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Endolymphatic sac surgery: controversial procedure for the treatment of Ménière’s disease

Landmark Paper: Thomsen J, Bretlau P, Tos M, Johnsen NJ. Ménière’s disease: endolymphatic sac decompression compared with sham (placebo) decompression. Ann N Y Acad Sci 1981;374:820-30. Of all of the chapters in the Landmark Papers book, the chapter that discussed...

Patient initiated follow-up in head and neck cancer

Is it time for a change in the way we follow up head and neck cancer patients after treatment? Paul Nankivell and Hisham Mehanna explain the rationale for the PETNECK2 trial. After completion of curative intent treatment, clinical follow-up currently...

Targeting the microbiome in chronic rhinosinusitis

Researchers at St Paul’s Sinus Centre and UBC in Vancouver are testing a novel treatment for CRS: transferring mucus from a healthy donor into a patient’s sinuses. Chronic rhinosinusitis (CRS) is one of the most common diseases managed by otolaryngologists...

Central auditory changes in SNHL

Robert Harrison discusses some of the most obvious ways in which cochlear hearing loss has central consequences. It is convenient to classify hearing loss according to the most obvious site of lesion, for example, conductive, cochlear, retro-cochlear, or central hearing...

Vestibular dysfunction after cochlear implantation in children

Whilst vestibular dysfunction is a known outcome of cochlear implant surgery, do we know the risk factors associated with this, particularly in children? In this article a team from University of Tokyo discuss their findings. Cochlear implantation (CI) is an...

The astronomer’s nose: Tycho Brahe’s controversial prosthesis

Tycho Brahe (1546-1601) is a familiar and colourful figure in the history of science. The immense quantity of data he collected during his lifetime would enable the work of Johannes Kepler and has gained him admission to the astronomical pantheon....

ENTelligence: driving safe and transparent AI innovation in ENT

AI is seemingly going to be ubiquitous. How do we as ENT clinicians help to shape its direction? Artificial Intelligence (AI) is reshaping modern medicine. Algorithmic analysis is now influencing decisions once made solely by clinicians. Yet, in surgical specialties...

Is Dymista® useful for paediatric allergic rhinitis?

Allergic rhinitis (AR) affects up to 14.6% of the paediatric population. Whilst a recent Cochrane review has considered the evidence for intranasal corticosteroids as `weak and unreliable’ in paediatric AR, this product is a novel formulation combining Fluticasone and Azelastine...

Diagnosis and treatment of snoring in adults – S2k Guideline of the German Society of Otorhinolaryngology, Head and Neck Surgery

This article summarises the work done by the German Society of Otorhinolaryngology, who have developed guidelines for the management of snoring. ‘S2k’ is German nomenclature for a consensus based guideline, which (for those of you interested in such things), is...

Predicting CSF leaks pre FESS: Gera classification - a new tool?

An interesting study from Italy looking at an anterior skull base classification that may be useful in predicting risk of intraoperative CSF leak during FESS surgery. Traditionally we have used the Keros classification system, developed in 1962 to categorise olfactory...

CRSwNP, another monoclonal antibody

Interleukins 4, 5 and 13 were shown to be important factors in type 2 inflammation, which characterises chronic rhinosinusitis with nasal polyposis (CRSwNP). In CRSwNP non-responders and those who recur short after-surgery monoclonal antibodies might be an answer. Examples include...

A single blinded RCT comparing triamcinolone with 5-FU treatment for keloid scars

This single blinded RCT compared 43 patients with 50 symptomatic keloids that were randomised to two matched groups of 25 scars, receiving either 5-fluorouracil (5-FU) or current first line treatment, triamcinolone (TAC). The surgeon administering the injectable treatments was unblinded,...