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A funny thing happened on the way to a conference – and other stories
This series of stories is dedicated to those of you with whom some of these moments were shared (or endured) and, above all, to my amazing and long-suffering husband, David Howard. Most of you know him as an exceptional head...
Budesonide irrigation in polyposis
It is very well known through many RCTs and now meta-analyses that saline-based irrigation is beneficial in patients after sinus surgery. It is also demonstrated that intranasal steroids are beneficial postoperatively but there is also a trend for steroid based...Partial reconstruction of the pinna
Reconstruction of the pinna is one of the most challenging procedures in facial plastic surgery. Although there has been significant progress since one of the earliest recorded descriptions by Sushruta in 600 BC, the complex three-dimensional structure of the pinna...
Laryngeal Manifestations of Systemic Diseases
Laryngeal Manifestations of Systemic Diseases is a unique reference manual which will cater to a wide potential audience. It would represent a good text for laryngologists coming across patients with known comorbidities or as new diagnoses of underlying pathologies, but...
Diagnostic features of acute invasive fungal sinusitis
Acute invasive fungal sinusitis (AIFS) is a rare but frequently lethal condition, commonly associated with a high morbidity among those that survive. It has gained recent media attention on account of its increased incidence following infection with (and treatment for)...
Pain control for patients with chronic pain following surgery
There is an increasing number of patients with a background of chronic pain presenting to the otolaryngologist. Patients with chronic pain require extra consideration in postoperative pain control due to risk of tolerance and dependence. This article summarises postoperative management...
What to do if adenotonsillectomy does not cure sleep apnoea in children?
This article reviews the management of children with persistent obstructive sleep apnoea (OSA) following adenotonsillectomy (AT). Risk factors for patients to have persistent disease include obesity, being Afro-Caribbean and existing co-morbidities such as craniofacial and neuromuscular disorders. Initial assessment of...
Method of delivery: all topical nasal corticosteroids are not made equal
There is an increasing body of evidence that the role of surgery for chronic rhinosinusitis is to facilitate the delivery of topical medical treatment – most notably, topical corticosteroids. Two recent studies, one using flow dynamics and another one examining...
A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth
It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...
Measuring is understanding: an unsupervised PROM clustering of CRS patients
It has been clear for quite some years, at least for anyone dealing daily with chronic rhinosinusitis (CRS) patients, that CRS is an ‘umbrella’ diagnosis. There are significant differences between patients, including different demographic data, different endoscopic and radiographic images,...
Traditional incision and drainage of a quinsy may be more efficacious than aspiration
Peritonsillar abscess drainage has always been one of the first procedures an ENT junior doctor performs. Traditionally incision and drainage (I&D) was the mainstay of treatment. In recent years, needle aspiration of the abscess has become much more commonplace, perhaps...
