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The nasal cycle 122 years on – are we any wiser?

Published online by Cambridge University Press:  02 October 2017

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Abstract

Type
Editorial
Copyright
Copyright © JLO (1984) Limited 2017 

The nasal cycle was first described by Kayser as far back as 1895.Reference Kayser 1 In the latest of a recent series of articles on nasal airflow in The Journal of Laryngology & Otology, Price et al. challenge a previously held view concerning a relationship between hand dominance and nasal airflow laterality.Reference Price and Eccles 2 Reference Price and Eccles 4 In this most recent study, no correlation between nasal airflow dominance and handedness was identified.Reference Price and Eccles 2 Their results argue against the existence of a dominant nasal passage.

In a prospective randomised controlled trial involving 290 children, aged 2–11 years, with bilateral otitis media with effusion (OME), Hussein et al. conclude that the use of oral steroids leads to higher rates of early complete resolution of OME at 6 weeks.Reference Hussein, Fathy, Amin and Elsisy 5 However, no long-term benefit of using oral steroids, or intranasal steroids, was demonstrated. A randomised controlled trial assessing the use of oral steroids in OME (the Oral Steroids for the Resolution of Otitis Media with Effusion in Children (‘OSTRICH’) study) is ongoing and the results are eagerly awaited.Reference Waldron, Thomas-Jones, Cannings-John, Hood, Powell and Roberts 6 Also in relation to OME, another study in this month's issue investigated the relationship between OME and childhood obesity.Reference Kaya, Selimoğlu, Cureoğlu and Selimoğlu 7 The authors found a higher prevalence of obesity in the chronic OME group, highlighting a possible association that warrants further investigation.

Recent guidelines recommend a ‘watch and wait’ policy for neck management in patients with early lip carcinoma in the absence of clinically suspicious cervical lymph nodes.Reference Kerawala, Roques, Jeannon and Bisase 8 , Reference Bhandari, Wang, Li, Jiang, Guo and Koirala 9 A study by Eskiizmir et al. in this month's issue concludes that tumour stage is an important determining factor affecting prognosis in surgically treated patients with early-stage lip cancer for whom a ‘watch and wait’ policy for neck status has been implemented.Reference Eskiizmir, Ozgur, Karaca, Temiz, Yanar and Ozyurt 10

Finally, two articles in this month's issue report on the successes and complications of paediatric cochlear implantation. Mulwafu et al. report on the first four cases of cochlear implantation in Malawi. The challenges of establishing a cochlear implant service in the developing world are discussed, and in particular the need for collaboration, support and exchange of expertise are deservedly emphasised.Reference Mulwafu, Strachan, Bartlett and Caron 11 Schwartz et al. report on inadvertent intra-operative hyperthermic events in paediatric patients undergoing cochlear implantation, and explore possible mechanisms and predisposing factors.Reference Schwartz, Kaplan, Rosenzweig, Klein, Gruenbaum and Gruenbaum 12

References

1 Kayser, R. Die exacte messung der luftdurchgangigkeit der nase [in German]. Arch Laryngol Rhinol 1895;3:101–20Google Scholar
2 Price, A, Eccles, R. Is there any relationship between right and left hand dominance and right and left nasal airflow dominance? J Laryngol Otol 2017;131:846–52Google Scholar
3 Williams, M, Eccles, R. A model for the central control of airflow patterns within the human nasal cycle. J Laryngol Otol 2016;130:82–8Google Scholar
4 Price, A, Eccles, R. Nasal airflow and brain activity: is there a link? J Laryngol Otol 2016;130:794–9CrossRefGoogle ScholarPubMed
5 Hussein, A, Fathy, H, Amin, SM, Elsisy, N. Oral steroids alone or followed by intranasal steroids versus watchful waiting in the management of otitis media with effusion. J Laryngol Otol 2017;131:907–13Google Scholar
6 Waldron, CA, Thomas-Jones, E, Cannings-John, R, Hood, K, Powell, C, Roberts, A et al. Oral steroids for the resolution of otitis media with effusion (OME) in children (OSTRICH): study protocol for a randomised controlled trial. Trials 2016;17:115 CrossRefGoogle ScholarPubMed
7 Kaya, S, Selimoğlu, E, Cureoğlu, S, Selimoğlu, MA. Relationship between chronic otitis media with effusion and overweight or obesity in children. J Laryngol Otol 2017;131:866–70CrossRefGoogle ScholarPubMed
8 Kerawala, C, Roques, T, Jeannon, JP, Bisase, B. Oral cavity and lip cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016;130(S2):S839 CrossRefGoogle ScholarPubMed
9 Bhandari, K, Wang, DC, Li, SC, Jiang, BH, Guo, YX, Koirala, U et al. Primary cN0 lip squamous cell carcinoma and elective neck dissection: systematic review and meta-analysis. Head Neck 2015;37:1392–400CrossRefGoogle ScholarPubMed
10 Eskiizmir, G, Ozgur, E, Karaca, G, Temiz, P, Yanar, NH, Ozyurt, BC. Stage is a prognostic factor for surgically treated patients with early-stage lip cancer for whom a ‘wait and see’ policy in terms of neck status has been implemented. J Laryngol Otol 2017;131:889–90Google Scholar
11 Mulwafu, W, Strachan, DR, Bartlett, R, Caron, C. Cochlear implantation in Malawi: report of the first four cases. J Laryngol Otol 2017;131:914–18Google Scholar
12 Schwartz, A, Kaplan, D, Rosenzweig, V, Klein, M, Gruenbaum, BF, Gruenbaum, SE et al. The incidence of hyperthermia during cochlear implant surgery in children. J Laryngol Otol 2017;131:900–6Google Scholar