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Timing of surgery in chronic rhinosinusitis: does it matter?

While many patients with chronic rhinosinusitis respond to medical treatment, some do not. The next step for these patients is surgery, but how soon should this be offered? Sooner rather than later seems to be the answer, as Claire Hopkins...

Labour rights violations in the manufacture of healthcare goods

Every year trillions of dollars are spent on medical supplies globally. The operating theatre is a significant proportion of this spend, typically accounting for a third of a hospital’s supply costs. When making purchasing decisions consideration is given to value...

Systemic agents in thyroid cancer

For those patients who have disseminated or unresectable thyroid cancer, Dr Arabella Hunt and Dr Kate Newbold review systemic treatments, their differences, toxicities and outcomes. Thyroid cancer is the most common endocrine malignancy. It is subdivided into differentiated (papillary, follicular...

The use of repositioning chairs in the diagnosis and treatment of BPPV

The authors performed a systematic review assessing the utilisation of multi-axial repositioning chairs, such as the TRV chair and the Epley Omniax Rotator, in the diagnosis and treatment of BPPV. They reviewed nine studies, of which four were prospective studies....

Combination PPI and intralesional steroid treatment for recurrent laryngeal granuloma

The existence of a wide range of treatments for recurrent laryngeal granulomas (repeat surgery, high-dose proton pump inhibitor (PPIs), surgery with botulinum toxin injection, botulinum toxin injection alone, etc) is a testament to the refractory nature of this condition, with...

Neuromodulation in drug resistant epilepsy

Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...

Quality of life in children following balloon Eustachian tuboplasty

This study aimed to demonstrate the efficacy of balloon Eustachian tuboplasty (BET) in children by assessing their quality of life with the Otitis Media-6 questionnaire (OM-6). The OM-6 questionnaire is the most frequently used instrument to measure health-related quality of...

Preoperative prediction of pain outcomes in patients with trigeminal neuralgia

The authors of this retrospective study have developed a preoperative trigeminal neuralgia (TN) grading system for the preoperative prediction of long-term pain relief after microvascular decompression (MVD). Patients who had become refractory to or developed toxicity to carbamazepine or oxycarbamazepine...

Management of infantile haemagiomas of the airway

This paper reviews the diagnosis and management of infantile haemagiomas (IH) affecting the airway. Approximately half of infants with this condition would also have cutaneous haemagiomas which are usually in the beard distribution. IH could affect any parts of the...

Low risk options following failure of intratympanic gentamicin for Meniere’s

This article is a useful summary of the options available when intratympanic gentamicin (ITG) fails to adequately control vertigo episodes in Meniere’s patients. The authors describe the anatomical reasons that may impede drug delivery to the round window with the...

Acoustic shock: definitions and clinical aspects

Acoustic shock, a previously little-known and poorly understood clinical entity, came to the public’s attention in 2019 due to a high-profile legal case of a musician at the Royal Opera House. In this fascinating article, Andrew Parker and William Parker...

Royal Society of Medicine – the year ahead

Professor Peter Andrews and Professor Manohar Bance look forward to 2022-23.