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Experience on the front line

21st January 2021 Back to basics Yesterday I went right back to where my medical career began. I grew up in Germany, bilingual. A prerequisite to studying medicine in Germany is that applicants have to spend two months working as...

Why hearing above 8 kHz matters more than you think

This review explores the significance of extended high-frequency hearing loss (above 8 kHz) and why it may be worth doing clinically more frequently. There are many conditions that may hide underneath a normal audiogram, and one of the easiest to...

Acute peripheral vestibulopathy: is it really neuritis?

The pathophysiology of acute vestibular dysfunction has been debated for decades. By seeking to clarify the underlying aetiology, this study muddies the waters further by advocating systemic and intratympanic steroids as first line treatment if the aetiology is uncertain. The...

How well are we managing epistaxis cases?

Epistaxis constitutes 34.5% of all emergency admissions to otolaryngology departments nation-wide. Presently there are no detailed consensus guidelines for this commonest emergency, and there is tremendous variation of practice. Quite often, non-ENT trained doctors manage this emergency. This paper reviews...

Hereditary haemorrhagic telangiectasia

This is a very nicely written overview of this difficult condition by two expert rhinologists with a tertiary practice. The genetic basis, pathophysiology, diagnosis, natural history and available management options are all discussed. Clearly there is a large spectrum of...

Use of tranexamic acid in ENT surgery

Postoperative bleeding in otolaryngologic procedures causes delayed discharge, requires re-admission and adds considerably to the cost of patient care. Whether the anti-fibrinolytic activity of tranexamic acid should be used routinely to prevent haemorrhagic complications after ENT operations is speculation but...

A useful adjuvant treatment for SNAC or IP

5-Fluorouracil (5FU) is a topical preparation used in the treatment of various dermatological, ocular and gynaecologic malignant and pre-malignant conditions, and this literature review looks at the efficacy of 5FU in treating inverted papilloma and sinonasal tumours. The authors cite...

The connection between hearing loss and cognitive decline: current perspectives

Editorial clarification This article reviews research exploring associations between hearing impairment, cognitive decline and dementia. While evidence shows a dose-dependent relationship, it is important to note that association does not prove causation, and current research does not definitively show if...

Redeployment of audiologists during COVID-19

As the demand on intensive therapy units in the NHS increased, volunteers from the audiology profession stepped in to support colleagues. Here, they share their experiences of caring on the frontline. Redefining normal: from outpatients to the ICU By Emilee...

A voice as smooth as silk?

A number of materials currently exist for vocal fold injection medialisation. Popular options include calcium hydroxylapatite (CaHA), hyaluronic acid (HA) and polydimethylsiloxane (PDMS). The authors of this paper state that there is an unmet need for an injectable material that...

The electromagnetic larynx

Current treatment options for a bilateral vocal cord palsy (tracheostomy, posterior cordotomy, arytenoidectomy) are suboptimal, with a focus primarily on a static means of airway restoration at the expense of voice production and potentially swallow safety. This paper reports on...

Non-autologous graft material in paediatric tympanoplasty – is it as good as temporalis fascia and is it cost-effective?

This retrospective case review looks at the experience of a single unit using a variety of autologous (temporalis fascia, n=292) and non-autologous graft material, n=241 (alloderm (human dermis), biodesign (porcine submucosa, $170-$255) and tutoplast (human pericardium, $350). The average patient...