Prepared by Mark Greener

Many Ear, Nose and Throat (ENT) problems are treated surgically. However, pharmaceutical executives can't afford to ignore ENT. Indeed, there are a growing number of pharmacological treatments for ENT conditions as diverse as tinnitus, allergic rhinitis, infections and even snoring. (You - or your partner - might like to know that allergic rhinitis treatments, HRT and tricyclics may be effective in selected patients.)

The last nugget comes from a review of snoring treatments by Consultant Otolaryngoloist Ray Clarke in the latest issue of ENTNews: essential reading for anyone interested in the field. The bimonthly magazine reviews current literature in ENT and related fields. (It's been on my essential reading list for the last few years.) There is also a useful Internet review each issue.

Their web-page ENTNews on-line supplements the printed journal and contains lead articles, features, conference reviews, product information and so on. ENTNews on-line also acts as a valuable gateway site for a tour around the area. The American Journal of Otology's site is another good place to start. The site offers an index back to 1979, making it one way to begin to get a handle on the ENT literature.

From here, you can access areas that interest you. Tinnitus, for example, affects around one in five of us sometimes during our lives and quarter of sufferers seek medical care. Until recently, there was little physicians could offer - retraining was perhaps the most effective measure. However, new drugs - such as local anaesthetics and agents that modulate GABA - may offer effective pharmacological therapies.

For further information on the condition and current treatments, the try the pages hosted by University College London and the American Tinnitus Association. The Coast Community College District answers some frequently asked questions. The CCCD site also offers links to a number of on-line and other resources, a glossary and patient information.

Despite recent advances in several fronts in the war against cancer, head and neck tumours remain among the hardest neoplasms to treat. Fortunately, a number of treatments are undergoing clinical trials. The Pharmaceutical Research and Manufacturers of America's pages can keep you up to date with anticancer drugs in development. Indeed, for everyone working in the pharmaceutical industry, the Pharmaceutical Research and Manufacturers of America's drugs in development database is an invaluable site - it's worth book marking and visiting regularly. For example, the main menu offers links to reviews of drug in development for children, AIDS, heart disease and stroke, infectious diseases, African Americans, mental illnesses, women etc. It also covers biotechnology medicines.

For more specific background information on head and neck cancers point your browser at, for example, Baylor College of Medicine. Baylor offer a selection of grand tours appropriate for those with a medical background, including head and neck cancer http://www.bcm.tmc.edu/oto/grand/hnca.html. You can also link to tours on, for example, chemotherapy and radiation for advanced head and neck cancer, Kaposi's sarcoma and advanced skin cancer of the head and neck among others. Worth a visit for further education and to impress your medical director if nothing else.

Finally, the CancerNET UK Information Database reviews nasopharyngeal cancer http://www.graylab.ac.uk/cancernet/101402.html as well as covering paranasal sinus and nasal cavity cancer http://www.graylab.ac.uk/cancernet/102892.html. The CancerNET UK Information Database is also an excellent gateway site for anyone wanting to explore cancer.

Steroids are one of the mainstays of therapy for allergic and inflammatory ENT conditions, such as allergic rhinitis. And their role is growing. For example, the Canadian Paediatric Society site reviews steroid therapy for croup - one of the commonest childhood diseases. In most cases, croup is generally self-limiting lasting an average of four days. However, up to 15 per cent of children with croup seen as outpatients are admitted to hospital. As a result, there is growing interest in using steroids to improve outcome. The site provides some valuable background information on this new steroid indication. There's also an index of position papers from the Infectious Diseases and Immunization Committee, which could provide some useful background information in other areas.

Allergic and non-allergic rhinitis - hay fever and so on - is another common complaint widely treated with topical steroids. Around 40 million Americans suffer from rhinitis, for example. And it's an area set to rise up the medical and marketing agenda following the introduction of oral leukotriene inhibitors that reduce inflammation along the whole length of the respiratory tract. As a result, leukotriene inhibitors are effective against allergic rhinitis as well as asthma.

AstraZeneca, MSD have oral leukotriene inhibitors on the market and others are in development. AstraZeneca back their marketing with a dedicated Accolate (zafirlukast) and asthma site. For a patients' eye view try National Jewish Medical and Research Center site.

If all this gets a bit heavy, there is a light side to ENT. Also in the latest issue of ENTNews, their Internet compiler Tunde Odutoye reviewed the ear candling web site. Apparently, North American Indians insert a candle into the external canal and light it. This creates a vacuum that cures most nasal and otological symptoms - and gives a whole new meaning to the term earwax.

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