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Biologic therapies for chronic rhinosinusitis with nasal polyps: a new paradigm

Surgery for nasal polyposis has evolved significantly in the last 30 years, and now the medical management may be on the cusp of a revolution. Biologics using monoclonal antibodies to target specific immune pathways have introduced a paradigm shift in...

Treatment of incus lysis with hydroxyapatite bone cement

Middle ear implants provide a suitable alternative for some patients with a certain degree of sensorineural or mixed hearing loss, not wanting a hearing aid. Vibrant SounBridge® (VSB) middle ear implant (MEI), of Med-El®firm, is one such implant. In this...

Do endonasal approaches for meningiomas have more CSF leaks?

Rarely, patients presenting to the ENT surgeon with anosmia may have an anterior skull base neoplasm such as a meningioma. Historically, the traditional approaches have focused on several transcranial, external routes, including the pterional craniotomy, and the subfrontal craniotomy. The...

What’s new in protecting hearing?

Preventing an avoidable hearing loss before it begins would be the public health dream. In this article Kathleen Campbell takes us through one option that is showing the potential to fulfil that ambition. Kathleen explains the development of a preventative...

Managing CRS in pregnancy

An International team of experts from both sides of the Atlantic set out to perform a systematic review of the management of chronic rhinosinusitis in pregnancy. Despite a thorough search no scientific evidence was found that could form the basis...

#BecauseIhearIlive – an international message from Smiling Crocodile

There are 34 million children worldwide afflicted by disabling hearing loss, 60% of whom are suffering from hearing loss due to preventable causes [1]. This article is an account of the Smiling Crocodile Charity, founded in 2009 by Dagmar Herrmannová,...

The search for the holy grail of rhinosinusitis: another step towards phenotyping in CRS wNP?

For many years, scientists and clinicians have been trying to understand the infinite variability within the term ‘rhinosinusitis’ using radiology, basic science, epidemiology and then using their insights to solve the riddle of management: how to explain why some patients...

The stubborn polyp cases are ‘different’

The widely different behaviour of nasal polyp disease between patients is a major feature of rhinology practice and makes counselling of patients difficult when approaching their first operative intervention. Setting aside aspirin sensitivity (Samter’s triad), which is known to be...

Metaplasia of the concave septum

This group conducted a one year prospective study and sampled mucosa from 42 randomly selected patients with septal deviation at a single centre. They found significantly higher rate of squamous metaplasia and lymphocytic infiltration in septal mucosa on the concave...

Effects of nasal sprays on ciliary function

What do topical nasal sprays do to the nasal mucosa in the long term? This study reports the effect of corticosteroids, antihistamines and common preservatives in nasal sprays, benzalkonium chloride (BKC) and potassium sorbate (PS), on an in-vitro model of...

Nasal decongestants don’t improve Eustachian tube function

Prescribing nasal steroids and decongestants. It’s something most of us do routinely, in an effort to reduce chronic middle ear effusion in an adult by trying to improve eustachian tube (ET) patency. This study used clever devices (tube manometry and...

Electronic nicotine delivery systems (e-cigarettes): what you need to know

As an aid to stopping smoking e-cigarettes may have a role, but they are heavily promoted by industry as a leisure pursuit and desirable fashion accessory. Sneh Biyani and Craig Derkay gives a thorough account of what we know about...