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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...

Strengthen your communication: better conversations can reduce the risk of frailty

Our population is ageing and, with this, the incidence of frailty is increasing. Frailty is defined as increased vulnerability to stressors resulting in adverse outcomes. Stressors can include communication and swallowing difficulties, yet these are poorly recognised. Management of communication...

Is there a role for hyperbaric treatment in sudden hearing loss?

Sudden sensorineural hearing loss is a common presentation to ENT departments with a significant difference in management both at a local and regional level. The authors seek to clarify the role of hyperbaric oxygen therapy in combination with oral and...

A review of endoscopic sinus surgery outcomes

This review discusses the outcome measures that may be considered in the assessment of patients with chronic rhinosinusitis (CRS) as well as the outcomes of endoscopic sinus surgery (ESS) published so far. The authors also discuss the role of peri-operative...

ChatGPT to select patients for biologic therapies in CRSwNP?

This short communication describes programming the artificial intelligence (AI) algorithm for systematic review of current literature about guidelines on the clinical efficacy and safety of biologics in the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP). The authors first performed...

Use of topical steroids and antibiotics, compared to systemic antibiotics in the treatment of acute rhinusinusitis

Acute rhinusinusitis is mainly initiated by viral infections. Bacterial infection is usually superadded. The inflammatory cascade upregulates the pro-inflammatory mediators resulting in pain, nasal obstruction and nasal discharge. Local application of steroids and antibiotics could provide a higher concentration of...

Percutaneous tracheostomy in anticoagulated patients

This Belgian study looked at the risks and complications of bedside percutaneous tracheostomy in patients who received anticoagulant therapy. The 231 tracheostomies included in the study were performed over an eight-year period by two otolaryngologists using bronchoscopic guidance. The mean...

Round window niche drilling with intratympanic for ISSHL. A new option for salvage?

This paper from China compares the technique of widening the round window via a posterior tympanotomy approach and steroid-soaked gelatin sponge with intratympanic steroids alone for salvage therapy in severe idiopathic sensorineural hearing loss. Salvage therapy was defined as patients...

The nice therapist effect: does the therapeutic relationship matter?

Quality of relationships is considered a core component of all speech and language therapy work, yet there is little agreement of what constitutes a therapeutic relationship. This study describes a scoping review to map existing evidence that has investigated this...

Surgery or medicine: when should we stop trying to be conservative?

Although most otolaryngologists would agree that surgery improves the outcomes of patients with CRS when medical treatment has failed, both Cochrane reviews state that there is no proof of improved efficacy of surgery over medicine – however, that was after...

Cough no more?

The challenge of the ‘unexplained chronic cough’ that just will not go away is a challenge that frustrates many of us. Often patients have seen respiratory, upper GI and eventually they see you as the last resort! Is behavioural therapy...

Prolactinomas: when to operate

Prolactinomas are the most common functional pituitary adenomas, comprising 40% of all pituitary adenomas. There are consensus guidelines and several common management pathways. This article discusses the role of surgery for these patients. Following diagnosis, the goals of treatment are...