Cocaine-induced granulomatosis with polyangiitis-an under-recognized condition.

Objectives: Cocaine and cocaine mixed with levamisole are increasingly used in the UK and result in significant direct nasal damage in addition to promoting vasculitis. Our aims were as follows: (1) to identify the main symptoms and presentation of cocaine-induced vasculitis; (2) to provide evidence regarding the best practice for the investigation and diagnosis of cocaine-induced vasculitis; and (3) to analyse the clinical outcomes of patients in order to understand the optimal management for the condition.

Methods: We performed a retrospective case series analysis of patients presenting with cocaine-induced midline destructive lesions or vasculitis compatible with granulomatosis with polyangiitis (GPA) from two large tertiary vasculitis clinics between 2016 and 2021.

A rare case of nasal gout.

Gout is an increasingly common metabolic disorder worldwide. Classical presentation is with acute attacks of arthritis affecting the first metatarsophalangeal joint. With disease progression, tophi may also appear.

Removal of foreign bodies from children's ears: a nurse-led clinic.

This article presents an account of the rationale for and the introduction of a change in practice. The successful removal of foreign bodies from children's ears requires appropriate skills and experience. While traditionally a role for junior doctors, removal of foreign bodies from children's ears at the ear, nose and throat outpatient clinic at Birmingham Children's Hospital was associated with a low success rate.

Patient attitudes to tonsillectomy.

Introduction. Recent changes to primary care trusts' Procedures of Limited Clinical Value (PLCV) policy mean that otolaryngologists must now follow policy rather than exercising clinical judgment when listing patients for tonsillectomy. Objectives.

Transoral laser microsurgery for early glottic cancer.

Objectives. To assess the outcome of transoral laser-assisted microsurgery (TLM) with regards to local and distant tumour control, quality of voice and swallowing. Design.

Paediatric salivary gland epithelial neoplasms.

Salivary gland epithelial neoplasms in children are rare. Clinicians of all disciplines need to have a high level of suspicion when a non-inflammatory single mass lesion presents in the parotid or submandibular glands. There is high likelihood of malignancy when such a mass presents.

Role of ciclosporin in steroid-responsive sudden sensorineural hearing loss.

Conclusions: A subgroup of patients with idiopathic sensorineural hearing loss (SNHL) will have steroid-dependent symptoms which can be confirmed using pure-tone audiometry. Long-term treatment with high-dose corticosteroids exposes patients to potentially serious adverse effects. Immunosuppression with ciclosporin can be an effective and well-tolerated treatment for steroid-responsive sudden SNHL.