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Are quinsies worth draining?

Recent data is providing accumulating evidence that treatment failure in the management of peritonsillar abscesses (PTAs, aka ‘quinsies’) is similar when these are managed with medical treatment (MT) alone versus MT plus surgical drainage (M+ST). However, in the absence of...

Immunosuppresants and ototoxicity

There is a wide range of immunosuppressant drugs ranging from calcineurin inhibitors (e.g. cyclosporine), anti-folic agents (e.g. methotrexate) to anti-TNF and monoclonal antibodies, many of which could be ototoxic. The authors performed a systematic review assessing ototoxicity secondary to immunosuppressant...

Ramifications of the pandemic on acute paediatric mastoiditis: a national UK audit

Acute mastoiditis is a common presentation in the paediatric population across ENT services worldwide. An initial expectation of a rise in the numbers of acute mastoiditis associated with the initial findings of SARS-CoV-2 (COVID-19) virus presence in middle ear in...

Neuromodulation in drug resistant epilepsy

Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...

Vestibular migraine or BPPV?

There are close similarities between benign paroxysmal positional vertigo (BPPV) and vestibular migraine (VM) as both can be presented by positional nystagmus. Though BPPV remains the commonest cause of pure positional vertigo, VM can mimic this condition. This study is...

How has management and outcomes of necrotising otitis externa changed over the past decade?

Necrotising otitis externa (NOE) remains a challenging condition for ENT departments, particularly with the increased prevalence of diabetes mellitus (DM) in the general population. There is no international consensus on treatment, although many institutions now have local guidelines drawn up...

Effects of coronavirus pandemic on presentation of head and neck cancer patients

The COVID-19 pandemic caused unprecedented disruption of NHS services. This was compounded by patients’ reluctance to attend hospitals at that time. How this affected the presentation of patients with head and neck cancer is the subject of this study. Head...

Recurrent ENT infections in children – is it a sign of primary immunodeficiency disease?

ENT clinicians often come across children with recurrent ear, sinus and pulmonary infections. These recurrent infections, albeit common in childhood, can represent an early sign of primary immunodeficiency diseases (PIDD). PIDD is an underdiagnosed group of genetic disorders involving absent...

Predicting the prognosis of oral squamous cell carcinoma after salvage surgery

Loco-regional recurrence of oral cavity squamous cell carcinoma (OCSCC) continues to be a life-threatening and difficult clinical situation. Salvage surgery can result in significant morbidities, and survival following recurrence is generally poor. In this study from Ontario, Canada, prognostic factors...

Predicting which oropharyngeal SCC HPV-positive patients should avoid de-escalated treatment

This study is timely for many reasons and raises very important questions in the management of the current rise in HPV-positive patients with oropharyngeal cancer (OPC). The uniqueness of this group within head and neck cancer in terms of favourable...

New MRI technique assesses treatment response in skull base osteomyelitis

This paper describes another useful imaging technique to monitor Necrotising Otitis Externa (NOE). Echoplanar diffusion weighted magnetic resonance (DW MR) shows high signal on the ‘ADC map’ with active disease and this reduces in signal intensity as symptoms improve. This...