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Location, location, location: How to get the steroid where you need it, in chronic rhinosinusitis

What almost all current guidelines on chronic rhinosinusitis have in common is the importance of intranasal steroid (INCS) use. However, it is increasingly understood that the efficacy of INCS depends on their efficient delivery to the point of need, i.e....

General overview of endoscopic ear surgery: advantages and principles

The philosophy of endoscopic ear surgery presents surgeons with a tricky concept – does the magnificent view make up for the fact I need to operate with one hand? In this article, Jane Lea discusses the advantages of operating transcanal...

SmartVS™: revolutionising audiology education with virtual simulation

Professor Brown introduces the Smart VS™ simulation system developed during the 2020 pandemic to support students in gaining experience without direct patient interaction. Universities have been training audiologists essentially the same way for the past 40+ years. It’s time to...

Microbiome changes after endoscopic sinus surgery: all is not what it seems

As we keep fighting a losing battle with bacteria and antibiotics, it becomes clear that it is not about killing bacteria, not even diminishing the bacterial load, but rather about shifting the different types of bacteria that colonise and live...

Those little friends in our noses

Human microbiota plays an important role in both health and disease including metabolism, immunomodulation, and a potential role in chronic inflammatory conditions such as chronic rhinosinusitis (CRS). The authors aimed to investigate the sinonasal microbiome using 16S rRNA gene sequencing...

CRS vs. migraine: which is the culprit in most headaches?

‘Sinus headache’ is a common diagnosis according to patients and primary care physicians, but relatively infrequent in the eyes of otolaryngologists. This study examines 104 patients with a primary headache syndrome (PHS) and 130 patients with CRS, looking at SNOT-22...

In conversation with Prof Metin Önerci

Prof Valerie Lund caught up with friend and colleague, Prof Dr Metin Önerci, to discuss his various positions in rhinology, the FOAM programme with which he is involved, and rhinology in Turkey and the Balkan and the Central Asian region....

New curricula: trainees’ and trainers’ thoughts

After the disruption to training and clinical practice from COVID, it is interesting and perhaps encouraging that plans are in place to support ENT training in both mainland Europe and the UK with new formal curricula. We hear trainees’ and...

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...

Preoperative CT checklist (using the ‘CLOSE’ mnemonic) improves identification of anatomical variants for endoscopic sinus surgery

Computed tomography (CT) scans of the paranasal sinuses act as roadmaps for endoscopic sinus surgery (ESS) and careful inspection preoperatively warns the operating surgeon of critical anatomical variants. This study aimed to investigate if implementation of a pre-ESS CT checklist...

Do parents sleep better after paediatric adenotonsillectomy?

Paediatric adenotonsillectomy for sleep disordered breathing (SDB) is amongst the commonest surgical procedures performed in ENT. In the outpatient clinic, parents routinely express their concern about their child’s breathing but the impact of sleep disordered breathing on the parent is...

From the editor Jul/Aug 2025

Declan Costello, MA, MBBS, FRCS(ORL-HNS),Consultant Ear, Nose and Throat Surgeon, Wexham Park Hospital, Slough, Berkshire, UK. E: d.costello@nhs.netTW / X: @Voicedoctor_uk Regular readers will know that we have been publishing supplements in different specialties every four months; these give us...