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Location, location, location: How to get the steroid where you need it, in chronic rhinosinusitis

What almost all current guidelines on chronic rhinosinusitis have in common is the importance of intranasal steroid (INCS) use. However, it is increasingly understood that the efficacy of INCS depends on their efficient delivery to the point of need, i.e....

Sinus implants to treat recalcitrant polyps

It is well established that the burden of chronic rhinosinusitis on healthcare costs and patients’ quality of life is high, and that current mainstream treatment options of oral or topical steroids are not without problems. This paper compares two RCTSs...

Is there a role for hyperbaric treatment in sudden hearing loss?

Sudden sensorineural hearing loss is a common presentation to ENT departments with a significant difference in management both at a local and regional level. The authors seek to clarify the role of hyperbaric oxygen therapy in combination with oral and...

Allergen specific subcutaneous immunotherapy helps in prolonged control of allergic rhinitis

One of the commonest allergens involved in perennial allergic rhinitis is house dust mite. A good proportion of these cases prove intractable to treatment with oral and intranasal antihistamines and intranasal steroid sprays. Immunotherapy is considered a useful alternative and...

IL-25 and nasal polyps, another target

Immune response in chronic rhinosinusitis with nasal polyps (CRSwNP) is mainly via type 2 T-helper (Th2) cells while Th1 cells characterise chronic rhinosinusitis without nasal polyps (CRSsNP) immune response. CRSwNP is heterogeneous on a cytological level causing a varied response...

Medical control of allergic rhinitis in children

The authors of this randomised trial aim to answer an important question – which is better: daily versus on demand use of intranasal steroids (fluticasone probionate) or antihistamines (levocetirizine dihydrochloride) for symptomatic control of allergic rhinoconjunctivitis secondary to pollen? The...

Recovery rates in sudden sensorineural hearing loss

Sudden sensorineural hearing loss (SSNHL) is most commonly idiopathic, and is seen relatively frequently in ENT practice. Recovery spans a period of around 1-2 months, and ultimate outcomes are highly variable, from complete recovery to no detectable hearing. Although the...

Delayed facial palsy post vestibular schwannoma resection

This article presents findings of a retrospective evaluation of 489 patients who underwent vestibular schwannoma surgery and developed delayed facial palsy. The authors define delayed facial palsy as deterioration of at least two HB grades between postoperative days five and...

Combined sprays for allergic rhinitis maintenance

This meta-analysis looked at the reported efficacy for allergic rhinitis control of various topical sprays, particularly comparative studies. There were fewer ‘head to head’ studies than we would have hoped to exist. This review included intranasal anti-histamines, intranasal steroids and...

Audiology in this issue...Amplification 2019

Gareth Smith, MSc, AuD, Consultant Clinical Scientist (Audiology), Southend University Hospital, UK. E: Gareth.Smith@southend.nhs.uk In previous areas of the Audiology Features Section, this theme would have been called ‘Hearing Aids’. With the increased interest in ‘over-the-counter’ or ‘direct-to-consumer’ devices, we...

Lies, damned lies and relative risk reduction

Chris Potter has a thing or two to say about the use of statistics and, in doing so, he takes us to a Friday night steak house that is prone to airway disasters and on a short tour of his...

A ‘smarter’ way to examine the ear?

Otoscopes and endoscopes, essential tools for ENTs, audiologists, and general practitioners, are on the receiving end of a modern twist thanks to smartphone technology. Aimed at adapting smartphones for otoscopic and endoscopic imaging, these reimagined devices might just change the...