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What is Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE)?
THRIVE is a physiological mechanism for oxygenating and ventilating patients who are under general anaesthesia and who have diminished or absent respiratory effort [1]. Classical ventilation requires bulk flow of gases into and out of the lungs driven by chest...
How best can we manage Samter’s Triad/AERD?
The classic ‘Samter’s Triad’ of asthma, chronic rhinosinusitis with nasal polyposis (CRSwNP), and aspirin sensitivity is now referred to as aspirin-exacerbated respiratory disease (AERD) or non-steroidal anti-inflammatory-exacerbated respiratory disease. We often come across in our rhinology setting, patients with recalcitrant...
Gardasil vaccination – an effective adjuvant therapy for RRP?
The clinical manifestations of recurrent respiratory papillomatosis (RRP) can vary hugely from individual to individual. Whilst some affected children will outgrow the disease, a subset of patients will experience frequent recurrences and require multiple surgical procedures over the course of...
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,...In this issue...Rising to the challenge of COVID-19
Like much of our lives during this period, our planned focus for this issue was suddenly shifted and redefined by the global pandemic. COVID-19 has realigned our personal and professional focus; this issue reflects some of the journey we have...
Adenotonsillectomy day-case discharge criteria: a systematic review
In this paper, Gowda et al review the literature aiming to answer a long-standing question regarding the criteria for same-day discharge of paediatric patients post adenoidectomy and/or tonsillectomy performed for treatment of obstructive sleep apnoea (OSA). Following PRISMA consensus, they...
Friendly bacteria in the ear nose and throat to combat the bad…
The author presents a thorough review of bacterial interference and the studies that have been conducted in common ENT conditions. The simple concept is that a strong population of normal flora will interfere with colonisation and subsequent infection by pathogenic...
Do spreader grafts improve nasal airflow?
This Portuguese study looks at pre- and postoperative peak nasal inspiratory flow (PNIF) in 72 consecutive patients undergoing septorhinoplasty surgery. The aim was to demonstrate the functional value of spreader graft insertion, the aesthetic value having already been confirmed. In...
Unilateral vocal cord mobility impairment and laryngopulmonary physiology
The concept of iatrogenic recurrent laryngeal nerve injury following thyroid surgery is often considered with respect to voice change but its potential impact on airway physiology has thus far not been evaluated. A cross-sectional observational study reviewed 21 patients with...
How useful is AHI?
There is a growing unease in the sleep medicine world about the usefulness of the apnoea-hypopnoea index (AHI). Most of our objective evidence about obstructive sleep apnoea (OSA) is in some way related to the AHI, and the respiratory physicians...Use of a diode laser for the removal of a frontal sinus osteoma
In this How I Do It, Professor Sergei Karpischenko introduces a gentle method of reduction of mobilised frontal sinus osteoma which has been successfully used in five patients in his university clinic using a diode laser in contact mode. Osteoma...
