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Use of tranexamic acid in ENT surgery

Postoperative bleeding in otolaryngologic procedures causes delayed discharge, requires re-admission and adds considerably to the cost of patient care. Whether the anti-fibrinolytic activity of tranexamic acid should be used routinely to prevent haemorrhagic complications after ENT operations is speculation but...

Malignant craniopharyngiomas

Craniopharyngiomas are successfully managed with surgery and / or adjuvant chemoradiotherapy. The transnasal endoscopic route has become increasingly utilised in the management of these challenging tumours. This paper reviews 23 cases from the literature of the rarely reported malignant transformation....

CRS vs. migraine: which is the culprit in most headaches?

‘Sinus headache’ is a common diagnosis according to patients and primary care physicians, but relatively infrequent in the eyes of otolaryngologists. This study examines 104 patients with a primary headache syndrome (PHS) and 130 patients with CRS, looking at SNOT-22...

How safe is sinonasal surgery for the operating surgeon in times of COVID-19?

I’m sure we have all wondered how safe we are in the operating theatre from virus circulating in the room and therefore the risk of subsequent COVID-19 infection. The authors addressed this by measuring the airborne particle concentrations in the...

Swallowing and breathing: speech and language therapy

Swallowing difficulties are a common comorbidity in just over a quarter of people living with chronic obstructive pulmonary disease (COPD). Given the associated risks of aspiration and exacerbation of COPD symptoms, speech and language therapists (SLTs) can offer valuable guidance...

When to operate on a patient without chronic disease?

As ENT surgeons, we spend a lot of time managing chronic rhinosinusitis, so a review and update on the management of the acute disease is always helpful. The standard medical treatment of antibiotics, nasal steroids and nasal decongestants are reported...

Does sleep quality improve when we adequately treat CRS?

In addition to the well-known symptoms associated with chronic rhinosinusitis (CRS), patients often suffer with poor sleep quality which is also detrimental to health and wellbeing. This meta-analysis looked at 35 papers reporting outcomes for CRS patients post surgery on...

Shifting paradigms – how a visionary can change a specialty

The Tarabichi-Stammberger Ear and Sinus Institute came about because of a close working relationship and friendship between two senior figures in the specialty. Professor Muaaz Tarabichi tells us the story. My first meeting with Heinz Stammberger was in 1988 in...

CO2 Laser Dohlmans: Does It Still Have A Role In Pharyngeal Pouch Management?

Background The commonest active management of a pharyngeal pouch is the division of the “interparty” wall using a stapling device [1, 2]. The technique is relatively straight forward to perform and theoretically should have less complications than other techniques such...

Is benign intracranial hypertension underdiagnosed in patients with spontaneous CSF leaks?

In ENT practice we come across spontaneous CSF leaks. Patients present either as unilateral watery rhinorrhoea or otorrhoea, or sometimes as hearing loss with a watery middle ear effusion. Clinicians, after confirming the diagnosis of CSF leak with beta 2...

Can we predict how much benefit patients will get from ESS with a novel monoclonal antibody

Mepolizumab (Nucala) is a humanised IgG1 monoclonal antibody that acts as an IL-5 antagonist. It has been shown to be highly effective in treating severe asthma. It is hypothesised that it will be effective for patients with recalcitrant CRSwNP. This...

Cuff up or cuff down; to occlude or not to occlude? What effect does tracheostomy tube modification have on swallowing outcomes?

Dysphagia is commonly seen in patients with tracheostomy. The current global pandemic has increased interest in the impact of a tracheostomy on swallowing outcomes. This systematic review is therefore a timely addition to the literature and a useful read for...