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The artificial eardrum: how an eggshell membrane fed a German ENT family

In the pre-antibiotic era, purulent otitis media often resulted in a permanent eardrum perforation with hearing loss. In addition to pig or fish bladders, eggshell membranes and cigarette paper were used as eardrum prostheses. I have vivid personal boyhood memories...

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...

Incidental thyroid nodules: should we observe or operate?

Thyroid nodules are extraordinarily prevalent, detected by physical examination in 7% and by imaging studies in 67% of the population. Although most of these nodules are benign, up to 20% are found to be malignant on excision. It’s a very...

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...

Gadolinium enhanced MRI and the diagnosis of Ménière’s disease

Despite various criteria applied over the years to diagnose Ménière’s disease since the concept of endolymphatic hydrops was first observed in postmortem examinations of patients in 1938, the diagnosis still remains mainly clinical. To visualise endolymphatic hydrops in MRI imaging,...

A safe management pathway for low-risk head and neck cancer suspected referrals

Head and neck cancer is the eighth most common malignancy and numbers are increasing. This has led to increasing number of suspected cancer referrals which, with imposition of the 28-day Faster Diagnosis Standard implemented in 2020, has further burdened the...

Audiological evaluation and management of teenagers with tinnitus

There is a growing interest in investigating, understanding and managing tinnitus in children and adolescents, with several articles on the subject published in journals over the last year. Brian Fligor describes the approaches to consider when discussing tinnitus with teenagers....

What happens to donated hearing aids?

According to the WHO, only 3% of people in developing countries who require hearing aids have one. Over the years many people, organisations and companies have donated old hearing aids to charities. Bhavisha Parmar, an audiologist who volunteered with Sound...

Transnasal oesophagoscopy (TNO)-guided secondary tracheoesophageal puncture (TEP) under local anaesthesia

Here, the authors describe a convenient use of the transnasal oesophagoscope to create a new tracheoesophageal puncture in the outpatient clinic setting. Tracheoesophageal puncture (TEP) with voice prosthesis insertion is a reliable and effective technique for surgical voice restoration (SVR)...

Dysphagia in complex laryngology – maintaining the balance

These authors from the speech and language therapy department at Imperial College Healthcare NHS Trust, describe their view of a patient-centred approach to managing dysphagia in complex laryngology. Careful consideration of the balance of airway, voice and swallow, which is...

Cell therapies for hearing loss

Cell therapies could offer a way to repair damage to the auditory system and reverse many types of hearing loss. This article looks at the progress being made.

Narrow band imaging in the management of carcinoma of unknown primary

This was a retrospective study to assess the utility of narrow band imaging (NBI) in the detection of a primary site in carcinoma of unknown primary (CUP). Patients with CUP who underwent transoral robotic surgery (TORS) and preoperative imaging with...