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Allergen immunotherapy and allergic rhinitis – EAACI guideline 2017

Allergic rhinitis (AR) is a common chronic childhood disease with considerable social burden and impact on quality of life, frequently necessitating treatment with various combinations of antihistamines and corticosteroids. The allergen immunotherapy (AIT), sometimes known as desensitisation therapy, can modify...

Chronic cough hypersensitivity syndrome

We all have patients who give us a ‘heartsink’ feeling; for many of us, the coughing patient is exactly such a situation. In this overview, Bhaskar Ram and Sangeeta Maini outline their approach to diagnosis. Declan Costello, Editor. Introduction Chronic...

Head and neck cancer multidisciplinary team

Why do we have MDTs? Do they make a difference to outcomes? Jon Bernstein explores the whys and wherefores of the head and neck cancer MDT, and wonders where things might go from here… Head and neck (upper aerodigestive tract)...

Consider PCR testing in culture negative necrotising otitis externa

Necrotising otitis externa (NOE) often does not yield identification of a causative organism to treat although in 90% of cases it is a member of the pseudomonas species. The incidence of fungal NOE is not to be forgotten and this...

Myringoplasty in a bottle?

Management of large traumatic TM perforations can involve observation and water precautions or surgical repair. Closure rates for larger perforations can be 8-12 weeks and occurs for between 38-79%. Animal and human studies have shown that exogenous application of epidermal...

The role of macrolide antibiotics in chronic rhinosinusitis

The use of long-term antibiotics in the treatment of chronic rhinosinusitis is a contentious issue, not only because of the increasing problem with antibiotic resistance but also because of the potential cardiac risks, including sudden death. In this article, Anders...

Absorbing the hurt

In this article, taken from his blog, ENT surgeon John McGarva reminds us that while we can’t fix everything, we may still be able to help. It was a long time ago. I was a scarily young Houseman, barely 22,...

Transnasal endoscopic choanal atresia surgery

Surgery is currently the only definitive treatment for congenital choanal atresia (CCA). There are various surgical approaches including transnasal, transeptal or transpalatal. The authors propose that the preferred option is transnasal endoscopic choanal atresia surgery (TECAS) and set out to...

Minimally invasive techniques for benign salivary gland obstruction

Salivary gland obstruction is a common condition – it is recognised by a complaint of intermittent meal-time swelling of the affected salivary gland and can be accompanied by recurrent infections. Imaging can identify the nature and location of an obstruction...

Maxillary osteotomy stability

This systematic review assesses inferior repositioning of the maxilla six months after surgery. Two articles were identified with a total of 22 patients. The repositioning was of a mean of 3.2 to 4.5mm anteriorly and 0.1 to 1.8mm posteriorly. Six...

Subjective tinnitus – adding mutebutton™ to your tinnitus toolbox

Neurophysiologic tinnitus or subjective tinnitus is typically a sound or a number of sounds that originate from the auditory nervous system. They are unwanted sounds that do not exist in the external environment. They can be heard in one or...

Dupilumab prospective RCT for CRSwNP, a multinational trial of 60 patients with a 16-week CT follow-up

This transcontinental work describes a randomised, double blind, placebo controlled parallel group study over a 16-week period, assessing 60 patients with CRSwNP by CT scan scores. All patients had a four-week period of intranasal corticosteroids followed by randomisation to add...