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Pulse synchronous tinnitus
This article reviews the most common neurosurgical causes of pulse synchronous tinnitus. Traditionally, tinnitus has been characterised as subjective vs. objective, or vascular vs. nonvascular. The authors observe that, in some cases, pulsatile tinnitus (PT) is not heard by examiners...
Molecular and genetic nature of skull base tumours drives management
This article reviews the molecular basis and paradigm shift in the diagnosis and management of skull base tumours. It is now known that the phenotype of meningiomas is influenced by their genotype. Endolymphatic sac tumours are observed in up to...
Safety factors in use of balloon tuboplasty
Various medications used to restore eustachian tube function have unpredictable results and these are often disappointing. Balloon dilatation of eustachian tube came around 2010 but has not really gained momentum, mainly due to apprehended complications. In this review article, the...The death of Attila the Hun, a 70s film and Japanese cartoons
The 6th century Gothic monk, Jordanes, tells us that Attila the Hun, the notorious and allegedly merciless barbarian (who was a prime mover in the fall of the Roman Empire), died of a nosebleed on his wedding night in 453...
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...
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...
Canal wall down with obliteration of cavity for paediatric cholesteatoma
The authors present evidence that canal wall down (CWD) surgery with primary obliteration is an effective way to treat paediatric cholesteatoma. Fifty-eight ears were operated on and follow-up was for five years on average. Residual cholesteatoma rate was 9.9% with...
Application of paper patching in patulous eustachian tube
The condition of patulous eustachian tube, as opposed to dysfunctional eustachian tube, is less frequently diagnosed. Symptoms related to this, such as autophony, aural fullness, ‘being under water’, ‘hearing their own breathing’, and hearing sensitivity (varying in either direction) can...
Investigation of the role of KPNA2 biomarker in oral SCC invasiveness
This edition of Head and Neck has a strong focus on studies using immunohistochemistry (IHC) to elucidate potential roles of various cell-signalling molecules in both HNSCC and thyroid cancer. The ‘cellular-protein heavy’ title of this article may be off-putting to...
Vascularised tissue in salvage total laryngectomy
Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...
Recurrent ENT infections in children – is it a sign of primary immunodeficiency disease?
ENT clinicians often come across children with recurrent ear, sinus and pulmonary infections. These recurrent infections, albeit common in childhood, can represent an early sign of primary immunodeficiency diseases (PIDD). PIDD is an underdiagnosed group of genetic disorders involving absent...
