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The sleep nasendoscopy learning curve

There seems to be no accepted way of surgically assessing patients with sleep disordered breathing (SDB). Because of this, clinicians fall roughly into three camps: those who just use one operation for all patients, those who have given up surgery...

Nasal nitric oxide – an inflammatory marker in paediatric allergic rhinitis?

Nasal nitric oxide (nNO) is mainly produced in the paranasal sinus mucosa and was shown in some studies to have increased expression in allergic rhinitis (AR). Although it represents a potential non-invasive tool for AR measurement, there remains no consensus...

Adenoidal hypertrophy in children with allergic rhinitis

Nasal congestion in children with allergic rhinitis can be confounded by adenoidal hypertrophy. This retrospective Turkish study examines this association in more detail. The sample studied was 566 children (age 2-18) that were diagnosed (based on ARIA guidelines) and treated...

Is it possible to fix condylar neck fractures with one plate?

Fractures of the condylar neck are fairly common and account for over 25% of all mandible fractures. Over the years a number of modalities have been used to fix these fractures. Direct reduction is complicated by the overlying proximity of...

Outpatient closure of CSF leaks: a good idea or a step too far?

After day-case septoplasty, day case thyroidectomy, now day case CSF leak repair – has the pendulum moved too far? The authors put forward a convincing case for what, only 10 years ago, would have sounded like a provocation. They quote...

Cystic fibrosis – sinus surgery delays chronic Gram-negative lung infection

This prospective clinical follow-up study is of 106 patients with cystic fibrosis in Copenhagen. Morbidity and mortality in CF are significantly associated with pulmonary colonisation and infection, usually with Gram-negative bacteria. Initially this can be well treated with antibiotics until...

Voice therapy is an effective treatment for presbyphonia

The quality of an individual’s voice often declines with age. This deterioration occurs firstly as a result of vocal fold atrophy secondary to histologic alteration of the vocal fold mucosa as well as atrophy of the laryngeal musculature. Phonatory efficiency...

CT-scan instead of rigid bronchoscopy in paediatric foreign body aspiration?

Many centres would still use rigid bronchoscopy as the gold standard for possible foreign body aspiration (FBA) in children. Evidence is growing that CT scanning in these situations is a reliable alternative, especially as rigid bronchoscopy (RB) still carries a...

Radiation-induced dysphagia in head and neck cancer

This is a helpful reference paper that provides an overview of the biomolecular effects of radiation on the tissues of the upper aero-digestive tract. The authors explain that radiation injuries occur in a repetitive and accruing manner over the duration...

Differing types of pharyngeal pouch

This article raised an eyebrow on the grounds that apparently more than one type of pharyngeal pouch exists! They differ in terms of aetiology, site and approach to treatment, therefore awareness of them is advised to ensure the appropriate surgical...

Myringoplasty in a bottle?

Management of large traumatic TM perforations can involve observation and water precautions or surgical repair. Closure rates for larger perforations can be 8-12 weeks and occurs for between 38-79%. Animal and human studies have shown that exogenous application of epidermal...

Contemporary UK experience of oropharyngeal transoral laser microsurgery

It is well recognised that the current emergence of HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) as a distinct disease entity requires a fresh look at standard treatment modalities that are based on chemoradiotherapy for stage III/IVa OPSCC. The Newcastle experience...