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Precision medicine in allergic rhinitis and chronic rhinosinusitis
Precision medicine (PM) with its ‘four Ps’ (personalised, predictive, preventive and participatory) is about appreciating differences between individuals when offering management options for health problems. Multiple groups interested in rhinology such as EPOS and ARIA supported a review of the...
Helicobacter pylori and chronic tonsillitis
Helicobacter pylori infection in the stomach has long been associated with chronic gastritis, duodenal and peptic ulceration and even gastric cancer. Whether laryngopharyngeal reflux (LPR) brings up these organisms and induces chronic tonsillitis is an interesting concept, which the authors...
Dutch pharyngeal pouch surgery experience
A decade’s experience of pharyngeal pouch surgery was reported in this paper from Rotterdam. A total of 94 patients were analysed. The majority (80%) underwent an endoscopic approach, either with stapling or CO2 laser-assisted. Interestingly, 13 of 75 (14%) procedures...
Otolith malfunction can be a cause of orthostatic dizziness
This prospective study evaluated otolith function with vestibular evoked myogenic potentials (VEMPs) and subjective visual vertical / horizontal (SVH) tests in 50 adults with normal hearing between the ages of 18 and 50 years. The authors hypothesised that there are...
Cough no more?
The challenge of the ‘unexplained chronic cough’ that just will not go away is a challenge that frustrates many of us. Often patients have seen respiratory, upper GI and eventually they see you as the last resort! Is behavioural therapy...
Surgery for class III malocclusions pharyngeal airway and sleep apnoea effects
Thirty-three patients from Brazil were assessed for obstructive sleep apnoea and hypopnoea syndrome pre- and six months postoperatively. The 33 patients were made up of nine having mandibular set back surgery, six maxillary advancement and 18 bi-maxillary surgery. They identified...
Extrapolating lessons from vestibular schwannoma management
This paper presents a delightfully simple and sensible hypothesis for the management of benign schwannomas in the head and neck region. They have taken the approach used for the management of vestibular schwannomas and used the same principles to assess...
3D is the future?
This is an interesting take on yet another way to incorporate modern technology into medical practice, and the novel use of a 3D printer to create a custom-made prosthesis for large and irregular nasal septal perforations. These prostheses have the...
Balloon dilatation is an effective adjunct
This is a good study design, sufficiently powered, comparing medical management to balloon sinus dilatation. All patients had failed medical management and were thoroughly assessed preoperatively with Lund-Mackay score confirming abnormal CT findings, SNOT 20 index score, chronic sinusitis score...
Classification of maxillofacial pain
The patient that presents with oral and facial pain can prove a diagnostic conundrum. Whilst most often dental causes can explain the origin and help from our maxillofacial colleagues is warranted, it is useful to have a system for approaching...
Epley Manoeuvre: number of times it is required and its diagnostic value
Benign paroxysmal positional vertigo is a common condition but if inadequately treated or wrongly diagnosed, can prolong the distressing symptoms of momentary dizziness, nausea and visual disturbances which can be due to other causes and deteriorate quality of life. Studies...
