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Role of intratympanic corticosteroid for treatment of Bell’s palsy and Ramsay Hunt syndrome
Acute peripheral facial palsy occurs annually in 30 in 1,000,000 individuals in the general population. Bell’s palsy and Ramsay Hunt syndrome account for about 70% of cases of peripheral facial palsy. They are believed to be caused by viral reactivation...
Dysphagia in people with HPV-related oropharyngeal cancer
Human papilloma virus (HPV) associated oropharyngeal cancers are becoming much more prevalent and, in some geographic areas, have overtaken tobacco as the leading cause of oropharyngeal cancer. HPV-associated cancers are also reported to have better prognosis in general, and research...
Corticosteroid prescribing in ENT - are we at risk of being sued?
Of medications leading to malpractice claims, corticosteroids comprise the third most common. They are used widely and have a significant side-effect profile: hypertension, lipodystrophy, diabetes, avascular necrosis of the femoral head, peptic ulceration and psychiatric reactions to name but a...
Allergic rhinitis, the usual suspects
Allergic rhinitis (AR) is characterised by allergen binding to IgE on mast cells and basophils and subsequent histamine, prostaglandine D2 (PGD2) and cysteinyl leukotrienes (cysLTs) release causing early-phase response. This is followed by late-phase response mediated by eosinophils. Other cells,...
Rhinotillexomania - how bad can nose picking get?
This is a fascinating first case report of rhinotillexomania associated with empty nose syndrome (ENS). Rhinotillexomania encompasses compulsive, pathological nose picking and is a variant of self-harm. Tranchito and Chhabra describe an elderly patient presenting with longstanding symptoms of nasal...
Strength of evidence in otolaryngology research – do women make the difference?
Clinicians around the world understand the need for research and publication of gathered evidence to inform practice and improve patient outcomes. The introduction of the Oxford Centre for Evidence-based Medicine (CEBM) Levels of Evidence guideline in 2011, has been invaluable...
Surgical management of permanent facial paralysis
This article explores the management of flaccid facial palsy focusing on weakness less than one to two years’ duration. As a general rule, primary nerve repair produces the best outcome and should be performed where possible. For long-standing paralysis of...
Button batteries – how can we reduce harm to children?
This article explores the history of button batteries and how clinicians and industries alike could reduce the harm to children following ingestion. Following ingestion, if lodged, button batteries cause an alkaline reaction leading to necrosis of mucosa. Significant oesophageal injury...
The hot nose
Capsaicin nasal spray can offer moderate to significant symptomatic relief to 70-80% of patients with idiopathic rhinitis (IR). Efficacy was also shown in lab studies. Nasal hyper reactivity (NHR), absence of allergy / infective rhinosinusitis, age limits (18-60), no anatomical...
Concussion and vestibular processing deficits
It is well known that patients with mild traumatic brain injury (mTBI), also referred to as concussion, display longstanding vestibular symptoms but often clinical signs and objective vestibular function test abnormalities are lacking. The aim of the study was to...
THRIVE: redefining airway management in endoscopic oesophageal surgery
Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) is no longer just a tool to help anaesthetists secure a difficult airway. Thanks to the work of authors like Yang and colleagues, it is being revolutionised to provide apnoeic oxygenation during endoscopic...
