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Active smoking predicts poor outcome in HPV positive oropharyngeal squamous cell carcinoma
Tobacco smoking is a well-known risk factor in human papilloma virus (HPV)-negative head and neck squamous cell cancer. Its effects include increased risk of treatment failure, distant metastases and reduced overall survival. HPV has been increasingly implicated as a causative...
Allergic rhinitis, the usual suspects
Allergic rhinitis (AR) is characterised by allergen binding to IgE on mast cells and basophils and subsequent histamine, prostaglandine D2 (PGD2) and cysteinyl leukotrienes (cysLTs) release causing early-phase response. This is followed by late-phase response mediated by eosinophils. Other cells,...
Does balloon tuboplasty work in the long term, and how can we measure outcomes?
There is much interest and debate at ENT conferences and within current literature about the role of balloon dilatation techniques for Eustachian tube dysfunction (ETD), a condition which we still only have limited understanding of, and which can be challenging...
How can we improve outcomes for patients with acute vestibular neuritis?
Vestibular neuritis is a common disorder that can leave up to 50% of patients with persistent vertigo symptoms for months to years following the acute insult. Often their first contact with ENT or balance specialists is many months after the...
Bespoke is best for children with communication difficulties
Children with communication difficulties can benefit from augmentative alternative communication (AAC) aids to support them in daily interaction, as well as in developing milestones. One of the most difficult aspects of choosing a device is not only meeting the child’s...
Should we be doing earlier MRIs in sudden sensorineural hearing loss?
There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....
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...
Management of frontal sinus fractures
Frontal sinus fractures are uncommon (associated with around 5-15% of facial fractures). The authors divide frontal sinus fractures into isolated anterior table fractures, fractures involving the frontal sinus outflow tract and posterior table fractures, discuss some of the recent relevant...
The hippo and the nose
Chronic rhinosinusitis with nasal polyps (CRSwNP) leads to histological changes including thickening of the basilar membrane and epithelial proliferation. Molecular mechanisms underlying these changes are still not fully clear. A signalling pathway called the hippo with Yes‐associated protein (YAP) as...
Imaging of the parathyroid glands in primary hyperparathyroidism: where do we stand?
Primary hyperparathyroidism (PHPT) refers to an intrinsic parathyroid gland abnormality that produces excessive secretion of parathyroid hormone. PHPT is diagnosed biochemically, and surgical excision of the abnormal parathyroid tissue represents the only definitive cure. Historically, the standard operative management of...
Is dissection of level IV necessary in patients with negative neck oral cancer?
Supraomohyoid neck dissection (SOHND) refers to the removal of lymph nodes contained in levels I-III and is currently referred to as a selective neck dissection levels I-III. This type of neck dissection has been frequently used in the management of...
