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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...

Otology, Neurotology and Skull Base Surgery Book Review

This concise pocket-sized textbook aims to provide a practical reference that clinicians can use in every day otological and skull base practice. The senior author, Derald Brackmann, is one of the leading neurotologists of the modern era and, together with...

Local dexamethasone infiltration in tonsillectomy

Intravenous dexamethasone is routinely given during tonsillectomy for its effects on postoperative pain and nausea. This Chinese randomised study divided 240 children undergoing tonsillectomy into three groups, receiving either no steroid, intravenous dexamethasone, or the same amount of dexamethasone infiltrated...

Prevention better than cure?

This systematic review looks at methods of ‘barrier protection’ or ‘barrier-enforcing’ to minimise allergic rhinitis symptoms, using 15 RCTs. Whilst the authors admit that patient numbers were small in a number of these studies, generally it seems that barrier techniques...

Should we be doing earlier MRIs in sudden sensorineural hearing loss?

There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....

Biologicals for severe chronic rhinosinusitis with nasal polyps. Any use?

Recent advances and knowledge of inflammatory endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP) led to introduction of biological agents such as monoclonal antibodies targeting IgE (omalizumab) and Interleukins (ILs) such as IL4R alpha (dupilumab) and IL5. The European Academy...

Prognostic value of vascular ultrasonographic findings in patients with idiopathic sudden sensorineural hearing loss

Sudden sensorineural hearing loss is often idiopathic. Although the aetiology of idiopathic sudden sensorineural hearing loss (ISSNHL) is unclear, vascular compromise is one of the frequently proposed hypotheses to explain its pathophysiology. Existing studies have shown an association between ISSNHL...

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...

How rare is vocal fold paralysis after spinal and epidural anaesthesia – should we be more concerned?

The authors present an unusual case of right vocal fold paralysis. Their patient was a 38-year-old woman who experienced new onset dysphonia following neuraxial anaesthesia (NA) for a caesarean section. Flexible nasendoscopy showed a right VFP with fixation in the...

Surgical approach to trigeminal neuralgia

This article provides a summary of the operative techniques available for treating patients with trigeminal neuralgia who have medication resistant pain or medication intolerance. Microvascular decompression is performed via suboccipital craniotomy to find and resolve the underlying nerve compression. The...

Associated findings in MRI used for detecting acoustic neuroma

Presently, gadolinium enhanced magnetic resonance imaging is the ‘gold standard’ for investigating acoustic neuroma. There are often ‘incidental’ findings that may or may not be significant. In this study of 109 scans, the authors noted an uptake of 0.9% for...