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Persistent postural-perceptual dizziness: a functional neuro-otologic disorder

Persistent postural-perceptual dizziness (PPPD) is a neuro-otological disorder that is the most common cause of chronic vestibular syndrome. It is not a purely structural or psychiatric disease but a functional disorder. The authors reviewed the literature to summarise the diagnostic...

Middle ear muscle disorders: presentation, diagnosis and management

Patients often report symptoms relating to disorders of the middle ear muscles. Prof Bance gives us an overview of the anatomy and function, as well as guides our diagnosis and management. The middle ear muscles (MEMs) are a mystery, both...

Vestibular migraine – the story so far and the work still to do

This interesting discussion paper begins with an overview of the background to the development of vestibular migraine as a separate diagnostic category. It discusses in some depth the diagnostic uncertainties in the context of an entity without a biomarker and...

Unexplained dizziness in elderly patients

How do we explain unexplained dizziness in elderly patients? How far should we go with investigations? And most importantly, how should we manage this challenging and expanding group of patients whose balance affects their safety? Richard Ibitoye and Diego Kaski...

Does pre-op intratympanic gentamicin improve balance control after vestibular schwannoma surgery?

This retrospective study was based on data from 44 patients selected from a cohort of 153 who had undergone surgical resection of vestibular schwannoma over a 10-year period. The aim was to evaluate the dynamics of the postural control system...

Does vestibular rehabilitation help patients with vestibular migraine? Is this also true if these patients have had a traumatic brain injury?

Vestibular migraine (VM) is a common diagnosis in ENT, and there is growing evidence that vestibular rehabilitation therapy (VRT) is an effective treatment, reducing self-perceived dizziness and improving gait. This is a retrospective review of the outcomes of 93 patients...

Balance and vestibular disorders in children

Discover the world of paediatric vestibular assessment and management from the team at Alder Hey Children’s Hospital, which is revolutionising services in this field. Dizziness and balance problems generate significant morbidity in children of all age groups. Vestibular disorders are...

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...

In this issue...Inner Ear Therapeutics

Emma Stapleton, MBChB, FRCS (ORL-HNS), Consultant Otolaryngologist, Cochlear Implant and Skull Base Surgeon, Manchester Royal Infirmary, UK. E: emmastapleton@doctors.org.ukTwitter: @otolaryngolofox Ralph Holme, Director of Research and Insight, RNID, UK. Ralph. E: Holme@rnid.org.uk W: www.rnid.org.uk For Mar/Apr 2022, we sang the...

Migraine medication and benign paroxysmal positional vertigo (BPPV)

BPPV is a very common form of dizziness (lifetime prevalence 2.4%) and has been noted to have an association with migraine. The cause of otoconia displacement in BPPV is often unclear. A vascular mechanism theory has been postulated in varying...

Global health missions – not just for consultants. A guide for trainees.

Lulu Ritchie is a courageous and driven trainee in London, inspired by humanitarian missions but conscious of the usual requests for consultant level doctors. Lulu didn’t let that hold her back. She found a way and has kindly summarised her...

Bell’s palsy outcomes

Bell’s palsy is a common, idiopathic, unilateral facial paresis or paralysis of sudden onset. This retrospective study reviewed the records of 193 patients diagnosed with Bell’s palsy. The patient’s clinical data, House-Brackman (h-B) grade, and data from five electrophysiological tests...