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Adenotonsillectomy can improve ADHD and nocturnal enuresis
The link between chronic adenotonsillar hypertrophy (CAH) and behavioural disturbance is well recognised. Several studies have found that CAH has been associated with attention deficit hyperactivity disorder (ADHD) and treatment of CAH may diminish symptoms of ADHD in a subset...
The middle way: treating idiopathic facial nerve palsy
Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...
Patient reported outcomes improve if antibiotic choice is directed from endoscopic culture results in chronic rhinosinusitis
The use of antibiotics in chronic rhinosinusitis (CRS) has been established as part of the EPOS guidelines, as has the role of taking swabs for microbiology culture. There has not been much literature however on whether tailoring antibiotics in response...
Clinical assessment in OSA
This paper divides the assessment up into anatomical (nasal and oropharyngeal), endoscopic and imaging. It points out the salient features to look out for in OSA patients with regards the nasal valve and also oropharyngeal anatomy, with tonsil hypertrophy grading...
Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture
Placement of voice prosthesis at the time of trachea-oesophageal puncture is well described using 20-French prostheses. There is debate about the optimal size of the prosthesis with work in the 1980s and 1990s supporting larger prostheses. The rationale was that...
Immunotherapy – could it be cheaper?
Immunotherapy is the only treatment for allergy to alter the disease course. Limited data exist on direct and indirect costs of subcutaneous (SCIT) and sublingual (SLIT) immunotherapy in America. This article assesses the cost effectiveness worldwide of the two immunotherapies....
Medialisation laryngoplasty can relieve pain related to voice use
Odynophonia, or pain associated with voice use, is a relatively uncommon manifestation of glottal insufficiency related to vocal fold motion impairment (VFMI). Its incidence is approximately 15% in patients with vocal fold paresis. Medialisation laryngoplasty (ML) was popularised by Isshiki...
Botulinum toxin and drooling – how much, how often and where?
This was an incredibly useful article covering all aspects of the use of botulinum toxin as a treatment modality in sialorrhoea. The article starts by outlining why treating sialorrhoea is important and describes the non-pharmacological and pharmacological options, highlighting that...
Early ENT involvement can improve long-term quality of life after temporal bone fractures
Sports injuries and road traffic accidents are common causes of head injuries, with 18-40% of skull base fractures involving the temporal bone. Often these patients have other more life threatening injuries so ENT intervention is delayed or absent. Facial palsy,...
Curettage adenoidectomy impairs eustachian tube function
Adenoidectomy is a common procedure undertaken for obstructive sleep apnoea and nasal obstruction. Curettage is the most common technique but is associated with complications (mucosal trauma, bleeding) that may cause eustachian tube dysfunction (ETD). This study analysed changes in middle...
Hyperbaric oxygen for sudden onset sensorineural hearing loss
Idiopathic sudden onset sensorineural hearing loss (SSNHL) is a relatively common presentation to the ENT emergency department, and can have profound effects on patients’ lives. This retrospective study looked at 15 patients who were treated with hyperbaric oxygen after failure...
