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Smoking and immunotherapy – does it worsen outcome?

This interesting study aimed to address the issue of smoking in patients who had their allergic rhinits treated by sublingual immunotherapy (SLIT). Assessment was with validated quality of life questionnaires. There were 163 patients recruited in Greece who had completed...

Getting your nose dry: endoscopic vidian neurectomy – an old technique given new life

We are often faced with patients with intractable watery rhinorhea – patients with no demonstrable allergy, a diagnosis of NAR and no response to ipratropium or capsaicine. For such patients, vidian neurectomy has been devised – an old technique that...

Budesonide irrigation in polyposis

It is very well known through many RCTs and now meta-analyses that saline-based irrigation is beneficial in patients after sinus surgery. It is also demonstrated that intranasal steroids are beneficial postoperatively but there is also a trend for steroid based...

Adjuvant intratympanic steroid therapy in sudden sensorineural hearing loss

Sudden sensorineural hearing loss (SNHL) means abrupt hearing loss by 30dB affecting three consecutive frequencies within 72 hours. This is treated by high tapering doses of systemic steroids, the role of which is controversial and fraught with possible complications in...

Advances in vestibular function testing

Vestibular function testing has historically been limited by difficulties in testing individual parts of the vestibular apparatus. Jas Sandhu describes new tests available to clinicians that address this problem. Advances in vestibular function testing Vestibular function testing has historically been...

Does septoplasty improve smell?

This is a study from Barcelona on a very interesting topic: does septoplasty change sense of smell? The theory being that a deviated septum would prevent airflow to the olfactory region and once the anatomical obstruction has been relieved, that...

Rock Steady: Healing Vertigo or Tinnitus with Neuroplasticity

Rock Steady guides the reader through a change in attitude towards chronic tinnitus or imbalance. The premise is that changes in the human body are an inevitable part of life, through trauma, ageing and illness. These changes can produce sensations...

Tinnitus in patients on therapy with PPI and in PPI non–users

Tinnitus is a chronic and debilitating condition and approximately 10% of the population is afflicted. A myriad of pharmacological treatments for tinnitus are available but only a few controlled studies have shown positive results. The relationship between proton pump inhibitors...

Does sleep quality improve when we adequately treat CRS?

In addition to the well-known symptoms associated with chronic rhinosinusitis (CRS), patients often suffer with poor sleep quality which is also detrimental to health and wellbeing. This meta-analysis looked at 35 papers reporting outcomes for CRS patients post surgery on...

How best to follow up a sinonasal cancer?

Sinonasal malignancies are rare tumours and, in the UK, are usually treated in tertiary treatment centres but may well be followed up long term in the patient’s local hospital, so advice on how best to manage these patients is invaluable....

Core biopsies are good enough for lymphomas

This paper, from the South of England, has reviewed ultrasound-guided core needle biopsies over a six-year period investigating the use of the detection of head and neck lymphomas. There were 367 samples included from 226 patients; 215 of the 226...

Can we predict how much benefit patients will get from ESS with a novel monoclonal antibody

Mepolizumab (Nucala) is a humanised IgG1 monoclonal antibody that acts as an IL-5 antagonist. It has been shown to be highly effective in treating severe asthma. It is hypothesised that it will be effective for patients with recalcitrant CRSwNP. This...