How reliable is non-echoplanar diffusion-weighted MRI in picking up postoperative cholesteatoma in children?

Cholesteatoma occurs more often in children than in adults and is more aggressive, often resulting in ossicular erosion and marked conductive loss, amongst other more serious possibilities. Recurrence happens in all three methods used, namely canal wall up, canal wall...

Correlation between middle ear and mastoid volumes with results of type 1 paediatric tympanoplasty

This is a retrospective study of 45 paediatric patients, aged between eight and 18 years, who underwent Type 1 cartilage graft tympanoplasty using conchal cartilage. Middle ear and mastoid volumes of these children were correlated with anatomical and functional outcomes...

Impact of COVID-19 on ear surgeries

The authors review the impact of the coronavirus pandemic on the practice of ear surgeries in this article. The pandemic has changed how we practise medicine and introduced new guidelines to ensure safety of healthcare personnel. Studies have demonstrated COVID-19...

A comparison between trainee and trainer outcomes in mastoid surgery

In this era where training faces restrictions due to theatre time, fewer sessions available to trainees and requirements of consultant-led and consultant-delivered services, one unit confirmed that myringoplasties given to trainees reduced from 34.2% to 16%. This study compares outcomes...

Is endoscopic approach more precise in addressing failed ventilation system in chronic mucosal ear disease?

Chronic mucosal disease, as opposed to cholesteatoma, is more directly related to failure of the ventilation system involving three channels. Isthmus anticus and isthmus posticus are channels in front and behind the long process of the incus and there is...

Is canal wall down with obliteration a useful compromise between canal wall up procedure and open mastoid cavities?

Controversy has raged for many years between open mastoid cavity procedures and canal wall up techniques in terms of postoperative recidivism and ear discharge. It is generally believed that canal wall up procedures can miss hidden cholesteatoma but preserve useful...

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...

Accuracy of CT scans for cholesteatoma and its complications

Chronic ear disease with cholesteatoma generally requires active surgical management and the requirement for this needs precise assessment. A retrospective study was conducted to evaluate the accuracy of CT scan findings in terms of predicting cholesteatoma and its associated complications...

Radiological diagnosis of mastoiditis in patients screened for acoustic neuroma

Magnetic resonance imaging is the ‘gold standard’ for screening patients suspected to have acoustic neuroma. Various abnormalities are picked up through this investigation, one of which, not uncommonly reported, is mastoiditis. This requires referral to otolaryngology and further evaluation. In...

Evidence based outcomes for canal wall up, canal wall down and subsequent canal wall reconstruction for primary cholesteatoma

There has been a long standing controversy over whether to treat primary cholesteatoma with open or closed technique. The general consensus is that limited disease can be treated with closed technique whereas the canal wall down approach helps reduce recidivism...

Robot controlled mastoid surgery!

This is a fascinating piece of work by a Korean team developing a human-robot collaborative control. Their model uses image guidance surgery to locate the drill tip’s position. Important structures can be highlighted – in this case the facial nerve....