Journal Reviews
A cost reducing protocol for magnetic resonance imaging in patients suspected to have acoustic neuroma
Magnetic resonance imaging is the ‘gold standard’ for screening patients suspected to have an acoustic neuroma. However, inappropriate referrals for imaging are not helpful, especially with the growing need to reduce costs. In this study the authors compared two audit...
Cochlear implantation in adults has a positive impact on overall cognitive function as early as six months postop
The link between improving hearing and thus improving cognition is an important emerging area of research in hearing rehabilitation, due to the independent association between hearing loss and dementia. This study uses visually assessed neurocognitive tests of working memory, information...
Tablet-audiometer school hearing screening in the context of a developing country
This paper presents a novel use of innovation to tackle the challenges of providing school-age hearing screening in low and middle income countries (in this case Nicaragua, second poorest in the western hemisphere), from the creators of a tablet-based audiometer...
CIs and lymphoma
In this editorial, the authors raise a very serious (albeit hypothetical) question: can the silicon of cochlear implants induce an anaplastic lymphoma akin to breast implants? The case of breast implant-induced large cell anaplastic lymphoma has been highly publicised. Although...
Treatment of incus lysis with hydroxyapatite bone cement
Middle ear implants provide a suitable alternative for some patients with a certain degree of sensorineural or mixed hearing loss, not wanting a hearing aid. Vibrant SounBridge® (VSB) middle ear implant (MEI), of Med-El®firm, is one such implant. In this...
Learning from reimplantation
The Irish implant centre in Dublin undertook a retrospective study of their reimplantation cases to look at what lessons could be learnt. Device failures fall into two classes: hard and soft failures. Hard failures are implant malfunction or altered performance....
Patient factors associated with spontaneous CSF leak
This article highlights the role of obesity, sleep apnoea and raised intracranial pressure as linked pathologies in the aetiology of the spontaneous cerebrospinal fluid (sCSF) leak. The authors link sCSF leak with obesity and comment on sCSF leak incidence increasing...
Diagnosing complications of acute mastoiditis in emergency situations
In many cases, acute mastoiditis is manageable with intravenous antibiotics and hospitalised care. However, the decision whether to intervene surgically remains crucial and reliance is based on radiological findings – CT scans for bony changes and MRI for possible intra-cerebral...
Does balloon tuboplasty work in the long term, and how can we measure outcomes?
There is much interest and debate at ENT conferences and within current literature about the role of balloon dilatation techniques for Eustachian tube dysfunction (ETD), a condition which we still only have limited understanding of, and which can be challenging...
How can we improve outcomes for patients with acute vestibular neuritis?
Vestibular neuritis is a common disorder that can leave up to 50% of patients with persistent vertigo symptoms for months to years following the acute insult. Often their first contact with ENT or balance specialists is many months after the...
Stapedotomy in osteogenesis imperfecta
Osteogenesis imperfecta (OI) is a rare connective tissue disease caused by a defect in collagen structure. Hearing loss is a characteristic feature of OI. It typically presents with conductive hearing loss initially, followed by a superimposed sensorineural component later in...
Acute ENT activity in a teaching hospital
This Belgian prospective audit attempted to provide justification for the provision of a 24-hour emergency service at a large 1038-bed teaching hospital (with 31 ENT consultants). The authors looked at a one-month period during which 190 patients were admitted. They...