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Rhinotillexomania - how bad can nose picking get?

This is a fascinating first case report of rhinotillexomania associated with empty nose syndrome (ENS). Rhinotillexomania encompasses compulsive, pathological nose picking and is a variant of self-harm. Tranchito and Chhabra describe an elderly patient presenting with longstanding symptoms of nasal...

Neuromodulation in drug resistant epilepsy

Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...

Combination PPI and intralesional steroid treatment for recurrent laryngeal granuloma

The existence of a wide range of treatments for recurrent laryngeal granulomas (repeat surgery, high-dose proton pump inhibitor (PPIs), surgery with botulinum toxin injection, botulinum toxin injection alone, etc) is a testament to the refractory nature of this condition, with...

Benign oesophageal strictures: overview and management strategies

Benign oesophageal strictures may have several attributable causes including caustic injuries, long-term acid reflux, eosinophilic oesophagitis, anastomotic strictures and endoscopic therapy. Endoscopic dilation via bougies or balloon dilators may treat most strictures successfully and satisfactorily. However, in some situations treatment...

Cochlear implantation following radiotherapy treatment of vestibular schwannomas

The authors presented a case report and systematic review assessing the outcomes of patients from cochlear implantation (CI) following radiotherapy treatment for vestibular schwannoma (VS). Outcomes of cochlear implantation in these patients are uncertain due to the combination of both...

Can diet alone be used to treat laryngopharyngeal reflux?

In this crossover observational study, a low-fat, low-quick-release sugar, high-protein, alkaline, and plant-based diet was investigated as a single treatment for laryngopharyngeal reflux (LPR). Authors recruited 50 participants with demonstrated LPR on hypopharyngeal-oesophageal multichannel intraluminal impedance-pH-monitoring (HEMII-pH), off acid suppressive...

Does the appearance, texture, and flavour of food affect how we swallow?

Texture modification and the use of thickened fluids are well-known strategies used to facilitate swallowing in people with dysphagia. However, some controversy exists around thickeners and their possible negative impact on hydration and medication absorption. This paper considers other properties...

Getting to grips with acoustic trauma

Our understanding of hearing loss caused by noise exposure to those in the armed forces is growing in interest and understanding. Research at a cellular level is essential to increase our understanding so that we can better diagnose, manage and...

The Indian method: Sushruta’s influence on modern nasal reconstruction

Ancient Indian medicine, as documented in the Sushruta Samhita, contains one of the earliest known references to nasal reconstruction, including surgical techniques still resembling modern practices. (The Sanskrit word ‘Samhita’ is used to define a collection of written work, similar...

Practical training courses for otolaryngology trainees

In this extended Trainee Matters, it’s a pleasure to present a trio of excellent articles with a theme of practical training courses for otolaryngology trainees. Miss Rachel Edmiston, Professor Nirmal Kumar and colleagues have written a valuable guide to setting...

Call for action on hearing loss

The British and Irish Hearing Instrument Manufacturer’s Association (BIHIMA) and Alzheimer’s UK are encouraging people to book regular hearing tests and get hearing concerns checked earlier, as it could significantly lower their chances of developing dementia.

14th Congress of the ELS

Shiying Hey, MB ChB, DO-HNS, PGDipClinEd, MFTSEd, FRCS (ORL-HNS), Laryngology Fellow, Guy’s and St Thomas’ NHS Foundation Trust, London, UK. The 14th European Laryngological Society (ELS) Congress took place in the culturally rich and vibrant city of Milan, marking its...