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Unravelling the mystery of hyperacusis with pain

When a person says that sound causes them pain, how can we understand this, and determine what processes are involved? Bryan Pollard navigates us through what is presently known. Pain has long been underrepresented – and often, completely overlooked –...

App-solute relief: tackling tinnitus with your smartphone

The sound experienced by individuals with tinnitus can vary to a huge extent. It can range from a mild occasional ringing to a constant, loud noise causing disruption to daily life and sleep. Reassuringly, tinnitus is rarely a sign of...

The Temporal Bone: Anatomical Dissection and Surgical Approaches

The Temporal Bone: Anatomical Dissection and Surgical Approaches does exactly what it says on the tin. It is an excellent combination of anatomical atlas and dissection manual for temporal bone surgical procedures, designed to be kept open at the benchside...

SPECT-CT imaging improves surgical efficiency in sentinel lymph node biopsy in melanoma

Sentinel lymph node biopsy is used in clinically lymph node negative, primary cutaneous melanoma. A combination of planer lymposcintigraphy using a radiolabelled colloid detected intra-op by gamma probe, and cutaneous injection of blue dye is used. However, with lymphoscintigraphy spillage...

The video head impulse test: an aid to the diagnosis of spinocerebellar ataxias

Spinocerebellar and Friedreich ataxias (SCA and FA) by their nature present in neuro-otology clinics. The diagnosis is ultimately genetic but the authors investigated the characteristics of the VOR using the video head impulse test (vHIT) in order to distinguish between...

Beware of GPA as a cause of subglottic stenosis

Up to 92% of patients with granulomatosis with polyangiitis (GPA) have concurrent ENT manifestations of the disease. Whilst we are familiar with sinonasal and middle ear presentations of GPA, subglottic stenosis (SGS) is another important and potentially life threatening manifestation....

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...

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...

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...

Diagnosing and managing somatic tinnitus

Interactions between auditory and somatosensory pathways can lead to interesting tinnitus experiences which can be very bothersome. Dr Sarah Michiels describes her pioneering work in this area, and the possibilities of physiotherapy based therapy. Background Somatic (also called somatosensory) tinnitus...