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PPPD - the problem with the label

The recently described diagnostic entity of persistent postural perceptual dizziness (PPPD) has its merits regarding guiding intervention and treatment, but the label itself can be problematic for patients. This study was designed to determine the views of patients of the...

Neuromodulation in drug resistant epilepsy

Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...

To montelukast or not to montelukast

Both histamine and cysteinyl leukotrienes play an important role in both seasonal allergic rhinoconjunctivitis (SARC) and asthma. A combination therapy against both was shown to give benefit both in vitro and in vivo. Authors wanted to test the efficacy of...

Does balloon tuboplasty work in the long term, and how can we measure outcomes?

There is much interest and debate at ENT conferences and within current literature about the role of balloon dilatation techniques for Eustachian tube dysfunction (ETD), a condition which we still only have limited understanding of, and which can be challenging...

Silent sinus syndrome: which approach offers the best outcome?

Silent sinus syndrome (SSS) is a rare condition with patients presenting as spontaneous, painless enophthalmos, hypoglobus, orbital asymmetry, and maxillary sinus collapse on the ipsilateral side. The orbital resorption occurs secondary to negative pressure created in the maxillary sinus by...

Minimise waiting times with Peptest!

In laryngopharyngeal reflux (LPR), refluxed stomach contents travel up the oesophagus and reach the larynx, causing chronic extra-gastrointestinal symptoms such as a persistent cough, hoarseness or difficulty swallowing, meaning it is often attributed to ENT problems.

From a dysphagia clinical trial to a multidisciplinary head and neck clinical pathway – the road to implementation

This paper describes the barriers and facilitators to establishing a structured and coordinated multidisciplinary care pathway for patients with head and neck cancer at a medical centre in the USA. The initiative was set in motion by the roll out...

Can and should vestibular schwannoma surgery be carried out via the endoscopic transcanal approach?

The extent and scope of endoscopic ear surgery has rapidly progressed in recent years, and this paper, from one of the leading proponents of this technique, reports on the outcomes of a case series of patients who have had total...

Is there a role for facial nerve decompression in Ramsay Hunt syndrome?

This is an interesting paper. The authors recommend a transmastoid facial decompression for patients with complete facial nerve paralysis with House Brackman HB 5/6 who do not show any sign of recovery after two weeks of treatment following a diagnosis...

The lateral neck cystic mass – diagnostic dilemma. Can HPV status help?

Solitary cystic masses in the lateral neck can present a significant diagnostic dilemma as they can be metastases from tumours of the oro or nasopharynx. This retrospective paper detailed all patients presenting to a university hospital in Germany, from September...

Empty Nose Syndrome: Evidence Based Proposals for Inferior Turbinate Management

To cut or not to cut, that is the question… The authors of Empty Nose Syndrome emphatically implore the reader to spare the inferior turbinate, lest they cause patients this undue misery! This book is a thought-provoking journey through the...

Impact of the updated cancer staging system on HPV-positive disease

The AJCC cancer staging manual was updated in 2017 (8th edition). It is used in the MDT setting for planning treatment and assessing prognosis for individual patients, and is also widely used internationally in clinical trials. Unlike previous iterations of...