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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...

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...

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...

Earlier intervention to correct anosmia?

This is an interesting study aimed to determine the timing for successful surgical intervention in improving the sense of smell in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). A total of 86 CRSwNP patients with loss of smell and...

PET-CT for malignant nasopharyngeal lesions

This retrospective Turkish review of 92 patients aimed to determine the ability of fluorine 18-fluorodeoxyglucose (FDG) maximum standardised uptake value (SUVmax) on positron emission tomography/computerised tomography (PET/CT) to differentiate benign processes and malignant nasopharyngeal lesions. The authors retrospectively reviewed the...

An objective office-based method for diagnosing allergic rhinitis

There are several signs of allergic rhinitis which, helped with skin prick and blood tests, can diagnose the problem. However, an endoscopic, on-the-spot test may surmount clinical uncertainties and invasive testing to acquire the same goal. In this study, the...

Narrow band imaging in laryngopharyngeal reflux

Narrow band imaging (NBI) is a tool on the Olympus endoscopic systems that uses blue and green wavelengths to enhance visualisation of mucosal vasculature. It has been used to aid in the early diagnosis of upper aerodigestive tract cancers. A...

Sinus implants to treat recalcitrant polyps

It is well established that the burden of chronic rhinosinusitis on healthcare costs and patients’ quality of life is high, and that current mainstream treatment options of oral or topical steroids are not without problems. This paper compares two RCTSs...

Helicobacter pylori infection delays mucociliary clearance in the nose

Chronic rhinosinusitis is not uncommonly a difficult condition to treat and therefore any possible association of this condition with factors outside the nose and sinuses is the subject of worthwhile research. Impairment of mucociliary clearance is paramount to upper respiratory...

Swallow this: management of dysphagia post-stroke

We know that between 50% and 80% of people who have had a stroke present with swallowing difficulties that may be associated with even a small lesion of the cortical or subcortical brain regions. This article provides an up-to-date overview...