutive frequencies within 72 hours. This is treated by high tapering doses of systemic steroids, the role of which is controversial and fraught with possible complications in...

Whale hearing tests through evoked potential audiometry

Covering over 70% of the earth’s surface and reaching known depths of 11km, the world’s oceans tick the box for an extreme environment. What do we know of the impact of environmental noise on the deep-sea dwellers of this habitat?...

Head injury and prolonged bed rest, but not inner ear disease, predict poorer outcome after Epley manoeuvre in posterior semicircular canal benign paroxysmal positional vertgo (P-BPPV)

This Japanese study included 197 patients with P-BPPV treated over a two and a half year period. The vast majority had idiopathic BPPV (n=157). The remaining 40 had secondary BPPV, eight following head trauma, 14 due to prolonged bed rest...

Nasal polyps, does size matter?

This study from Germany investigates the correlation between nasal polyp size and return of olfactory function following endoscopic sinus surgery. Olfaction is affected more in patients with CRSwNP than with CRSsNP and the best chance of smell recovery occurs in...