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Is posterior epistaxis really ‘posterior’?

In absence of any clear bleeding points seen on the septum, it is generally presumed that the epistaxis is posterior, especially when simple cauterisation of the septum does not help and may progress to sphenopalatine ligation. In this publication, the...

Sinus implants to treat recalcitrant polyps

It is well established that the burden of chronic rhinosinusitis on healthcare costs and patients’ quality of life is high, and that current mainstream treatment options of oral or topical steroids are not without problems. This paper compares two RCTSs...

Outpatient solution for a Patulous tube?

Definitive diagnosis and management of Patulous Eustachian tube (PET) is unsatisfactory. Several different treatment methods are currently used for PET which itself indicates no satisfactory solution. The objective of this study was to compare the outcomes of two different treatment...

Should we do septoplasty in young adults/adolescents?

Nasal obstruction is a common complaint in both children and adults in the outpatient department. Causes for obstruction include allergic rhinitis, septal deviation, turbinate hypertrophy and chronic sinusitis with or without nasal polyps. For symptomatic patients with moderate to severe...

Can obstructive snoring affect the snorer’s ears as well?

Patients with obstructive sleep apnoea (OSA) often show severe nasal obstruction, chronic sinusitis and/or a deficit of nasal mucociliary clearance with nasopharyngeal stagnation of secretions possibly predisposing to eustachian tube dysfunction (ETD). This clinical prospective study investigates ETD, nasal resistance...

The double-half bilobed flap or traditional bilobed flap: which is better?

Reconstruction of the nasal tip following ablative surgery can be taxing. The nasal tip is a very visible area with largely immovable skin and reconstruction needs an appreciation of the various subunits to achieve best results. The traditional superiorly based...

Prospective evaluation of quality of life in the flaccid

Flaccid midface paralysis causes nasal valve collapse due to the lack of tonic muscular support. This causes both external nasal valve narrowing and collapse during inspiration. Correction of the nasal valve is performed in functional rhinoplasty. However, these procedures do...

How well are we managing epistaxis cases?

Epistaxis constitutes 34.5% of all emergency admissions to otolaryngology departments nation-wide. Presently there are no detailed consensus guidelines for this commonest emergency, and there is tremendous variation of practice. Quite often, non-ENT trained doctors manage this emergency. This paper reviews...

Why do septoplasties fail?

If you are amongst the ones who wonder what keeps your patient blocked in spite of a reasonable septoplasty, it will be worth your time going through the chapter on nasal valve management. The concise table detailing the surgical techniques...

Transverse venous sinus stenosis – a risk factor for CSF leak in patients with idiopathic intracranial hypertension

This was a multicentre (six French tertiary hospitals) retrospective case-controlled study aiming to investigate the rate of transverse venous sinus stenosis (TVSS) in patients with idiopathic intracranial hypertension (IIH) with nasal cerebrospinal fluid (CSF) leaks. They compared the preoperative MRI...

Olfactory neuronal damage in sinusitis

So many patients with nasal disorders have poor olfactory function, yet sometimes the nose may seem comparatively clear of conductive problems. This study postulated that neuronal damage in the olfactory apparatus would lead to a leakage of neuron specific enolase...

“Rhinosweetometry”

An article that elicits a wry smile from the reader is worth drawing attention to particularly in the winter months. This account of brave self-experimentation is unlikely to lead to a future Nobel prize but nonetheless reinforces the important principle...