Mepolizumab (PBS-listed April 2023) is now a second biologic option, alongside
dupilumab, for chronic rhinosinusitis with nasal polyposis. See
Rhinitis, Sinusitis & Rhinosinusitis and
Nasal Polyps.
Sudden sensorineural hearing loss is now framed as a time-critical otologic
emergency — urgent ENT/ED referral and immediate high-dose corticosteroids, without
waiting for an audiogram. See
Loss of Hearing (Acute & Chronic).
SSNHL management now extends beyond the acute window. Patients presenting
more than 30 days after onset should still get urgent ENT referral to assess
candidacy for intra-tympanic corticosteroid injection as salvage treatment
(a meta-analysis found a mean +13.3dB improvement); hyperbaric oxygen therapy
is a reasonable adjunct started early for acute SSNHL (Cochrane review: NNT 5
for improvement) but shows no benefit once loss is chronic (≥6 months); a
separate Cochrane review found no added benefit from antiviral drugs. See
Loss of Hearing (Acute & Chronic).
Adding a topical corticosteroid to topical antibiotics for chronic suppurative
otitis media has no proven added benefit — a 2025 Cochrane review of 19 studies
found no difference in resolution of discharge at 1–2 weeks, with low-certainty
evidence that antibiotic alone may in fact do better for some drug classes;
quinolone drops (ciprofloxacin/ofloxacin) remain preferred over
aminoglycoside/polymyxin drops, which risk ototoxicity through a perforated
eardrum. See
Chronic Suppurative Otitis Media.
Medical treatment for otitis media with effusion (“glue ear”) still lacks
durable benefit — 2023 Cochrane reviews found antibiotics only “might slightly
reduce” effusion at 3 months, oral steroids show unclear/modest benefit at 6–12
months against harms like bone loss, and nasal steroids show even less evidence
of benefit — reinforcing watchful waiting as the default for most children. See
Otitis Media with Effusion.
Button-battery and disc-magnet ear/nose foreign bodies now carry an explicit
urgent-referral safety warning (rapid tissue damage risk).
The Modified Centor Criteria has demonstrated antibiotic-stewardship benefit
(77.7% vs 85.5% prescribing).
“All adult neck masses are malignant until proven otherwise” — reinforced with
documented 180-day-referral and 3× mortality associations, plus rising HPV-driven
oropharyngeal SCC. See Neck Lumps.
Parotitis management ladder expanded (aetiology, red-flag referral, imaging
comparison), plus a new postoperative-parotidectomy section (Frey syndrome,
sialocele, first-bite syndrome). See Parotitis.
Paediatric OSA evidence (polysomnography, oximetry screening, adenotonsillectomy
effectiveness) added. See Snoring.
Laryngeal cancer gained a survivorship/surveillance section. See
Laryngeal Cancer.
Sudden sensorineural hearing loss no longer needs a routine laboratory
work-up — a 2024 AJGP review notes current American Academy of
Otolaryngology–Head and Neck Surgery guidance recommends against routine
labs for idiopathic SSNHL; testing is now targeted to specific clinical
suspicion only. See
Loss of Hearing (Acute & Chronic).
New “Peritonsillar abscess (quinsy)” section on the sore-throat page —
point-of-care ultrasound is now recommended first-line imaging (contrast CT as
gold standard where POCUS isn’t available), plus a Cochrane-sourced NNT for
antibiotics in sore throat generally (3.7 in strep-positive patients, 14.4 if
unswabbed). See Sore Throat.
New pages added
Dental & Oral Emergencies
(2026-09-01) — odontogenic infection: severity classification
(localised / spreading / spreading with severe or systemic features
including Ludwig angina), antibiotic regimens for each tier, red flags
for airway compromise, and infection after dentoalveolar surgery.
Written against 5 eTG odontogenic-infection topics. Currently covers
infection only — dental trauma and dry socket are not yet written.
Nasal Foreign Body (2026-09-01) —
where objects lodge, the positive-pressure (“parent’s kiss”) technique,
microsuction/forceps removal, why irrigation isn’t recommended, and the
button-battery same-day emergency. Scoped to nasal foreign body only —
aural foreign body was already comprehensively covered on
Blocked Ear, so this page cross-links there rather
than duplicating it.
Auricular Haematoma (2026-09-01) — time-
critical drainage (needle aspiration under 6 hours/2 cm vs incision and
drainage beyond that), pressure-dressing techniques that actually
prevent recurrence, otolaryngology referral’s effect on reaccumulation
rates, and ear-protection prevention data.