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ENT clinics – 50 years of progress…?

Cocaine in abundance, eustachian tube catheterisation, and the ever-present threat of a fire in the clinic… How have things changed in the last few decades? Retired ENT surgeon, Douglas MacMillan, tells us of his experiences starting out in the late...

Less pain more gain: impact of prophylactic gabapentin on swallowing outcomes in head and neck cancer patients undergoing radiation treatment

Patients planned for chemoradiation to the head and neck are usually advised to expect some pain and soreness during their treatment and that pain relief will be offered as and when it is required. Uncontrolled pain and mucositis affect oral...

Blocked nose in children with allergic rhinitis

Nasal obstruction is a classic symptom in children with allergic rhinitis. While the nasal obstructive disorders including septal deformity, turbinate hyperplasia and adenoidal enlargement are widely recognised in adult nasal blockage, their relationship with paediatric allergic rhinitis however, is scarcely...

NSC- HHT – a systematic review of intranasal Bevacizumab

This systematic review of 13 studies concerning the use of an anti-angiogenic nasal treatment in the management of epistaxis in HHT patients finds no significant effect. This paper looked at four RCTs, three prospective studies, three retrospective, one case series...

Evidence based guidelines for ONS treatment in occipital neuralgia

Occipital neuralgia (ON) can flummox otolaryngologists especially when it follows mastoid surgery. The paroxysms of sharp, electrical pain originating from the occiput can extend along the posterior aspect of the scalp and even up to the mastoid. Although the aetiology...

Management of the neck in maxillary sinus carcinomas

Primary malignant tumours of the sinonasal tract account for less than 10% of head and neck cancers, of which the maxilla is the second most common subsite and squamous cell carcinoma (SCC) is the most prevalent histological type. Maxillary SCCs...

Full Vs tapered dose of oral prednisolone for sudden sensorineural hearing loss

I was drawn in by the title of this article, in the expectation that it might be a randomised controlled trial, but it was not. Sudden sensorineural hearing loss is an uncommon condition, which has a potentially disastrous outcome, so...

Oral versus oral and intratympanic corticosteroid treatment for sudden sensorineural hearing loss

The 2012 American Academy of Otolaryngology- Head and Neck Surgery Foundation (AAO-HNSF) clinical practice guidelines on sudden sensorineural hearing loss (SNHL) have two statements that address steroid use. Statement eight indicates an option to offer corticosteroid as initial treatment for...

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...

Diagnosis and management of acute sensorineural hearing loss: a Japanese perspective

In this paper, the authors set out the clinical guidelines to standardise diagnosis and treatment of acute sensorineural hearing loss in Japan. They categorised acute sensorineural hearing loss into five disorders: idiopathic sudden sensorineural hearing loss (iSSNHL), acute low-tone sensorineural...

Management of patulous eustachian tube dysfunction

Idiopathic sudden sensorineural hearing loss (iSSNHL) is defined as a hearing loss of 30 dB or more at three contiguous frequencies within 72 hours, with acute low-tone hearing loss (ALHL) excluded from this category. Despite standard treatment, outcomes vary: one-third...

Rotational chair testing: “To rotate, or not to rotate, that is the real question”

Passive whole body rotation tests are widely considered to be the ‘gold standard’ for the identification of bilateral peripheral vestibular disorders (bPVD), but also have a part to play in identifying unilateral disorders (uPVD). In this article Paul Radomskij discusses...