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What to do if adenotonsillectomy does not cure sleep apnoea in children?

This article reviews the management of children with persistent obstructive sleep apnoea (OSA) following adenotonsillectomy (AT). Risk factors for patients to have persistent disease include obesity, being Afro-Caribbean and existing co-morbidities such as craniofacial and neuromuscular disorders. Initial assessment of...

The hippo and the nose

Chronic rhinosinusitis with nasal polyps (CRSwNP) leads to histological changes including thickening of the basilar membrane and epithelial proliferation. Molecular mechanisms underlying these changes are still not fully clear. A signalling pathway called the hippo with Yes‐associated protein (YAP) as...

In this issue...Inner Ear Therapeutics

Emma Stapleton, MBChB, FRCS (ORL-HNS), Consultant Otolaryngologist, Cochlear Implant and Skull Base Surgeon, Manchester Royal Infirmary, UK. E: emmastapleton@doctors.org.ukTwitter: @otolaryngolofox Ralph Holme, Director of Research and Insight, RNID, UK. Ralph. E: Holme@rnid.org.uk W: www.rnid.org.uk For Mar/Apr 2022, we sang the...

Is there a role for facial nerve decompression in Ramsay Hunt syndrome?

This is an interesting paper. The authors recommend a transmastoid facial decompression for patients with complete facial nerve paralysis with House Brackman HB 5/6 who do not show any sign of recovery after two weeks of treatment following a diagnosis...

Allergen immunotherapy and allergic rhinitis – EAACI guideline 2017

Allergic rhinitis (AR) is a common chronic childhood disease with considerable social burden and impact on quality of life, frequently necessitating treatment with various combinations of antihistamines and corticosteroids. The allergen immunotherapy (AIT), sometimes known as desensitisation therapy, can modify...

Which technique is better for turbinate reduction: surgical turbinoplasty or radiofrequency ablation?

Turbinate hypertrophy; radiofrequency; surgical turbinoplasty; visual analogue score

An app to help display hearing results

Vestibular neuronitis (VN) is a common condition that we treat. Despite this, many of us lack the in-depth knowledge and scientific reasons for doing what we do. Granted, the evidence is lacking in some areas but this paper is worth...

Blocked nose in children with allergic rhinitis

Nasal obstruction is a classic symptom in children with allergic rhinitis. While the nasal obstructive disorders including septal deformity, turbinate hyperplasia and adenoidal enlargement are widely recognised in adult nasal blockage, their relationship with paediatric allergic rhinitis however, is scarcely...

Do certain chronic medications increase dysphagia in older people?

Oropharyngeal dysphagia is known to affect a high number of older people in the community, in care homes and in acute geriatric admissions to hospital. The authors of this study have recognised that many older people take drugs for chronic...

Is the lack of sunshine the reason behind allergic rhinitis?

Deficiency in Vitamin D, an in vogue immunomodulator, has been shown in emerging data to have a substantial pathogenetic role in allergic related diseases, particularly asthma. The concept of a shared upper and lower airway has allowed the natural extrapolation...

Persistent dysphonia due to cricothyroid muscle dystonia – should we be requesting laryngeal EMGs for non-resolving ‘functional’ dysphonia?

This article is an interesting report of a case of persistent voice problems affecting a 43-year-old physician that significantly compromised her ability to converse and communicate at work. Specifically, she had a fluctuating voice quality that would ‘choke off’, combined...

Patient reported outcomes improve if antibiotic choice is directed from endoscopic culture results in chronic rhinosinusitis

The use of antibiotics in chronic rhinosinusitis (CRS) has been established as part of the EPOS guidelines, as has the role of taking swabs for microbiology culture. There has not been much literature however on whether tailoring antibiotics in response...