Background/aims There is a growing backlog of patients with sino-nasal disorders waiting for a follow-up appointment. This study aimed to identify rhinology patients on the outpatient follow-up list who could be removed from the waiting list for a face to face follow-up appointment and instead either given a phone consultation by a clinical nurse specialist or discharged from the service. Methods The clinical records of patients on the waiting list for a follow-up appointment at a nasal disorders clinic were reviewed by a panel comprising a consultant rhinologist, a rhinology fellow, a specialist registrar and two nurse specialists. Results A total of 300 clinical records of patients on the follow-up list of the Rhinology clinic were identified, of which 253 were found to have a sino-nasal disorder. Of these, 137 patients (54%) were discharged from the rhinology face to face follow-up clinics, while 116 patients (46%) were given face to face review appointments. Conclusions A multi-professional rhinology review panel is an effective way of managing the waiting list of an outpatient rhinology clinic and providing nurse-led telephone consultations could decrease the strain on resources while maintaining patient safety.

Introduction: Globus pharyngeus is a well-known disorder accounting for 3-4% of ENT referrals. Various treatment strategies have been proposed for this condition, including speech and language therapy. The aim of this article is to highlight the evidence-based approach to the development of a mobile application to improve patient access to speech therapy as a treatment for globus pharyngeus. Patients and Methods: A literature search was performed to identify articles exploring the use of speech therapy as a management option for this disorder. A survey of speech and language therapists (SLT) in the UK to determine patient access to this treatment and their views on the development of a mobile application is also described. Results: Four studies were identified, including one randomised controlled study. All articles demonstrate a significant improvement in symptoms following the use of speech therapy. SLTs from 27 departments responded to the survey. The globus pharyngeus patient workload was variable and in excess of 1000 patients per year in some departments. Most respondents supported the development of a mobile application for speech therapy for use by globus pharyngeus patients. Conclusion: Speech therapy is an effective treatment for globus pharyngeus patients. Speech therapy is not available in all NHS Trusts in England and some SLT departments have a high workload. Alternative methods for the delivery of this effective treatment should be considered including the use of mobile applications. It is important to rule out the possibility of upper aerodigestive tract malignancy before referring a patient for speech therapy.

Rhinophyma represents a progressive deformity of the nose which leads to cosmetic disfigurement and has a significant impact on the patient's quality of life. This pathological entity originates from hyperplasia of sebaceous gland tissue, connective tissue, and vessels of the nose and is associated with rosacea and more specifically, stage III rosacea. Surgical treatment is the method of choice. We present five cases of rhinophyma that we treated with microdebrider-assisted excision. The procedure was divided in two main steps: scalpel excision of the main bulk of the rhinophyma and then further contouring with the microdebrider. All patients had weekly follow-up for the first four weeks, and then three-monthly. All patients had uneventful recovery and satisfactory cosmetic outcomes. No postoperative infections or other complications were reported in our case series. The use of the microdebrider reduces the operating time, preserves the islands of skin regeneration, and allows finer manipulations than the standard scalpel techniques. Microdebrider-assisted rhinophyma excision is a safe approach, with good aesthetic results. Larger series of patients need to be examined in order to establish the value of the method.

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