Objective: Cases of chronic otitis externa (OE) resistant to conventional treatment remain a significant challenge. This paper describes our experience of utilising fluticasone propionate (Flixonase®) drops in the treatment of such cases. Methods: We included a series of patients with resistant chronic OE that were referred to ENT consultant clinic between 2016 and 2018, all of whom failed to respond to the conventional treatments. The patients were prescribed 200 micrograms of Flixonase® once daily and followed up in the clinic to assess response to the treatment. The case notes were reviewed retrospectively. Results: Total of 25 patients identified over 2 years. Patients reported itching as the most common symptom (83%), and skin changes were the most common sign identified under examination (72%). The combination of steroid and antibiotic drops had been the most common treatment modality prescribed. Fluticasone propionate was started a median of 5 months after the diagnosis (range: 0-54 months) with a median treatment duration of 3 months (range: 1-18 months). All 17 patients who attended the follow-up clinic were classified as having been cured. Conclusions: Our findings suggest fluticasone propionate as an exciting and potentially important modality in the treatment of chronic OE cases, especially where all other treatment options have been exhausted.
Treating twenty-five cases of chronic resistant otitis externa with fluticasone propionate (Flixonase®): a case series Utilising Flixonase® in treatment of chronic otitis externaKey points:Chronic cases of otitis externa, resistant to conventional treatments are notoriously difficult to treat, with resolution in these cases challenging.Guidelines suggest the use of corticosteroid in chronic otitis externa, however, there is no specific advice on which corticosteroid to utilise.Our case-series demonstrates the potential benefit of fluticasone propionate in patients who have previously failed a multitude of conventional management options.Despite the limitations of our study, our experience highlights a gap in the literature and suggest fluticasone propionate as an exciting and potentially important tool in the arsenal of the otolaryngologist.
Objective: To determine the number of academic papers which have been submitted and published by ENT specialty trainees at each level of higher surgical training. Design: A cross-sectional survey was designed and validated according to the ‘Good Practice in Conduct of and Reporting of Survey Research’ checklist. Settings: Voluntary completion of a web-based questionnaire which was distributed to participants between 11 May – 22 June 2020. Participants: All ENT higher surgical trainees (ST3-ST8 level) in the UK. Main outcomes measured: The number of submitted and published articles by each higher surgical trainee. Comparisons were made between deaneries, training grades and trainees who had achieved a higher degree. Trainees in academic training pathways and those in less than full-time training were analysed separately. Results: One hundred fifty-three ENT speciality trainees across the UK took part in the survey, giving a national response rate of 46.5%. There was a slight male preponderance in the respondents, with 85 males and 68 females completing the survey. Across all years of training, the mean number of first author publications was three and for non-first author publications the mean number was two. For trainees at ST8 level, these numbers were nine and five, respectively. Trainees undertaking a PhD programme produced a mean number of nine first author publications – 5.31 more than the rest (p < 0.0001). Those in academic training pathways achieved 3.48 more publications compared to those who were not (p = 0.092). Trainees with additional undergraduate degrees and those in less than full-time training had an overall lower number of first author publications compared to the general cohort. Conclusions: ENT specialty trainees achieve a higher average number of academic publications than is currently required in order to successfully obtain a Certificate of Completion of Training (CCT). This is particularly the case for trainees in an academic training programme and those with a higher degree. It is the authors’ hope that the data from this study will help in informing and guiding junior trainees, educational supervisors and training programme directors when considering the level of research engagement required for gaining a CCT.