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Can diet alone be used to treat laryngopharyngeal reflux?

In this crossover observational study, a low-fat, low-quick-release sugar, high-protein, alkaline, and plant-based diet was investigated as a single treatment for laryngopharyngeal reflux (LPR). Authors recruited 50 participants with demonstrated LPR on hypopharyngeal-oesophageal multichannel intraluminal impedance-pH-monitoring (HEMII-pH), off acid suppressive...

Combination PPI and intralesional steroid treatment for recurrent laryngeal granuloma

The existence of a wide range of treatments for recurrent laryngeal granulomas (repeat surgery, high-dose proton pump inhibitor (PPIs), surgery with botulinum toxin injection, botulinum toxin injection alone, etc) is a testament to the refractory nature of this condition, with...

Neuromodulation in drug resistant epilepsy

Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...

An alternative device for obstructive sleep apnoea

Continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnoea (OSA), primarily due to the vast amount of short-term evidence in the medical literature it has accrued. The enduring obstacle to CPAP from becoming a treatment option...

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...

Is Gamma Knife Surgery effective for intracanalicular vestibular schwannomas?

Vestibular schwannomas (VSs) are rare, occurring in approximately five per 100,000 adults a year. In circa 8% of cases, the VS is contained within the internal auditory canal, i.e. intracanalicular (iVS). Although radiosurgery is a recognised treatment modality for VSs,...

Dizziness questionnaire and telemedicine during Covid pandemic

During the initial phases of the Covid-19 pandemic in 2020, delivery of ENT care adapted significantly. Kaleva et al present their findings of telephone balance consultations during the pandemic with a randomised prospective study utilising a dizziness questionnaire in West...

Vestibular paroxysmia, diagnostic controversy clarified?

Historically, the cause of vestibular paroxysmia (VP) had been attributed to neurovascular compression of the eighth cranial despite the observation that such compression is very common in asymptomatic subjects. This paper, part of International Classification of Vestibular Disorders (ICVD) by...

Anticoagulated patients and epistaxis

This systematic review looks at the increasing complexity in this space as anti-thrombotics become more sophisticated and move away from the more well understood management of warfarinised patients. After a thorough search, 29 papers were found to be relevant and...

Do certain chronic medications increase dysphagia in older people?

Oropharyngeal dysphagia is known to affect a high number of older people in the community, in care homes and in acute geriatric admissions to hospital. The authors of this study have recognised that many older people take drugs for chronic...

Role of sentinel lymph node biopsy in managing papillary thyroid cancer

Although studies have shown that the presence of lymph nodes metastases in papillary thyroid carcinoma does not alter survival, other studies have shown that it increases morbidity and mortality and that the presence of cervical lymph node metastasis at diagnosis...