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A trial of house dust mite sublingual tablet in children with allergic rhinitis

The house dust mite (HDM) is one of the commonest causative agents in allergic rhinitis (AR), affecting patients across all demographics. Recently, sublingual immunotherapy (SLIT) has been shown in clinical trials and meta-analysis to be effective compared to placebo in...

The continued evolution of surgical techniques for bone anchored hearing devices

This paper is not the first, and is unlikely to be the last, to look at a variation on the current technique for inserting the percutaneous titanium bone-anchored component of a bone conduction hearing device. In less than a decade,...

Which graft is better for type 1 tympanoplasty in elderly patients?

Type 1 tympanoplasty is a procedure performed to repair tympanic membrane perforations, primarily to reduce otorrhoea. This may subsequently lead to improvement of hearing. The common graft materials used are temporalis fascia and cartilage from tragus or concha. The authors...

Peripheral nerve stimulation for chronic refractory pain

Peripheral nerve stimulation (PNS) plays an important role in treating chronic refractory pain syndromes that manifest in limited distributions and overlap with areas of neurologic innervation. The process is generally thought to capitalise on the inhibition and activation of pain-related...

Auditory deprivation and single-sided deafness

In cases of bilateral auditory deprivation, there is clear evidence of an inverse relationship between performance after cochlear implantation and the length of severe to profound deafness prior to implantation (i.e. the longer the deprivation the poorer the outcome on...

Is virtual reality the future of vestibular rehabilitation?

The use of virtual reality (VR) in vestibular rehabilitation is gaining some popularity but availability is hampered by cost. One VR system in use in some centres is the Hybrid VR unit which incorporates motion trackers and force platforms. This...

How to train adults with single-sided deafness and cochlear implants

Cochlear implantation (CI) in patients with single-sided deafness (SSD) has been carried out in Perth, Australia from 2008. It poses challenges to clinicians and patients who are trying to tune in the poorer ear while still having a normally hearing...

The debate: endoscopic vs microscopic ear surgery – meta-analysis of outcomes

Although the endoscopic approach to ear surgery has become more common in clinical practice, the debate about its role versus the traditional microscopic approach continues in many ENT units. This meta-analysis from the Mount Sinai ENT department in New York...

An alternative device for obstructive sleep apnoea

Continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnoea (OSA), primarily due to the vast amount of short-term evidence in the medical literature it has accrued. The enduring obstacle to CPAP from becoming a treatment option...

Stapedotomy in osteogenesis imperfecta

Osteogenesis imperfecta (OI) is a rare connective tissue disease caused by a defect in collagen structure. Hearing loss is a characteristic feature of OI. It typically presents with conductive hearing loss initially, followed by a superimposed sensorineural component later in...

X-ray vs. intraoperative testing for determining cochlear implant placement

Most cochlear implant centres confirm electrode position after surgery using X-rays to ensure optimal electrode placement. As well as transorbital view X-rays, this team check placement using impedance measures and neural response telemetry (NRT) performed intraoperatively. The former indicates whether...

Risks of tracheostomy in head and neck cancer

Tracheostomy is associated with several complications, with rates quoted as high as 8-45%, including: bleeding; displacement; obstruction; surgical emphysema; pneumothorax; fistulae and failure to decannulate. There are now many studies that confirm the increased length of stay and complications of...