Much discussion is taking place regarding the role of gastric reflux disease in the development and maintenance of chronic sinus disease. We studied 31 patients in a large urban private practice who had recalcitrant chronic sinusitis despite aggressive medical and surgical therapy. After we obtained information on the severity of each patient's sinus disease, we performed either double- or triple-catheter probe pH testing to assess the presence of reflux disease. Of the 30 patients who were successfully tested (1 patient did not tolerate probe testing), 25 demonstrated reflux disease, including 2 whose reflux reached the level of the nasopharynx. These 25 patients were placed on a proton-pump inhibitor (PPI) regimen and reassessed at least 1 month later. At follow-up, 14 of 15 evaluable patients demonstrated at least some improvement in their sinus symptoms, including 7 who experienced either a complete or almost-complete resolution of symptoms. The improvements in sinus symptoms corresponded with improvements in reflux symptoms. These findings suggest that antireflux therapy might play a role in the treatment of recalcitrant chronic sinus disease.

No abstract

Meniere's disease continues to pose a difficult diagnostic and therapeutic problem, resulting in heterogeneous approaches to both evaluation and treatment. Despite the 1995 American Academy of Otolaryngology guidelines in the diagnosis of Meniere's disease, most clinicians rely in part on ENG or ECOG in diagnosing Meniere's disease. Furthermore, despite the passing of 20 years since the publications claiming a purely placebo effect, ESS is the most commonly employed initial surgical treatment for Meniere's disease.

Surgery was performed faster with similar postoperative outcomes in individuals undergoing implantation of bone-anchored hearing devices using the described technique that necessitated minimal soft tissue reduction.

The image commonly held of hearing aids by the general public is a negative one that can be improved with greater education.