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The hot nose

Capsaicin nasal spray can offer moderate to significant symptomatic relief to 70-80% of patients with idiopathic rhinitis (IR). Efficacy was also shown in lab studies. Nasal hyper reactivity (NHR), absence of allergy / infective rhinosinusitis, age limits (18-60), no anatomical...

Type 2 diabetes and BPPV

Previous research has shown an association between BPPV and certain medical conditions such as hypertension, hyperlipidaemia and type 1 diabetes. The authors in this retrospective observational study investigated the interaction between BPPV and type 2 diabetes by examining the ‘role...

Nasal steroids do not cause ocular problems

This excellent, high quality and detailed systematic review from Australia dispels the myth propagated recently by some poorly designed studies that intranasal corticosteroids cause intraocular problems. A 40 year review of the usual databases found 665 articles and 19 were...

Management of infantile haemagiomas of the airway

This paper reviews the diagnosis and management of infantile haemagiomas (IH) affecting the airway. Approximately half of infants with this condition would also have cutaneous haemagiomas which are usually in the beard distribution. IH could affect any parts of the...

Management of necrotising otitis externa

Although uncommon, necrotising (previously malignant) otitis externa (nOE) can be very aggressive, particularly if not managed appropriately. In this study the authors perform a retrospective review of 25 patients admitted with nOE over a four year period at a tertiary...

Is there a role for facial nerve decompression in Ramsay Hunt syndrome?

This is an interesting paper. The authors recommend a transmastoid facial decompression for patients with complete facial nerve paralysis with House Brackman HB 5/6 who do not show any sign of recovery after two weeks of treatment following a diagnosis...

Otosclerosis - to scan or not to scan?

In an era of insidiously reducing thresholds for investigating patients, Maxwell and colleagues pose an important question: is high-resolution computed tomography (HRCT) prior to stapes surgery for otosclerosis worthwhile? Their practice typically considers HRCT for cases of suspected otosclerosis presenting...

Unravelling the Meniere’s vs. migraine conundrum – what does the mastoid contribute?

This is an interesting observational study that attempts to classify subtypes of Meniere’s disease (MD) in relation to the coexistence of migraine. It is well known that the two conditions share common characteristics, making diagnosis and treatment challenging at times....

An advance in imaging for sinonasal tumours?

Benign sinonasal growths are incredibly common, and malignant sinonasal growths thankfully rare. We know that malignant tumours often present late, and the imaging can sometimes be misleading, so the authors here compare using diffusion weighted imaging (DWI), dynamic contrast enhanced...

Is it beneficial for children to undergo bilateral cochlear implantation before 12 months old?

Universal newborn hearing screening has allowed early diagnosis and, subsequently, early intervention in hearing loss. In 2020 the Food and Drug Administration candidacy criteria for cochlear implants (CI) expanded to include profound sensorineural hearing loss (HL) in children as young...

Balance and vestibular disorders Issue I

To skip directly to features, click the links below: Welcome from the editor - by Prof Peter Rea How to evaluate and treat the dizzy patient: non-medical diagnosis-based strategies - by Richard E Gans Diagnosis and treatment of BPPV with...

How to deliver bad news better

Delivering bad news well takes experience and time. The Ida team recommend the SPIKES protocol; providing structure for relaying bad news, giving confidence to those delivering it, and leaving recipients feeling cared for and informed. It’s among the most distressing...