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Guidelines for management of orbital infections

Orbital infections predominantly affect the paediatric population and complications can be very serious. The cellulitis can be preseptal or orbital and the abscess can be confined within the periosteum or extend into the orbit. Cavernous sinus thrombosis can complicate the...

Prevention better than cure?

This systematic review looks at methods of ‘barrier protection’ or ‘barrier-enforcing’ to minimise allergic rhinitis symptoms, using 15 RCTs. Whilst the authors admit that patient numbers were small in a number of these studies, generally it seems that barrier techniques...

Biologicals for severe chronic rhinosinusitis with nasal polyps. Any use?

Recent advances and knowledge of inflammatory endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP) led to introduction of biological agents such as monoclonal antibodies targeting IgE (omalizumab) and Interleukins (ILs) such as IL4R alpha (dupilumab) and IL5. The European Academy...

Prognostic value of vascular ultrasonographic findings in patients with idiopathic sudden sensorineural hearing loss

Sudden sensorineural hearing loss is often idiopathic. Although the aetiology of idiopathic sudden sensorineural hearing loss (ISSNHL) is unclear, vascular compromise is one of the frequently proposed hypotheses to explain its pathophysiology. Existing studies have shown an association between ISSNHL...

Should we be doing earlier MRIs in sudden sensorineural hearing loss?

There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....

Diagnosis and management of acute sensorineural hearing loss: a Japanese perspective

In this paper, the authors set out the clinical guidelines to standardise diagnosis and treatment of acute sensorineural hearing loss in Japan. They categorised acute sensorineural hearing loss into five disorders: idiopathic sudden sensorineural hearing loss (iSSNHL), acute low-tone sensorineural...

How rare is vocal fold paralysis after spinal and epidural anaesthesia – should we be more concerned?

The authors present an unusual case of right vocal fold paralysis. Their patient was a 38-year-old woman who experienced new onset dysphonia following neuraxial anaesthesia (NA) for a caesarean section. Flexible nasendoscopy showed a right VFP with fixation in the...

Olfaction in CRS

Conventional teaching tells us that hyposmia in chronic rhinosinusitis is due to mechanical obstruction of the olfactory cleft. But it might be that the story is slightly more complicated than that. Olfactory dysfunction is a common feature of chronic rhinosinusitis...

Ear, nose and throat surgery in children – where will it be in 15 and 50 years?

Michael Kuo, David Albert and Mike Saunders have put their collective heads together to predict the future of ENT surgery in children; will there be a rise in workload due to increasing survival of children with complex medical problems? Or...

The ENT operating theatre viewed down the retrospectoscope

We learn much of our future by looking at our past; Douglas MacMillan provides us with a fascinating glimpse into his years as a junior doctor. The operating theatre was a somewhat alien environment in the late 1960s: theatre sisters...

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...