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Preservation rhinoplasty

Hump reduction and osteotomies to close the open roof, or lowering the whole nasal dorsum? Charles East explains how preservation techniques can improve outcomes by maintaining the integral structures of the nose. What is preservation rhinoplasty? The origins of reduction...

BAHAs in single-sided deafness doesn’t improve sound localisation

This systematic review from South Korea nicely summarises what we know about SSD (single-sided deafness) and hearing rehabilitation with BAHAs (Bone Anchored Hearing Aids). SSD was defined as a PTA greater than 90 dB and a normal hearing opposite ear...

Is flexible nasendoscopy really aerosol generating?

Amid the COVID-19 pandemic, the safety of office-based laryngoscopy has been a source of considerable concern, speculation and debate. Flexible nasendoscopy is a key diagnostic tool in the assessment of the ENT patient, however most healthcare providers consider this to...

Precision medicine in allergic rhinitis and chronic rhinosinusitis

Precision medicine (PM) with its ‘four Ps’ (personalised, predictive, preventive and participatory) is about appreciating differences between individuals when offering management options for health problems. Multiple groups interested in rhinology such as EPOS and ARIA supported a review of the...

The structure and function of DNA

DNA structure and replication Genetic information within multicellular organisms, including man, is stored in molecules of deoxyribonucleic acid (DNA), which reside within the chromosomes of each cell nucleus. A DNA molecule consists of two very long chains, or strands, of...

Does balloon tuboplasty work in the long term, and how can we measure outcomes?

There is much interest and debate at ENT conferences and within current literature about the role of balloon dilatation techniques for Eustachian tube dysfunction (ETD), a condition which we still only have limited understanding of, and which can be challenging...

New ventilation technique FCV: improvement for patient, anaesthetist/intensivist and surgeon

Per-oral surgical access to the larynx can be hampered by the presence of an endotracheal tube. Various systems have been developed for tubeless ventilation, but these all carry a risk of aerosolisation of secretions with obvious inherent risks. We hear...

Ear, nose and throat surgery in children – where will it be in 15 and 50 years?

Michael Kuo, David Albert and Mike Saunders have put their collective heads together to predict the future of ENT surgery in children; will there be a rise in workload due to increasing survival of children with complex medical problems? Or...

Classification and assessment of midfacial fractures; no more Le Fort facial fractures

There is some evidence that severe or complex midfacial or orbital fractures have declined over the last decade. Interestingly there is also evidence of an increase in road traffic accidents but a decrease in facial injuries. This is possibly attributed...

Middle ear muscle disorders: presentation, diagnosis and management

Patients often report symptoms relating to disorders of the middle ear muscles. Prof Bance gives us an overview of the anatomy and function, as well as guides our diagnosis and management. The middle ear muscles (MEMs) are a mystery, both...

New MRI technique assesses treatment response in skull base osteomyelitis

This paper describes another useful imaging technique to monitor Necrotising Otitis Externa (NOE). Echoplanar diffusion weighted magnetic resonance (DW MR) shows high signal on the ‘ADC map’ with active disease and this reduces in signal intensity as symptoms improve. This...

Difficult consultations with HPV-positive oropharnyeal cancer patients

The aetiological role of human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OPSCC) is well established, and its incidence has massively increased over the last decade, whilst the incidence of HPV-negative OPSCC is declining. Although we know that HPV-positive OPSCC...