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Recent changes in vestibular science and assessment
Clinical assessment of the dizzy or imbalanced patient is all about the patient’s history. History, history, history. But what about puzzling cases when we feel we need more information? Sally Rosengren gives us a rundown of the vestibular tests which...
Operate, Operate, Operate! A young surgeon in the 1970s
The book is a memoir of Douglas MacMillan’s experiences as a young surgeon in the 1970s. MacMillan describes his journey from medical school to training and becoming a consultant ENT surgeon. He shares stories about his challenges as a young...
To monitor the nerves or not?
Whilst intraoperative nerve monitoring has become the standard of care for mastoid and parotid surgery, its benefit in thyroid surgery remains unclear. In the UK NICE was agnostic on the subject in 2008, stating that it was potentially helpful and...
Effects of age on neuro-physiological processing of speech at brainstem level
Degenerative changes associated with ageing may affect processing of spectral and temporal cues in speech at cortical and subcortical levels, even though these individuals may have normal audiometric thresholds. These changes are more likely to be picked up by speech...
Microbiome changes after endoscopic sinus surgery: all is not what it seems
As we keep fighting a losing battle with bacteria and antibiotics, it becomes clear that it is not about killing bacteria, not even diminishing the bacterial load, but rather about shifting the different types of bacteria that colonise and live...
Influence of smoking on vocal fold polyps
A vocal fold polyp is a benign lesion related to phonotrauma which induces upregulation of inflammatory processes and histological changes can occur in the epithelium and lamina propria. Whether smoking produces additional or enhanced changes is the subject of this...
Obstructive sleep apnoea: Does maxillomandibular advancement work?
This is a paper from the Netherlands reviewing 62 patients who underwent maxillomandibular advancement for moderate to severe obstructive sleep apnoea. The authors observed a 71% success rate with mean apnoea hypopnea index (AHI) reduction of 69%. There was no...
Changes in airway dimensions after orthognathic surgery
This is a systematic review of meta-analysis evaluating the effect of different types of orthognathic surgery on the cross sectional area and volume of the upper airway as assessed using CT or MRI. They found 28 articles of which only...
Middle ear pressures with different anaesthetic agents
The use of appropriate anaesthetic agents is essential to avoid complications during middle ear surgery. This Turkish study attempted to identify whether intravenous (IV) anaesthetics (propofol) or inhalational agents (sevoflurane) cause more variations in middle ear pressures. The authors performed...
What about the older adults?
The authors of this paper propose that significant changes in the delivery of services, including speech and language therapy management of swallowing difficulties, may be required. Among the most common causes of dysphagia in older adults are stroke, progressive neurological...
Possible correlation of ABR changes with prognosis in sudden sensorineural hearing loss
A sensorineural hearing loss (SNHL) of 30dB or more affecting at least three frequencies and occurring over less than three days is classified as ‘sudden’ SNHL (SSNHL). Treatment is urgently undertaken with systemic and/or intra-tympanic steroids, and ijn some cases...
