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High dose betahistine as effective as, but slower acting compared to intratympanic dexamethasone in intractable Meniere’s disease

The management of intractable Meniere’s disease poses a complex conundrum to otolaryngologists. The focus of treatment is decreasing the severity and frequency of vertigo and tinnitus whilst trying to preserve hearing. Betahistine has been used for many years in the...

Do steroids improve outcome in acute vestibular neuritis?

The role of steroids in short and long-term recovery from acute vestibular neuritis has been a subject of debate for several years. The authors reported findings of a prospective randomised trial in 60 adult patients. Inclusion criteria were acute vertigo...

Rhinotillexomania - how bad can nose picking get?

This is a fascinating first case report of rhinotillexomania associated with empty nose syndrome (ENS). Rhinotillexomania encompasses compulsive, pathological nose picking and is a variant of self-harm. Tranchito and Chhabra describe an elderly patient presenting with longstanding symptoms of nasal...

Neuromodulation in drug resistant epilepsy

Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...

Combination PPI and intralesional steroid treatment for recurrent laryngeal granuloma

The existence of a wide range of treatments for recurrent laryngeal granulomas (repeat surgery, high-dose proton pump inhibitor (PPIs), surgery with botulinum toxin injection, botulinum toxin injection alone, etc) is a testament to the refractory nature of this condition, with...

Benign oesophageal strictures: overview and management strategies

Benign oesophageal strictures may have several attributable causes including caustic injuries, long-term acid reflux, eosinophilic oesophagitis, anastomotic strictures and endoscopic therapy. Endoscopic dilation via bougies or balloon dilators may treat most strictures successfully and satisfactorily. However, in some situations treatment...

Cochlear implantation following radiotherapy treatment of vestibular schwannomas

The authors presented a case report and systematic review assessing the outcomes of patients from cochlear implantation (CI) following radiotherapy treatment for vestibular schwannoma (VS). Outcomes of cochlear implantation in these patients are uncertain due to the combination of both...

Can diet alone be used to treat laryngopharyngeal reflux?

In this crossover observational study, a low-fat, low-quick-release sugar, high-protein, alkaline, and plant-based diet was investigated as a single treatment for laryngopharyngeal reflux (LPR). Authors recruited 50 participants with demonstrated LPR on hypopharyngeal-oesophageal multichannel intraluminal impedance-pH-monitoring (HEMII-pH), off acid suppressive...

Does the appearance, texture, and flavour of food affect how we swallow?

Texture modification and the use of thickened fluids are well-known strategies used to facilitate swallowing in people with dysphagia. However, some controversy exists around thickeners and their possible negative impact on hydration and medication absorption. This paper considers other properties...