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Be sober to stay on your feet

Readers would either have had a personal experience or observed the inelegant gait of the inebriated. Re-aligning the body during postural perturbations involves changes in head position, shoulders, and hip, knee and ankle joints. The main hypothesis of this study...

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...

Nasal physiology and septal perforations

This interesting article from North Carolina and New York aims to assess the impact of anterior septal perforations on nasal physiology, using computational fluid dynamics and computer simulation. A computerised 3D model was constructed of a normal patient aged 37,...

CRSwNP, another monoclonal antibody

Interleukins 4, 5 and 13 were shown to be important factors in type 2 inflammation, which characterises chronic rhinosinusitis with nasal polyposis (CRSwNP). In CRSwNP non-responders and those who recur short after-surgery monoclonal antibodies might be an answer. Examples include...

Standardising videofluoroscopy assessment for bottle-fed babies

Swallowing problems in babies may occur for many reasons including complex medical problems, premature birth, and low birth-weight. Dysphagia causes several further morbidities such as poor nutrition and compromised respiration, often raising distress for both infants and their caregivers. Early...

A single blinded RCT comparing triamcinolone with 5-FU treatment for keloid scars

This single blinded RCT compared 43 patients with 50 symptomatic keloids that were randomised to two matched groups of 25 scars, receiving either 5-fluorouracil (5-FU) or current first line treatment, triamcinolone (TAC). The surgeon administering the injectable treatments was unblinded,...

Occlusal splint, injections or arthrocentesis in myofascial pain

Facial pain is a fairly common complaint and may present in a myriad of symptoms. These patients present to both dentists and general practitioners and could end up referred to a number of specialists. Temporomandibular disorders may originate from either...

Prognostic value of neutrophil-to-lymphocyte ratio in HPV-positive oropharyngeal cancer

The authors propose that high neutrophil-to-lymphocyte ratio (NLR) is associated with poor disease-free survival (DFS) in patients with human papillomavirus positive (HPV+) oropharyngeal cancer (OPC). This is a retrospective study that compared the outcomes of 43 patients treated for HPV+...

What to do with incidental findings on FDG PET/CT?

18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG PET/CT) is commonly used in head and neck cancer staging. This investigation frequently identifies incidental findings unrelated to the index head and neck cancer. To assess the nature of these incidental findings, notes of...

Does turbinoplasty outcome vary in the presence of allergic disease?

This well organised study from Australia looks at inferior turbinoplasty outcomes in patients with allergy and non-allergic rhinitis who have become refractory to medical treatment. There were 190 patients undergoing turbinoplasty with or without septoplasty assessed in this case-control study...

Acute peripheral vestibulopathy: is it really neuritis?

The pathophysiology of acute vestibular dysfunction has been debated for decades. By seeking to clarify the underlying aetiology, this study muddies the waters further by advocating systemic and intratympanic steroids as first line treatment if the aetiology is uncertain. The...

Managing CRS in pregnancy

An International team of experts from both sides of the Atlantic set out to perform a systematic review of the management of chronic rhinosinusitis in pregnancy. Despite a thorough search no scientific evidence was found that could form the basis...