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The future of inner ear drug delivery

The techniques for delivering drugs to the inner ear system are evolving. Jeffrey Harris considers the myths, the facts and the potential for drug delivery innovations and how they can improve tomorrow’s hearing outcomes. The inner ear’s delicate membranous structure,...

The stubborn polyp cases are ‘different’

The widely different behaviour of nasal polyp disease between patients is a major feature of rhinology practice and makes counselling of patients difficult when approaching their first operative intervention. Setting aside aspirin sensitivity (Samter’s triad), which is known to be...

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...

Assessment in ENT: Intra-operative videos

An article examining the reliability and validity of remote scoring; a video assessment of myringotomy and grommet insertion. The primary outcome measures were to determine construct validity (differentiating between different grades of surgeons) and reliability of video scoring. Unfortunately, the...

‘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...

Impact of Covid-19 on secretory otitis media (SOM) in terms of rate of intervention, effusion detected intraoperatively and seasonal variation

It is widely known that secretory otitis media (SOM) has seasonal variations. In well-judged cases, there is middle ear effusion found at the time of surgery. In this retrospective study, the authors have tried to assess if Covid-19 changed these...

Paediatric pain control post-tonsillectomy

The use of codeine in the paediatric population is widely debated since the American Food and Drug Administration (FDA) published warnings regarding overdose and death following the usage of codeine. Codeine is metabolised by the polymorphic cytochrome PY4502D6 (CYP2D6) in...

The incidence of coagulopathies in children presenting with post-tonsillectomy haemorrhage

Tonsillectomy is often the first haemostatic challenge for a child. Postoperative haemorrhage may therefore represent the first presentation of a child’s underlying bleeding disorder. This study aimed to quantify the rate of occult coagulopathy in patients who had experienced a...

Audiometric outcomes following endoscopic stapes surgery

Adding to the evidence base for endoscopic stapes surgery, this systematic review and analysis of outcomes sought to establish the efficacy and safety of this approach. This review included 14 studies with a pooled sample of 314 adult patients. The...

Outcomes following endoscopic vs. microscopic ossiculoplasty

Endoscopic ear surgery continues to increase in popularity with an expanding range of applications in otology. The variety of angled scopes allow for superior visualisation of the surgical field and difficult to reach areas. However, use of endoscopes reduce the...

Microvascular free flap failures – looking beyond surgical technique

Microvascular free flaps are commonly used in reconstruction for head and neck defects. Failures of these flaps, however, are associated with a significant morbidity and mortality. Flap failures within the first 72 hours are commonly attributed to technical failure of...

Do parents sleep better after paediatric adenotonsillectomy?

Paediatric adenotonsillectomy for sleep disordered breathing (SDB) is amongst the commonest surgical procedures performed in ENT. In the outpatient clinic, parents routinely express their concern about their child’s breathing but the impact of sleep disordered breathing on the parent is...