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‘Pen’doscope - writing in a reduction in healthcare delivery costs

Optimal management of cleft lip and palate requires a multidisciplinary team approach to treatment, with the goal being maintenance of facial growth and improvement in speech and hearing, in addition to closure of the cleft. This can be especially challenging...

ENT clinics – 50 years of progress…?

Cocaine in abundance, eustachian tube catheterisation, and the ever-present threat of a fire in the clinic… How have things changed in the last few decades? Retired ENT surgeon, Douglas MacMillan, tells us of his experiences starting out in the late...

Cocaine detection hours after FESS

This is a very interesting article from Australia regarding the bioavailability of cocaine following atomised application prior to endoscopic sinus surgery. The well-established practice of preparing the nasal mucosa for sinus surgery involves the placement of a usually modified Moffett’s...

Does Eustachian tube dysfunction improve with FESS?

This multinational study prospectively collected SNOT-22 data to determine the prevalence and severity of, and whether endoscopic sinus surgery (ESS) had improved, symptoms of Eustachian tube dysfunction in patient with chronic rhinosinusitis (CRS). The SNOT-22 includes two questions which are...

How good ideas become great products: in conversation with three medical innovators

Ever had a great idea for an innovation that would significantly improve your practice, but wondered how to go about developing it? Lucy Dalton interviewed three consultant ENT surgeons-come-successful innovators (one international, one novice and one experienced) who explain what...

Botulinum toxin injection in spasmodic dysphonia

Spasmodic dysphonia is a rare neurological voice disorder, which is often missed by the inexperienced ear. There is no laboratory test or investigation to diagnose this condition therefore, it is best diagnosed by listening to the patient’s voice. Laryngeal endoscopy...

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...

Omalizumab for CRSwNP: a monoclonal antibody

A prospective study from London, evaluating the response of chronic rhinosinusitis patients with nasal polyposis who were being treated with monoclonal antibody against IgE for severe allergic asthma. Thirteen patients were treated with Omalizumab, according to UK guidelines for their...

The impact of rhino-sinusitis treatment on olfaction

This study included 28 adults prospectively enrolled between March 2011 and May 2013 into a non-randomised, multi-institutional cohort. Adults electing endoscopic sinus surgery experienced gains in olfaction comparable to adults electing continued medical management. The evidence in this study comparing...

DISE as a rationalising tool for sleep apnoea surgery

This retrospective study on 85 adult obstructive sleep apnoea (OSA) patients provides further interesting information for sleep surgeons. These patients were all investigated with polysomnography (PSG) and drug induced sleep endoscopy (DISE). They all then underwent a simple uvulopalatoplasty with...

The sleep nasendoscopy learning curve

There seems to be no accepted way of surgically assessing patients with sleep disordered breathing (SDB). Because of this, clinicians fall roughly into three camps: those who just use one operation for all patients, those who have given up surgery...

Comprehensive Techniques in CSF leak repair and skull base reconstruction

This book certainly does what it says on the tin, and covers its subject very comprehensively. Normally a topic covered by a single chapter in a rhinology or skull base surgery textbook, this book offers 17 chapters on all aspects...