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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...

Clinical pathological features associated with malignant change in oral leukoplakias

This is a retrospective study from Sweden where 234 patients, diagnosed between 2003 and 2013 with a median nine-year follow-up, were reviewed. Of these 234 patients, 11.5% developed oral squamous cell carcinoma. Non-homogenous leukoplakia showed a 15-times higher transformation rate...

Eosinophilic or not eosinophilic: dupilumab seems to work

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammation with interleukin (IL)-4, IL-13, and IL-5. Tissue eosinophilia in nasal polyps dramatically increased over a 10-20-year period. Classification of the severity of eosinophil status is expected to lead to...

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...

Molecular and genetic nature of skull base tumours drives management

This article reviews the molecular basis and paradigm shift in the diagnosis and management of skull base tumours. It is now known that the phenotype of meningiomas is influenced by their genotype. Endolymphatic sac tumours are observed in up to...

How can we manage children with poor speech discrimination but with normal audiogram

We often come across children and young adults brought in for consultation for suspected hearing loss and having hearing difficulty in noisy backgrounds but who often have normal audiograms. Such patients are suspected to have auditory neuropathy. The term auditory...

Sinonasal inverting papilloma and HPV - a meta-analysis of recurrent tumours

Sinonasal inverting papilloma (SNIP) is a common benign tumour of the sinuses. Difficulty lies in the association with metachronous or synchronous SCC of the sinus and also in the complete removal of the lesions due to their anatomical location. An...

Not as rare as we think? Silent sinus syndrome incidence on CT heads

It is relatively uncommon to come across a case of silent sinus syndrome (SSS), but not as rare as the prevalence in the literature might suggest – the authors of this study note that only 100 cases are reported in...

Talking to the animals

People with communication difficulties have an increased risk of mood and anxiety disorders. This often means that speech and language therapists must actively engage in counselling as part of their intervention. It is not surprising, therefore, that the active components...

How interaural level differences differ between children with bilateral cochlear implants and their normally-hearing peers

A group in the Netherlands investigated interaural level differences (ILDs) in children who were bilaterally implanted with cochlear implants (CIs) and compared their performance to their normally-hearing peers. ILDs are used to localise sound and rely on the high-frequency cues....

Patients with auto-immune Meniere’s disease more likely to respond to intratympanic steroids

The authors retrospectively reviewed the duration of symptom control after intratympanic dexamethasone (IT) injections in 27 patients with Meniere’s disease (MD) over a six-year period. The patients received two IT injections of 3.3mg/ml of dexamethasone one-to-two weeks apart. Eleven patients...

Hearing outcomes after mastoid obliteration tympanoplasty

In this study, the authors retrospectively compare hearing outcomes after mastoid obliteration to non-obliterative techniques in cholesteatoma surgery. They have performed canal wall up with mastoid obliteration (bony obliteration tympanoplasty or BOT) since 2013. The procedure has replaced canal wall...