A study was carried out to compare the effectiveness of nasal splints (in preventing intranasal adhesions) with the morbidity associated with their use in nasal surgery. One hundred and ten patients undergoing a routine nasal operation were randomly allocated into two equal groups, one with splints and the other without. Post-operative pain and discomfort was assessed by a visual analogue scale at 48 hours and a week following surgery when either nasal suction (non-splinted group) or removal of splints was carried out. All patients were examined after six weeks for development of adhesions.Results showed that there was no significant difference in the incidence of adhesions between the splinted and non-splinted patient groups. However, the patients with splints had significantly more pain and nasal discomfort when assessed one week after surgery.It is concluded that the morbidity associated with nasal splints does not justify their use in routine nasal surgery if the aim is to prevent nasal adhesions, but they may still be indicated for enhancing the stability of the septum following septoplasty.

This study confirms the short-term efficacy of inferior turbinate coblation for the treatment of nasal obstruction. The benefit was greatest in patients with lower pre-operative nasal conductance. Objective measures of nasal obstruction may be important when selecting patients for inferior turbinate coblation.

The incidence of Human Papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) is increasing rapidly in the UK. Patients with HPV-positive OPSCC generally show superior clinical responses relative to HPV-negative patients. We hypothesised that these superior responses could be associated with defective repair of DNA double strand breaks (DSB). The study aimed to determine whether defective DNA repair could be associated with sensitivity to inhibition of DNA repair using the PARP inhibitor Olaparib. Sensitivity to Olaparib, and induction and repair of DNA damage, were assessed in a panel of 8 OPSCC cell-lines, including 2 novel HPV-positive lines. Effects on cell cycle distribution and levels of PARP1 and p53 were quantified. RNA-sequencing was used to assess differences in activity of DNA repair pathways. Two HPV-positive OPSCC lines were sensitive to Olaparib at potentially therapeutic doses (0.1–0.5 μM). Two HPV-negative lines were sensitive at an intermediate dose. Four other lines, derived from HPV-positive and HPV-negative tumours, were resistant to PARP inhibition. Only one cell-line, UPCISCC90, showed results consistent with the original hypothesis i.e. that in HPV-positive cells, treatment with Olaparib would cause accumulation of DSB, resulting in cell cycle arrest. There was no evidence that HPV-positive tumours exhibit defective repair of DSB. However, the data suggest that a subset of OPSCC may be susceptible to PARP-inhibitor based therapy.

The significance of post-operative vomiting as a risk factor in the development of a pharyngocutaneous fistula was examined. The case records of 50 consecutive patients undergoing laryngectomies (39 men, 11 women, average age 64 years) were examined, 17 also underwent a simultaneous radical neck dissection. A fistula developed in eight patients (16%) and the median time to its diagnosis was 11 days (range 3-15 days). Several potential risk factors were examined including age, gender, previous radiotherapy, TNM stage, differentiation of tumour, simultaneous radical neck dissection and also the occurrence of vomiting post-operatively. In this series of patients only vomiting in the early post-operative period appeared to be related to the development of a fistula (regression summary: R2 = 0.6, t-value 5.6, P < 0.0001). An episode of vomiting was recorded in eight patients and of these six (75%) subsequently developed a fistula. The median time of post-operative vomiting was 7.5 days (range 1-10 days) and the diagnosis of a fistula occurred at a mean of 1.2 +/- 0.4 days after the episode of vomiting. In a study of this nature it is not possible to conclude that a causal relationship exists between vomiting and fistula development. However, if this is the case a potential means of decreasing the incidence of fistulae following laryngectomy may be available.