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Fungal rhinosinusitis
Allergic fungal rhinosinusitis (AFRS) has been defined by the following characteristics: presence of nasal discharge, nasal obstruction, decreased sense of smell or facial pressure for 12 weeks, mucin within the sinus cavity containing fungal hyphae and degranulating eosinophils, endoscopic evidence...
Diagnostic features of acute invasive fungal sinusitis
Acute invasive fungal sinusitis (AIFS) is a rare but frequently lethal condition, commonly associated with a high morbidity among those that survive. It has gained recent media attention on account of its increased incidence following infection with (and treatment for)...
What to do if adenotonsillectomy does not cure sleep apnoea in children?
This article reviews the management of children with persistent obstructive sleep apnoea (OSA) following adenotonsillectomy (AT). Risk factors for patients to have persistent disease include obesity, being Afro-Caribbean and existing co-morbidities such as craniofacial and neuromuscular disorders. Initial assessment of...
Assessment and management of dysphagia in the elderly
This article covers dysphagia in older patients, which is an important topic due to an ageing population, and a relatively common symptom that we see in clinic. Dysphagia could be due to presbyphagia secondary to changes in head and neck...
Method of delivery: all topical nasal corticosteroids are not made equal
There is an increasing body of evidence that the role of surgery for chronic rhinosinusitis is to facilitate the delivery of topical medical treatment – most notably, topical corticosteroids. Two recent studies, one using flow dynamics and another one examining...
Should patients with dysphagia be allowed water freely?
Patients with dysphagia often experience dehydration as a consequence of “nil by mouth” or having to consume thickened fluids due to aspiration of thin fluids. However, not all incidents of aspiration develop into an infection. Factors that contribute to aspiration...
Newborn sensorineural hearing loss – what is the incidence?
In the last two decades, the introduction of newborn screening for hearing loss has dramatically lowered the average age of newborn hearing loss diagnosis to around two to three months of age. The benefits of early diagnosis are manifold, enabling...
A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth
It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...
Measuring is understanding: an unsupervised PROM clustering of CRS patients
It has been clear for quite some years, at least for anyone dealing daily with chronic rhinosinusitis (CRS) patients, that CRS is an ‘umbrella’ diagnosis. There are significant differences between patients, including different demographic data, different endoscopic and radiographic images,...A legendary ‘parotid adenoma’: teaching aid or trophy? & The stapes: a classical heresy
A legendary ‘parotid adenoma’: teaching aid or trophy? A wander through the glass cases of the newly refurbished Hunterian Museum at the Royal College of Surgeons in London presents a particularly impressive sight to any ENT surgeon. The salivary adenoma...
Techniques of Botulinum Toxin Injections in the Head and Neck
The foreword begins with a saying by George Bernard Shaw, “all great truths begin as blasphemies”. This certainly was the case with medical application of Botox initially, however, botulinum toxin now has an accepted role and is widely used in...
