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Why do septoplasties fail?

If you are amongst the ones who wonder what keeps your patient blocked in spite of a reasonable septoplasty, it will be worth your time going through the chapter on nasal valve management. The concise table detailing the surgical techniques...

Surgery for hypopharyngeal obstruction causing OSA

Surgical treatments for OSA are evolving with improved diagnostic accuracy of the level(s) involved. Where the collapsing segment lies below the soft palate, a variety of surgical techniques to correct the affected segment(s) are emerging. This article concentrates on one...

How should I excise sinonasal tumours, open or endoscopic? En bloc or piecemeal?

Sinonasal tumours often present late because initial symptoms mimic benign disease. They tend to produce more unilateral nasal symptoms, and patients with advance disease often describe paraesthesia and other cranial neuropathies. They only account for approximately 3% of upper aerodigestive...

ENT in this issue...Rhinoplasty

Joanne Rimmer, MBBS, MA(Hons)Cantab, FRCS(ORL‑HNS), Consultant Otolaryngologist / Rhinologist, Monash Health, Melbourne, Australia. E: rimmer.joanne@gmail.com Rhinoplasty may be done purely for aesthetic reasons, as an essential part of a functional septorhinoplasty, or for a combination of both cosmetic and functional...

Predicting CSF leaks pre FESS: Gera classification - a new tool?

An interesting study from Italy looking at an anterior skull base classification that may be useful in predicting risk of intraoperative CSF leak during FESS surgery. Traditionally we have used the Keros classification system, developed in 1962 to categorise olfactory...

OBITUARY: Nobuhiko Isshiki (1930–2022)

Ushering in a new era, the pioneer of laryngeal framework surgery remains an inspiration to this day. Prof Nobuhiko Isshiki in 2016 (courtesy: Mr Yakubu Karagama). The laryngological world has lost a great man. Professor Nobuhiko Isshiki passed away in...

Rhinotillexomania - how bad can nose picking get?

This is a fascinating first case report of rhinotillexomania associated with empty nose syndrome (ENS). Rhinotillexomania encompasses compulsive, pathological nose picking and is a variant of self-harm. Tranchito and Chhabra describe an elderly patient presenting with longstanding symptoms of nasal...

An alternative device for obstructive sleep apnoea

Continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnoea (OSA), primarily due to the vast amount of short-term evidence in the medical literature it has accrued. The enduring obstacle to CPAP from becoming a treatment option...

Clinical assessment in OSA

This paper divides the assessment up into anatomical (nasal and oropharyngeal), endoscopic and imaging. It points out the salient features to look out for in OSA patients with regards the nasal valve and also oropharyngeal anatomy, with tonsil hypertrophy grading...

Pharyngoplasty for palatal snoring

This prospective Belgian study looked at the benefits of barbed reposition pharyngoplasty in the management of patients with isolated unilevel palatal snoring. This technique involves using a barbed suture and repositioning the palatopharyngeal muscle in a more lateral and anterior...

Do adhesions actually cause nasal blockage?

All of us who perform nasal surgery are familiar with the disappointing presence of nasal adhesions (NA) or synechiae in our postop patients. These can often lead to patients deriving less perceived benefit from their surgery than that which they...

An effective treatment for post Covid-19 smell loss?

It is well understood that calcium levels in the nasal mucous affect the ability to smell, with higher levels having a negative impact, and some studies have shown increased calcium levels in patients suffering with Covid-19-related olfactory dysfunction. Calcium chelating...