The July issue of The Journal of Laryngology & Otology has much of interest. In this editorial, we look at just three of the many informative, interesting and useful articles in this month's issue of The Journal.

Biofilms have an acknowledged role in infections.Reference Ramakrishnan, Shields, Elbadawey and Wilson^1, Reference Youn, Jun, Jo, Jang, Song and Cho² Schrøder and colleagues found morphological evidence of bacterial biofilm in submandibular gland sections from patients with chronic sialadenitis; this was not seen in controls with no sialadenitis in their submandibular salivary glands.Reference Schrøder, Eickhardt-Dalbøge, Bjarnsholt, Nørgaard and Homøe³ The bacteria in the biofilms resembled cocci, which is not unexpected; however, these findings do raise questions regarding the role of biofilms in sialolithiasis, something the authors have commented on.

Adnan Ali et al. investigated patients with and without human papilloma virus (HPV) positive oral cavity squamous cell carcinoma and found no difference in five-year survival between these two groups.Reference Adnan Ali, Awan, Atif, Ali and Mirza⁴ This is based on an uncommon distribution of subsites in their population, possibly related to areca nut consumption and geographical variation. The study uses polymerase chain reaction assays for HPV status,Reference Mehanna, Evans, Beasley, Chatterjee, Dilkes and Homer⁵ rather than a P16 surrogate analysis. The involvement of HPV in the tumour biology of oral cavity tumours remains a controversial area and additional studies of this type are needed to provide more data.

A preliminary study on the treatment of recalcitrant chronic sinusitis with purulence, by de Bonnecaze et al., showed improvement in nasal function, as measured by the Sino-Nasal Outcome Test 22 (SNOT-22).Reference de Bonnecaze, Chaput, Dupret-Bories, Vergez and Serrano⁶ The authors prescribed a three-month course of low-dose trimethoprim/sulfamethoxazole. The number of patients in the study is small and there was no control; nevertheless, the authors report no side effects and consider the method safe. Further work on this is required, as the need to manage this difficult group of patientsReference Leonard, Masih, McDonald, Taylor, Maiden and Leyden⁷ is clear.