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Treatment outcomes and dose rate effects following gamma knife stereotactic radiosurgery for vestibular schwannomas

Gamma knife radiosurgery (GKRS) is one of the definitive stereotactic radiotherapy treatment modalities for vestibular schwannoma (VS) management. Its efficacy depends on the cobalt-60 source which has a half-life of 5.26 years. According to the study authors, the actual rate...

Is posterior epistaxis really ‘posterior’?

In absence of any clear bleeding points seen on the septum, it is generally presumed that the epistaxis is posterior, especially when simple cauterisation of the septum does not help and may progress to sphenopalatine ligation. In this publication, the...

Tramadol soaked nasal packs for post-septoplasty analgesia

Having had a septoplasty a number of years ago for the potential treatment of snoring, I was intrigued by this paper which compared the analgesic effect of tramadol-soaked and lignocaine-soaked nasal packs following septoplasty. In my practice, I have always...

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...

Daflon – a new way to treat idiopathic epistaxis

Epistaxis is a common ENT emergency and most cases are idiopathic. Flavonoids are natural substances with variable phenolic structures that are found in fruit and vegetables and take effect on blood vessels. Daflon is proposed to control epistaxis by “improving...

Non-surgical and surgical management of arytenoids granuloma

Arytenoid granulomas are often a sequelae of laryngopharyngeal reflux (LPR). Unless there is suspicion of malignancy, they require a very balanced approach between conservative management and surgical intervention. The authors present a series of 62 patients with whom the primary...

Peer-support group for people with a hearing loss

Peer-support groups’ (PSGs) involvement in rehabilitation of people with different health issues can have a very positive impact on the patients’ wellbeing as showed in a various literature on the subject. This study involves analysis of data from previous studies...

Avoiding the sweaty cheek

Frey’s syndrome is a common (10-40%) and important complication following parotid surgery. Gustatory sweating during oral stimulation can be embarrassing as it is accompanied by flushing and a sensation of heat. This is as a direct result of regenerated parasympathetic...

A novel way to reduce postoperative nausea and vomiting

This is an interesting RCT which evaluates the prophylactic effect of bilateral endoscopic injection of local anaesthetic in the sphenopalatine ganglion (SPG) on postoperative nausea and vomiting (PONV). It has a robust design, and is sufficiently powered and blinded, with...

We should all use ultrasound-guided core needle biopsy when investigating salivary gland lesions

Ultrasound core needle biopsy of salivary glands is an excellent diagnostic tool in terms of accuracy (both sensitivity and specificity), technical performance, and safety profile. This paper provided an update of the previous meta-analysis of the same question, which found...

Systematic review comparing transoral laser surgery versus open partial laryngeal surgery for advanced laryngeal cancer

The aim of this Italian systematic review was to establish outcomes (local control and survival) of conservative laryngeal surgery for advanced T stage laryngeal cancers. Articles published from 1980 onwards, had at least 10 patients that underwent partial laryngeal surgery...

The effect of adenotonsillectomy on the immune system

Parents often ask about the effect of adenotonsillectomy on the immune system, with concerns that the child may be prone to more infections postoperatively due to the absence of immune tissue. This Belgian literature review looked at the local and...