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Adjuvant intratympanic steroid therapy in sudden sensorineural hearing loss

Sudden sensorineural hearing loss (SNHL) means abrupt hearing loss by 30dB affecting three consecutive frequencies within 72 hours. This is treated by high tapering doses of systemic steroids, the role of which is controversial and fraught with possible complications in...

New aminoglycosides with reduced ototoxicity risk

Aminoglycoside antibiotics are widely used for infections affecting patients of all ages and at different sites, however they carry a risk of ototoxicity, nephrotoxicity and rarely peripheral neuropathy. Preventing ototoxicity is crucial to the maintenance of auditory function and quality...

Earplugs fit for purpose

The aim of occupational audiology is to prevent hearing loss caused by occupational sound exposure which can exacerbate the long-term effects of central presbyacusis as employees age. To provide the best noise protection over time, research suggests that best practice...

Harvesting the flexor hallucis longus: what is the increased morbidity?

The free fibula flap is now widely used in clinical applications for microvascular reconstruction and occasionally, to add bulk, the flexor hallucis longus (FHL) muscle is harvested along with the fibula. The post-operative morbidity is usually described as mild and...

DIY Epley manoeuvre

This is an interesting paper that looks at getting patients to do their own particle repositioning manoeuvre (PRM) after having it done by a clinician (‘Epley’ to you and me although there are some slight differences) once a week for...

Auditory processing in children with unilateral hearing loss

It is a common assumption that unilateral hearing loss (UHL) in children is of little consequence because appropriate development of speech and language can still occur with one normal hearing ear. Recent studies, however, suggest that there are significant differences...

Cycle helmets protective against facial injuries?

This is a meta-analysis completed by a maxillofacial unit on the South Coast of England. Nine studies from an initial literature review of 102 were included in the analysis. Cycling has been reported as the cause of 3-20% of facial...

Daflon – a new way to treat idiopathic epistaxis

Epistaxis is a common ENT emergency and most cases are idiopathic. Flavonoids are natural substances with variable phenolic structures that are found in fruit and vegetables and take effect on blood vessels. Daflon is proposed to control epistaxis by “improving...

Does minimally invasive surgery under local anaesthesia have a role in the management of chronic rhinusinusitis?

A formal FESS procedure usually done under local anaesthesia is considered as gold standard in the management of chronic rhinusinusitis. However, success is hampered by a significant recurrence rate of polyps requiring revision surgery, long waiting lists, reluctance of elderly...

A new era in the treatment of recalcitrant nasal polyps?

Chronic rhinosinusitis with nasal polyps (CRSwNP) can be difficult to treat effectively in patients with aggressive or recalcitrant disease. Omalizumab (Xolair) is a monoclonal anti-IgE antibody with proven benefits for patients with moderate/severe asthma and CRSwNP, but this study looks...

When to operate on a patient without chronic disease?

As ENT surgeons, we spend a lot of time managing chronic rhinosinusitis, so a review and update on the management of the acute disease is always helpful. The standard medical treatment of antibiotics, nasal steroids and nasal decongestants are reported...

Painful temporomandibular joints

This paper is a meta-analysis of randomised controlled trials comparing arthrocentesis with conservative management in painful and restricted mouth opening temporomandibular joint symptoms. Temporomandibular joint dysfunction comprises a spectrum of disorders commonly involving facial pain and loss of oral function...