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Combined sprays for allergic rhinitis maintenance

This meta-analysis looked at the reported efficacy for allergic rhinitis control of various topical sprays, particularly comparative studies. There were fewer ‘head to head’ studies than we would have hoped to exist. This review included intranasal anti-histamines, intranasal steroids and...

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...

Hereditary haemorrhagic telangiectasia

This is a very nicely written overview of this difficult condition by two expert rhinologists with a tertiary practice. The genetic basis, pathophysiology, diagnosis, natural history and available management options are all discussed. Clearly there is a large spectrum of...

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...

Benefit of prolonged voice rest following phonosurgery

The recommendation for voice rest following surgery is not agreed amongst surgeons, regarding either the type of voice rest (absolute or relative) or the optimal duration. In this ongoing study, 31 elective patients operated on for benign laryngeal lesions were...

Coblation versus microdebrider submucosal inferior turbinoplasty

This prospective randomised study from Riyadh compares submucosal coblation and submucosal microdebrider inferior turbinate reduction. Seventy patients were recruited who had failed medical treatment and were undergoing isolated inferior turbinate surgery. Outcome measures included the Friedman score and VAS for...

Clonidine based vs Remifentanil based hypotensive anaesthesia in FESS

A study investigating the use of clonidine preoperatively in FESS surgery. A double blinded trial of 47 patients in Barcelona randomised into receiving clonidine (20 minutes preoperatively) versus Remifentanil (continuous infusion). Propofol and fentanyl were used for induction and then...

Rhinosinusitis in secondary school children - Part 2: main project analysis of MSNOT-20 Young Persons Questionnaire (MSYPQ)

Rhinosinusitis in secondary school children - Part 2: main project analysis of MSNOT-20 Young Persons Questionnaire (MSYPQ) This study used the modified SNOT-20 in Young Persons Questionnaire (MSYPQ) to evaluate the prevalence and effects of rhinosinusitis in adolescent children (aged...

Quality of life after FESS or balloon sinuplasty

This randomised control trial compared the SNOT-22 questionnaires both pre-operatively and three months post-operatively in patients with chronic rhinosinusitis undergoing either FESS or balloon sinuplasty to the maxillary sinus. Forty two patients participated in the study, 21 in each treatment...

Back to basics: nasendoscopy beats CT, again!

There are few otolaryngologists (or patients) who have not been confronted with a computed tomography scan referring to a deviated septum. In a very similar way to the accidental findings of sinus mucosal thickening, the clinician is left in a...

Not so innocent, after all: a meta-analysis of the effects of intranasal corticosteroids on growth

The use of intranasal corticosteroids has revolutionised the management of allergic rhinitis and rhinosinusitis and there is now significant evidence of their safety. The problem with side-effects is that clinical studies are designed to demonstrate efficacy, but are underpowered to...

ENT and evidence-based medicine: How do they benefit each other?

How do we assess evidence, and how should ENT surgeons use EBM? Evidence-based medicine (EBM) is the practice of medicine based upon high quality scientific research. There are several formal definitions of EBM, the most widely quoted being that of...