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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....
The search for the holy grail of rhinosinusitis: another step towards phenotyping in CRS wNP?
For many years, scientists and clinicians have been trying to understand the infinite variability within the term ‘rhinosinusitis’ using radiology, basic science, epidemiology and then using their insights to solve the riddle of management: how to explain why some patients...
Rib grafts for mandibular reconstruction
Reconstruction of the mandible following ablation requires good bone stock to allow optimal function and the placement of dental implants. In the developed world, vascularised bony flaps are accepted as the gold standard but these may not be widely available...
Reliability of Koos classification
Vestibular schwannoma (VS) tumour size has been considered the primary determinant of hearing outcomes and facial nerve function according to several published studies. Varying methods are used to estimate the size and volume of the VS with very little consensus...
Benign positional paroxysmal vertigo manoeuvres in children and adolescents: a systematic review
In this paper of Saniasiaya et al, the literature review is conducted in accordance to the PRISMA consensus, aiming to investigate the outcomes of canalith repositioning manoeuvres (CRM) to treat benign paroxysmal positional vertigo (BPPV) in a paediatric and young...
Widen the ostium or keep it: that is the question
The original concept of wide endoscopic sphenoethmoidectomy for sinonasal polyposis has been a well-established principle since 1995. However, with the evolution of the understanding of sinonasal physiology, this might change. The authors present arguments based on the evolutionary and developmental...
Puberty and rhinitis
While asthma and rhinitis are more common in boys compared to girls in childhood, whether this trend persists after puberty or not is not yet clear. Authors inspected the European Commission funded MeDALL (Mechanisms of the Development of ALLergy) to...
Skull base imaging: a review
This excellent review paper describes the anatomy, imaging protocols and differentiating imaging findings on CT and MRI in myriad skull base lesions. Skull base protocol MRI and thin section CT are required to evaluate all skull base lesions. According to...
Multi-layered repair of lateral sphenoid CSF rhinorrhoea
This case series describes the author’s results with repairing lateral sphenoid encephalocoeles in seven patients. Alloderm inlay with abdominal fat onlay and nasoseptal flap onlay repair resulted in a 100% success rate with no recurrence of cerebrospinal fluid (CSF) rhinorrhoea,...
Tongue twisters to evaluate speech disorders
This interesting study compared errors in tongue twisters produced by adult patients with dysarthria with those produced by age-matched healthy controls. Audio recordings of all patients while they were vocalising tongue twisters were studied. The authors marked one word prominently...
Importance of face-to-face communication in clinical practice
Breakdowns in communication with patients who have difficulty in understanding, speaking or hearing may occur during a consultation. The authors of this paper studied the hearing-related breakdowns in communication especially amongst older adults with hearing impairment (HI) using conversational analysis...
