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Persistent postural-perceptual dizziness: a functional neuro-otologic disorder

Persistent postural-perceptual dizziness (PPPD) is a neuro-otological disorder that is the most common cause of chronic vestibular syndrome. It is not a purely structural or psychiatric disease but a functional disorder. The authors reviewed the literature to summarise the diagnostic...

Diagnosis and management of acute sensorineural hearing loss: a Japanese perspective

In this paper, the authors set out the clinical guidelines to standardise diagnosis and treatment of acute sensorineural hearing loss in Japan. They categorised acute sensorineural hearing loss into five disorders: idiopathic sudden sensorineural hearing loss (iSSNHL), acute low-tone sensorineural...

Does vocal tremor lead to changes in swallowing function?

Vocal tremor (VT) is a debilitating problem, but remains challenging to treat. Its pathophysiology remains indeterminate and there is a lack of consensus on phenotypes. Clinically, VT is often noted to be present in muscles outside of the larynx, including...

Bones, stones and surgical moans: rethinking PTH dynamics in parathyroid surgery

Intraoperative parathyroid hormone (IOPTH) testing has revolutionised minimally invasive unilateral parathyroidectomy (MIP) as the gold standard treatment for primary hyperparathyroidism, replacing old-timey four-gland exploration. IOPTH testing ensures reliable excision of all hypersecreting glands, including those pesky hard-to-find ones, without relying...

Management of patulous eustachian tube dysfunction

Idiopathic sudden sensorineural hearing loss (iSSNHL) is defined as a hearing loss of 30 dB or more at three contiguous frequencies within 72 hours, with acute low-tone hearing loss (ALHL) excluded from this category. Despite standard treatment, outcomes vary: one-third...

Auditory processing disorder (APD): knowledge and practice in hearing healthcare

Awareness and practice for children and adults presenting with APD is variable across healthcare practice. Recently reported experiences of individuals and their families affected by APD show difficulty accessing referral and overall lack of recognition, and note that audiologists show...

The use of 3D videos to improve patient engagement with compensatory swallowing strategies

Patients with dysphagia are often asked to use compensatory techniques or manoeuvres to facilitate safe swallowing. For example, they may be taught to do a supraglottic swallow to minimise aspiration or a specific postural adjustment to support bolus flow. These...

What are the consequences of facial palsy on working life?

Facial palsy (FP) has multiple causes, including iatrogenic or idiopathic paralysis, trauma and tumours. Whilst for certain aetiologies, such as Bell’s palsy, recovery of function is expected, many patients will experience permanent symptoms due to incomplete recovery of the facial...

The modern management of Ménière's disease

In this article, John Phillips considers the evolution of management options for Ménière’s disease. Treatment options past and present are discussed, together with an insight into future developments regarding the role of intratympanic steroids. Ménière's disease can be the source...

Endolymphatic sac surgery: controversial procedure for the treatment of Ménière’s disease

Landmark Paper: Thomsen J, Bretlau P, Tos M, Johnsen NJ. Ménière’s disease: endolymphatic sac decompression compared with sham (placebo) decompression. Ann N Y Acad Sci 1981;374:820-30. Of all of the chapters in the Landmark Papers book, the chapter that discussed...

Biologic therapies for chronic rhinosinusitis with nasal polyps: a new paradigm

Surgery for nasal polyposis has evolved significantly in the last 30 years, and now the medical management may be on the cusp of a revolution. Biologics using monoclonal antibodies to target specific immune pathways have introduced a paradigm shift in...

Patient initiated follow-up in head and neck cancer

Is it time for a change in the way we follow up head and neck cancer patients after treatment? Paul Nankivell and Hisham Mehanna explain the rationale for the PETNECK2 trial. After completion of curative intent treatment, clinical follow-up currently...