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Neurological idiopathic disease: a shared journey for NASA and medicine

Whilst Southampton can’t really be described as an extreme environment, experiments carried out in the city have certainly been taken out of this world. Robert Marchbanks discusses one of the associations between Southampton, The International Space Station and tympanic membrane...

Biologic therapies for chronic rhinosinusitis with nasal polyps: a new paradigm

Surgery for nasal polyposis has evolved significantly in the last 30 years, and now the medical management may be on the cusp of a revolution. Biologics using monoclonal antibodies to target specific immune pathways have introduced a paradigm shift in...

Hyposalivation: a review of current and future treatments

Hyposalivation remains a stubbornly difficult condition to treat, but novel therapies may not be far away. Saliva has many essential functions, including aiding digestion and swallowing, lubrication, maintaining tooth integrity and antibacterial activity. When patients experience reduced saliva production (hyposalivation),...

COVID-19 and medical practice

The pandemic has deeply affected all types of medical and surgical practice and even publications. In this issue, the lead article was on the French consensus on ENT practice during the pandemic. In ENT practice, both patients and health workers...

Surgical management of sleep disordered breathing

Snoring and sleep-disordered breathing are often described as multi-level problems, and different surgical procedures are required to treat the various sites of airway narrowing and/or collapse. Jonathan Hobson gives us an eloquent run-through the various options available to the ENT...

Dupilumab prospective RCT for CRSwNP, a multinational trial of 60 patients with a 16-week CT follow-up

This transcontinental work describes a randomised, double blind, placebo controlled parallel group study over a 16-week period, assessing 60 patients with CRSwNP by CT scan scores. All patients had a four-week period of intranasal corticosteroids followed by randomisation to add...

Timing of surgery in chronic rhinosinusitis: does it matter?

While many patients with chronic rhinosinusitis respond to medical treatment, some do not. The next step for these patients is surgery, but how soon should this be offered? Sooner rather than later seems to be the answer, as Claire Hopkins...

Unravelling the mystery of hyperacusis with pain

When a person says that sound causes them pain, how can we understand this, and determine what processes are involved? Bryan Pollard navigates us through what is presently known. Pain has long been underrepresented – and often, completely overlooked –...

Health related quality of life measures as outcome parameters in middle ear diseases

Surely the only outcome needed for post-surgical ears is a better PTA? Marcus Neudert argues there should be more to it than that. To draw a comprehensive picture of the disease-associated restrictions in patients with chronic otitis media, audiometric outcome...

Aetiology, investigation and acute management of sudden sensorineural hearing loss

The cause of a single sided sensorineural hearing loss has a wide variety of aetiologies. This review, by Edwin Halliday, looks specifically at the differential diagnostic causes of a sudden sensorineural hearing loss, the relevant investigations and the management should...

Minimally invasive techniques for benign salivary gland obstruction

Salivary gland obstruction is a common condition – it is recognised by a complaint of intermittent meal-time swelling of the affected salivary gland and can be accompanied by recurrent infections. Imaging can identify the nature and location of an obstruction...

Surgical management of congenital nasal pyriform aperture stenosis

Introduction Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of neonatal upper airway obstruction which was first described by Douglas in 1952 [1]. The first radiological description of CNPAS was described by Ey et al in 1988 [2]....