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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...
New MRI technique assesses treatment response in skull base osteomyelitis
This paper describes another useful imaging technique to monitor Necrotising Otitis Externa (NOE). Echoplanar diffusion weighted magnetic resonance (DW MR) shows high signal on the ‘ADC map’ with active disease and this reduces in signal intensity as symptoms improve. This...
Hyperbaric oxygen for sudden onset sensorineural hearing loss
Idiopathic sudden onset sensorineural hearing loss (SSNHL) is a relatively common presentation to the ENT emergency department, and can have profound effects on patients’ lives. This retrospective study looked at 15 patients who were treated with hyperbaric oxygen after failure...
Does stress and anxiety worsen idiopathic sudden hearing loss outcomes?
There have been suggestions that the natural course of the idiopathic sudden sensorineural hearing loss (ISSNHL) is not affected by intensive therapy. There is speculation as to whether unknown factors affect the treatment prognosis. This is a retrospective study of...
Chronic facial pain: types and long-term treatment
This publication discusses the details and differences between chronic tension type headache and migraine and followed a cohort of 240 patients over 36 months. The authors applied strict criteria to distinguish between chronic tension headache and migraine, these essentially being...
Vestibular migraine or BPPV?
There are close similarities between benign paroxysmal positional vertigo (BPPV) and vestibular migraine (VM) as both can be presented by positional nystagmus. Though BPPV remains the commonest cause of pure positional vertigo, VM can mimic this condition. This study is...
People with language-led dementia in India
Primary Progressive Aphasia (PPA) is a language led dementia characterised by slowly worsening speech and language. It is associated with atrophy of the dominant temporal-parietal lobe regions and is commonly caused by frontotemporal or Alzheimer’s pathologies. There are three PPA...
How has management and outcomes of necrotising otitis externa changed over the past decade?
Necrotising otitis externa (NOE) remains a challenging condition for ENT departments, particularly with the increased prevalence of diabetes mellitus (DM) in the general population. There is no international consensus on treatment, although many institutions now have local guidelines drawn up...
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,...
Hyperbaric oxygen therapy a treatment for sudden sensorineural hearing loss
Cochlear ischaemia has been postulated as one of the potential aetiologies for sudden sensorineural hearing loss. Hence, increasing oxygen delivery to the cochlea by hyperbaric oxygen therapy has been explored as a potential treatment to reverse hearing loss. The authors...
Patient-reported outcome measures: what do the people say?
Patient-reported outcome measures (PROMs) assess and quantify health outcomes from the patient’s perspective. Defining these questionnaires as outcomes indicates that they are psychometrically sensitive to change. This article describes three PROMS: namely the Patient Reported Outcome Measurement Information System (PROMIS),...
