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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...

CSOM in Mwanza, Tanzania

This is a prospective, cross-sectional study involving 301 patients consisting of farmers, students and employed professionals attending an ENT clinic in Mwanza, Tanzania. Of the 301 patients, 13 were HIV positive; 37.9% had some degree of conductive / sensorineural /...

No soup for you…! Early identification of postoperative perforation increases the success of conservative management

Iatrogenic perforation of the hypopharynx or cervical oesophagus is a well-recognised life-threatening complication. Previous studies have demonstrated that conservative management with broad-spectrum antibiotics and withholding oral feeding may avoid morbidity associated with surgical repair. This study addresses when conservative management...

Guidelines for management of orbital infections

Orbital infections predominantly affect the paediatric population and complications can be very serious. The cellulitis can be preseptal or orbital and the abscess can be confined within the periosteum or extend into the orbit. Cavernous sinus thrombosis can complicate the...

Early DCR may be better than delayed in acute dacrocystitis?

Traditionally, acute dacrocystitis has been treated conservatively with antibiotics, analgesia and warm compresses, with surgery reserved for later when the infection has subsided. This meta-analysis looks at early vs. late endonasal dacrocystorhinostomy (DCR) in the treatment of acute dacrocystitis, looking...

Rhinology: what does the future hold?

David Kennedy surveys the past, the present and the future of rhinology practice and research. An evolution of understanding in rhinology The dramatic growth of clinical and translational research within the field of rhinology in recent years is illustrated by...

Biofilms in Otitis

If you haven’t already heard of biofilms, this book will tell you that they are multicellular networks of bacteria encased in a matrix, a complex multidimensional biologic fortress that protects bacteria against changes in the environment, host immune responses and...

Management of necrotising otitis externa

Although uncommon, necrotising (previously malignant) otitis externa (nOE) can be very aggressive, particularly if not managed appropriately. In this study the authors perform a retrospective review of 25 patients admitted with nOE over a four year period at a tertiary...

Are quinsies worth draining?

Recent data is providing accumulating evidence that treatment failure in the management of peritonsillar abscesses (PTAs, aka ‘quinsies’) is similar when these are managed with medical treatment (MT) alone versus MT plus surgical drainage (M+ST). However, in the absence of...

Role of maxillary sinus irrigation as an adjuvant to current management of chronic rhinusitis without polyposis

Several decades have passed since irrigation of maxillary sinuses generally became a treatment of the past. A more recent concept of biofilms may have evoked new interest in this past procedure, fraught with its own issues. In this study, the...

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...

Infection and other factors influencing post-tonsillectomy haemorrhage

In this detailed narrative review article, the authors have addressed several factors which could be related to postoperative bleeding after tonsillectomy. As regards to microbiology, the significance of micro-organisms present both on surface and within the tonsils is emphasised and...