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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...

Diagnostic performance of non-echo-planar diffusion weighted MRI in detection of suspected cholesteatoma

Even though a ‘second look’ remains a gold standard for detection of residual cholesteatoma after intact canal wall techniques, non-echo-planar diffusion weighted MRI is considered a reasonable alternative to avoid further surgery. However, to establish or exclude a cholesteatoma de...

OSA – do the parents know best?

The difficulty in using the history and examination to determine the severity of sleep disordered breathing in children is well established. The relative prevalence of sleep disordered breathing symptoms in children, and the relative paucity of capacity and restrictive cost...

Global incidence of sporadic vestibular schwannoma

The incidence rate of sporadic vestibular schwannoma (VS) has commonly been quoted as one in 100,000. However, since the advent of screening for asymmetrical hearing loss and increased availability of modern MRI scanning, more recent studies have shown the incidence...

Early recognition aiding better prognosis?

As we are all aware, acute invasive fungal rhinosinusitis (AIFR) is a life-threatening disease which typically affects immunocompromised patients. It is diagnosed via typical signs, symptoms and presentation but gold standard is by biopsy of tissues demonstrating infiltration fungal hyphae....

Beware the skinny patient…

The adverse health impacts of an excessive BMI are well known. This study highlights one laryngeal pathology for which a low BMI appears to be a significant risk factor. The records of 28 patients treated for arytenoid cartilage dislocation were...

Random-pattern skin flaps: part 2 - rhomboid and bilobed flaps

In the second of our series on local skin flaps (see Part 1 here, Part 3 here and Part 4 here), the authors describe more techniques and examples of various skin flaps that trainees should find very interesting. Rhomboid flap...

Physiological mechanisms of hyperacusis: an update

Hyperacusis is a heterogeneous and complex clinical entity, and proposals about physiological mechanisms should reflect these issues. Ben Auerbach helps us navigate through present knowledge in this area, and proposes future directions for research. Hyperacusis is a debilitating hearing disorder...

Rhinoplasty for cleft nose deformity

Modern cleft lip and palate repairs produce excellent functional and aesthetic results at an early age. Tony Holmes, a craniofacial surgeon with over 40 years’ experience, shares his wisdom on the best timing and techniques for addressing the associated complex...

Tele-audiometry – a ShoeBOX solution

Access to hearing assessment is a global challenge. In relation to the global burden of hearing loss World Health Organisation’s (WHO’s) recent estimate (2013) is that 360 million people in the world have disabling hearing impairment. Two-thirds of these people...

Prevention is Better than Cure: Learning from Adverse Events in Healthcare

Ian Leistikow has an impressive CV; as Senior Inspector at the Dutch Healthcare Inspectorate and a member of the Strategic Advisory Board of the International Forum on Quality and Safety in Healthcare, it is clear he is passionate about advancing...

The future of rhinology

Over the last few decades, rhinology has been one of the most dynamic and progressive areas of ENT. Professor Fokkens is perfectly placed to offer insight into the future possibilities that could transform our patients’ care, many of which are...