Treatment of inflammatory and neoplastic disease in the maxillary sinus, pterygopalatine and infratemporal fossae requires appropriate surgical exposure. As modern rhinology evolves, so do the techniques available. This paper reviews extended endoscopic approaches to the maxillary sinus and the evidence supporting each technique.

A literature search of the Ovid Medline and PubMed databases was performed using appropriate key words relating to endoscopic approaches to the maxillary sinus.

Mega-antrostomy and medial maxillectomy have a role in the surgical treatment of refractory inflammatory disease and sinonasal neoplasms. The pre-lacrimal fossa approach provides excellent access but can be limited because of anatomical variations. Both the transseptal and endoscopic Denker's approaches were reviewed; these appear to be associated with morbidity, without any significant increase in exposure over the afore-described approaches.

A range of extended endoscopic approaches to the maxillary sinus exist, each with its own anatomical limitations and potential complications.

Recent studies have indicated a lack of ENT training at the undergraduate and post-graduate levels. This study aimed to review the impact of recent educational innovations in improving ENT training for medical students and junior doctors in the UK.

Three independent investigators conducted a literature search of published articles on ENT education. Included studies were analysed using qualitative synthesis methods.

An initial search yielded 2008 articles; 44 underwent full-text evaluation and 5 were included for final analysis. Most included studies demonstrated benefits for students when compared to existing teaching standards in terms of objective assessment (knowledge and skills gained) or subjective assessment (confidence and preference) following implemented educational innovations.

This study identified educational innovations developed in the past 15 years to enhance the teaching of core ENT competencies. More research is needed to establish their impact on the state of ENT medical education in the UK.

The number of medical mobile phone applications continues to grow. Although otorhinolaryngology-specific applications represent a small proportion, there are exciting innovations emerging for the specialty. This article will assess the number of applications available and review how they may be used in clinical practice.

The application stores of the two most popular mobile phone platforms, Apple and android, were searched using multiple search terms.

A total of 107 ENT applications were identified and categorised according to intended use. Eight applications were reviewed in more detail and assessed on whether a doctor or allied health professional was involved in their design and if they were evidence-based.

There are a number of ENT-specific smartphone applications currently available. As the technology progresses, their scope has extended beyond being purely for reference. Nevertheless, it remains difficult to assess the validity and security of these applications.

The following position statement from the Union of the European Phoniatricians, updated on 25th May 2020 (superseding the previous statement issued on 21st April 2020), contains a series of recommendations for phoniatricians and ENT surgeons who provide and/or run voice, swallowing, speech and language, or paediatric audiology services.

This material specifically aims to inform clinical practices in countries where clinics and operating theatres are reopening for elective work. It endeavours to present a current European view in relation to common procedures, many of which fall under the aegis of aerosol generating procedures.

As evidence continues to build, some of the recommended practices will undoubtedly evolve, but it is hoped that the updated position statement will offer clinicians precepts on safe clinical practice.

Socioeconomic risk factors may contribute to geographic variation in diseases, but studies are limited due to lack of large available cohorts.

A geographic analysis was performed of the association between socioeconomic risk factors and the distribution of vestibular schwannomas in adults diagnosed with sporadic vestibular schwannomas through the National Health Services in the West of Scotland from 2000 to 2015.

A total of 511 sporadic vestibular schwannomas were identified in a population of over 3.1 million. Prevalence of vestibular schwannomas were lowest in cases with good health (–0.64, 95 per cent confidence interval: –0.93,–0.38; p = 0.002) and level 1 qualifications (–0.562, 95 per cent confidence interval: –0.882 to –0.26; p = 0.01). However, these risk factors did not demonstrate consistent linearity of correlations. Prevalence was lower in people originating from European Union accession countries from April 2001 to March 2011 (–0.63, 95 per cent confidence interval: –0.84 to –0.43; p = 0.002). No correlation between distribution of vestibular schwannomas and socioeconomic risk factors met our threshold criteria (± 0.7).

This study demonstrated that there is little variation in distribution of vestibular schwannomas by socioeconomic risk factors.

To analyse the data for patients with otogenic intracranial complications during the study period and draw a comparison with internationally published literature.

A retrospective, observational study was conducted, covering a 10-year period between 1 January 2002 and 31 December 2012.

The study comprised 108 patients (66 males (61.1 per cent) and 42 females (38.9 per cent)), of which 75 per cent were aged less than 20 years. Post-auricular swelling, otorrhoea and a decreased level of consciousness were the most frequently reported symptoms in patients with otogenic intracranial complications. Patients with human immunodeficiency virus did not show any different patterns in terms of presentation and outcome.

A triad of post-auricular swelling, otorrhoea and a decreased level of consciousness should make the clinician more heedful of otogenic intracranial complications. Patients with human immunodeficiency virus and human immunodeficiency virus negative patients were equally affected and had similar presentations. Early surgical management of patients was associated with shorter hospital stays and better outcomes.