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A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth
It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...
Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture
Placement of voice prosthesis at the time of trachea-oesophageal puncture is well described using 20-French prostheses. There is debate about the optimal size of the prosthesis with work in the 1980s and 1990s supporting larger prostheses. The rationale was that...
Can and should vestibular schwannoma surgery be carried out via the endoscopic transcanal approach?
The extent and scope of endoscopic ear surgery has rapidly progressed in recent years, and this paper, from one of the leading proponents of this technique, reports on the outcomes of a case series of patients who have had total...
Robotic insertion of electrode array in cochlear implantation
Cochlear implants (CIs) are commonly used for profound bilateral hearing loss. They have specific national guidance for their insertion, however patients with a substantial residual acoustic hearing are potential CI candidates. Preservation of this residual hearing can be sought with...Beware of Bicycle Face!
Many of us were told as children that we would get square eyes from watching too much television. But spare a thought for those late Victorian ladies, embracing their first taste of liberty on a bicycle, who were threatened with...True Cut – a dramatic biopsy from the world of surgery
True Cut is a stage play that asks: “What happens when things go wrong in healthcare?” It brings the hidden world of the operating theatre onto the theatre stage. ENT surgeon, David Alderson, talks about how the play came about....
Balloon dilatation is an effective adjunct
This is a good study design, sufficiently powered, comparing medical management to balloon sinus dilatation. All patients had failed medical management and were thoroughly assessed preoperatively with Lund-Mackay score confirming abnormal CT findings, SNOT 20 index score, chronic sinusitis score...Introduction to speech testing
Let’s get back to basics: Dr Schoepflin introduces the concepts behind speech testing for hearing care professionals. While pure tone threshold testing is considered the ‘gold standard’ for assessing auditory sensitivity, the results of pure tone testing provide only limited...
