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The future of rhinology

Over the last few decades, rhinology has been one of the most dynamic and progressive areas of ENT. Professor Fokkens is perfectly placed to offer insight into the future possibilities that could transform our patients’ care, many of which are...

History of innovation in ENT

Innovation seems to have been in the strapline of every meeting, conference and course for the last few years. You would be forgiven for thinking it is a new a concept, but as Neil Weir beautifully details, innovation has been...

Temporal bone trauma

Introduction Temporal bone injuries represent one of the more complex management problems presenting to the otolaryngologist. This is largely due to difficulties in assessment and the frequent delays in referral, often as a result of other injuries demanding more immediate...

When to operate on a patient without chronic disease?

As ENT surgeons, we spend a lot of time managing chronic rhinosinusitis, so a review and update on the management of the acute disease is always helpful. The standard medical treatment of antibiotics, nasal steroids and nasal decongestants are reported...

Can we avoid FESS in patients with true isolated odontogenic sinusitis?

This is a useful study looking at how best to manage patients with odontogenic sinusitis and if FESS can be safely avoided. The authors treated patients by removing the odontogenic cause of the rhinosinusitis by extracting the offending tooth and...

Diagnosing complications of acute mastoiditis in emergency situations

In many cases, acute mastoiditis is manageable with intravenous antibiotics and hospitalised care. However, the decision whether to intervene surgically remains crucial and reliance is based on radiological findings – CT scans for bony changes and MRI for possible intra-cerebral...

Chronic rhinitis endotypes

Chronic rhinitis (CR) is common with up to 30% of the population affected, with a significant impact on quality of life. CR includes several phenotypes with different pathogenesis including allergy, autoimmune, age, occupation, pregnancy, neurogenic and drugs. Such variation means...

Perioperative management of the head and neck cancer patient

The perioperative care of patients with head and neck cancer is complex and requires significant preoperative planning and patient education. The issues include analgesia, antibiotics, stoma and wound care, general and chest physiotherapy, thromboprophylaxis and nutrition. This article provides a...

Managing spontaneous CSF leaks secondary to benign intracranial hypertension

Spontaneous CSF leaks are a rare entity. In this paper, a Spanish group report their experience managing the condition using endoscopic surgery in 35 patients over an eight year period. Leak locations included the cribriform plate (18/35), ethmoid roof (15/35)...

Surgery or medicine: when should we stop trying to be conservative?

Although most otolaryngologists would agree that surgery improves the outcomes of patients with CRS when medical treatment has failed, both Cochrane reviews state that there is no proof of improved efficacy of surgery over medicine – however, that was after...

An overview of cranioplasty

This article provides a summary of the indications, materials and current techniques available in cranioplasty. Cranioplasty is performed to restore the normal architecture of the skull following craniectomy for many reasons including intracranial infection, trauma and neoplasm. The timing of...

Microbiome changes after endoscopic sinus surgery: all is not what it seems

As we keep fighting a losing battle with bacteria and antibiotics, it becomes clear that it is not about killing bacteria, not even diminishing the bacterial load, but rather about shifting the different types of bacteria that colonise and live...