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Balloon dilatation of the eustachian tube: An evidence based review

Eustachian tube dysfunction has long provoked debate among otolaryngologists with wide-spread variation in management. Establishing a safe and effective surgical technique to bring about resolution would be of benefit to those affected, with an estimated incidence of 0.9% in the...

Objective versus subjective – again!

The use of objective measurements of nasal airflow has a long history; however, its clinical application remains, at most, patchy. The main reason for that has been the lack of convincing studies showing a good correlation between the findings of,...

CRS vs. migraine: which is the culprit in most headaches?

‘Sinus headache’ is a common diagnosis according to patients and primary care physicians, but relatively infrequent in the eyes of otolaryngologists. This study examines 104 patients with a primary headache syndrome (PHS) and 130 patients with CRS, looking at SNOT-22...

Don’t be too apologetic: disclosing communication difficulties

People who stutter are frequently considered less intelligent or less confident, and are often discriminated against. These negative perceptions have been found to differ slightly across different cultural groups. For Hebrew speakers in Israel, having a stutter can have a...

When to operate on a patient without chronic disease?

As ENT surgeons, we spend a lot of time managing chronic rhinosinusitis, so a review and update on the management of the acute disease is always helpful. The standard medical treatment of antibiotics, nasal steroids and nasal decongestants are reported...

A more comprehensive management for eosinophilic chronic rhinosinusitis after FESS

In recent years there has been increasing recognition of eosinophilic chronic rhinosinusitis which, in particular, results in persistent symptoms and recurrence of nasal polyps, even after FESS surgery. It therefore calls for measures adjuvant to FESS to stop persistence of...

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....

Endolymphatic sac tumours

The authors performed a systematic review of literature and describe the clinical signs and symptoms of endolymphatic sac tumours (ELST) in this article. A total of 113 patients and 118 cases from 26 studies were included in the study. The...

Is benign intracranial hypertension underdiagnosed in patients with spontaneous CSF leaks?

In ENT practice we come across spontaneous CSF leaks. Patients present either as unilateral watery rhinorrhoea or otorrhoea, or sometimes as hearing loss with a watery middle ear effusion. Clinicians, after confirming the diagnosis of CSF leak with beta 2...

Predicting outcomes in rhinology using fluid dynamic models

This article discusses the rhinological applications of computational fluid dynamics (CFD) – a method derived from engineering applications, such as aerodynamics. Its appeal is that it can provide simulated data on airflow velocity, pressure, resistance, temperature, humidity, heat flux and...

How to manage the concha bullosa in FESS

It is an interesting concept to assess how much impact the presence of a large concha bullosa (CB) has on both severity of chronic rhinosinusitis (CRS) and also postoperative outcomes after FESS. The authors accept that the paper has limitations...

Outcomes following endoscopic vs. microscopic ossiculoplasty

Endoscopic ear surgery continues to increase in popularity with an expanding range of applications in otology. The variety of angled scopes allow for superior visualisation of the surgical field and difficult to reach areas. However, use of endoscopes reduce the...