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Validating a new international cholesteatoma classification – a necessary but challenging task

A European and Japanese joint consensus statement was published in 2017 which proposed a new cholesteatoma staging classification (EJS), with four stages. This follow-up publication aims to assess the internal and external validity of the staging system using existing prospectively...

In conversation with Professor Patrick Gullane: My life in Otolaryngology-Head & Neck Surgery

Fellowship RCSEng 2009. Patrick, as you have recently ‘stepped down’ as Chairman and Chief of ORL-HNS at Toronto General Hospital, what next? Firstly, so often I have been asked why I selected this career path, from a quote by Johnny...

Role of interventional neuroradiology in otorhinolarygological pathology 
– a brief review

Introduction Since its advent in 1964 when Dotter percutaneously dilated a stenosed femoral artery [1], interventional radiology has undergone tremendous advancement in both imaging and devices that have enabled the operator (interventional radiologist) to access very distal small vasculature and...

Clinical and financial success by providing specialised audiological tinnitus management

Diagnosis and management of a patient with chronic subjective tinnitus is one of the most labour-intensive areas of hearing healthcare. This is one reason some hearing care providers opt to exclude specialised tinnitus care from their practice: it may not...

Should patients with dysphagia be allowed water freely?

Patients with dysphagia often experience dehydration as a consequence of “nil by mouth” or having to consume thickened fluids due to aspiration of thin fluids. However, not all incidents of aspiration develop into an infection. Factors that contribute to aspiration...

BPPV duration as a predictor for therapy

Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibuar disorders encountered in the neurotology clinic. The majority of cases of BPPV are due to vestibuar lithiasis in the posterior semicircular canal, but there are reports of cases...

Vascular loops found on MRI IAM for tinnitus

This group from the Netherlands looks at the finding of vascular loops found on MRI IAMs requested for tinnitus. It is a common finding for all who request such imaging. This work adds to the body of evidence that such...

Factors affecting the occurrence of salivary fistula after total laryngectomy

It is generally believed that patients should be fed by nasogastric tube for 7-10 days after undergoing total laryngectomy or laryngopharyngectomy to avoid the occurrence of post-operative salivary fistula. This study challenges this belief and looks into various factors that...

Lower respiratory involvement in allergic rhinitis and chronic sinusitis

The recent ARIA (Allergic Rhinitis and its Impact on Asthma) project has generated interest in simultaneous involvement of the lower respiratory airway in cases of chronic rhinosinusitis and allergic rhinitis. This study takes into account the extent of pulmonary function...

‘Dead ear’ after mastoid surgery

The primary aim of surgery in the management of cholesteatoma is eradication of the disease which can potentially result in serious complications such as intracranial extension, facial nerve weakness and further hearing loss. A profound hearing loss resulting postoperatively considerably...

Allergic rhinitis, the usual suspects

Allergic rhinitis (AR) is characterised by allergen binding to IgE on mast cells and basophils and subsequent histamine, prostaglandine D2 (PGD2) and cysteinyl leukotrienes (cysLTs) release causing early-phase response. This is followed by late-phase response mediated by eosinophils. Other cells,...

Immunosuppresants and ototoxicity

There is a wide range of immunosuppressant drugs ranging from calcineurin inhibitors (e.g. cyclosporine), anti-folic agents (e.g. methotrexate) to anti-TNF and monoclonal antibodies, many of which could be ototoxic. The authors performed a systematic review assessing ototoxicity secondary to immunosuppressant...