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A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth

It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...

New MRI technique assesses treatment response in skull base osteomyelitis

This paper describes another useful imaging technique to monitor Necrotising Otitis Externa (NOE). Echoplanar diffusion weighted magnetic resonance (DW MR) shows high signal on the ‘ADC map’ with active disease and this reduces in signal intensity as symptoms improve. This...

FESSing up

This story is dedicated to my dear friend and much-missed colleague, Heinz Stammberger, with whom some of these moments were shared (or endured). Having used a rigid endoscope in my postgrad thesis in the early 1980s to show that the...

Rhino Refresher – a virtual course

Overall, I thought it was a great initiative, well-organised and I hope that we will copy the idea to other subspecialties. Such revision days are an excellent opportunity to refresh our pre-existing knowledge and to point out areas for further reading.

Developing medical devices for children: opportunities and challenges

The development of medical devices for infants and children lags significantly behind the development of devices for adults. While in the United States the Food and Drug Administration (FDA) has set up incentives for developing child age-specific pharmaceuticals, there is...

Health related quality of life measures as outcome parameters in middle ear diseases

Surely the only outcome needed for post-surgical ears is a better PTA? Marcus Neudert argues there should be more to it than that. To draw a comprehensive picture of the disease-associated restrictions in patients with chronic otitis media, audiometric outcome...

Strategies to improve early development of vocabulary post-cochlear implantation

Cochlear Implantation (CI) is now the standard of care for rehabilitation of children with bilateral severe to profound sensorineural hearing loss. It improves the children’s linguistic input and helps them to develop language. The literature published so far has shown...

Multi-channel cochlear implants: past, present and future

Forty years since the first multi-channel devices were implanted, who better than Ingeborg Hochmair, who has been a key figure throughout their evolution, to offer her thoughts on the past, present and future of multi-channel cochlear implants? Read on for...

Loss of smell after COVID-19: a view from the patient forums

Patient advocate, Chrissi Kelly, founder of AbScent, talks about how the pandemic has changed the way we think about smell loss. The high prevalence of chemosensory impairment as a result of the SARS-CoV-2 virus has shone a much-needed spotlight on...

From the editor Jul/Aug 2025

Declan Costello, MA, MBBS, FRCS(ORL-HNS),Consultant Ear, Nose and Throat Surgeon, Wexham Park Hospital, Slough, Berkshire, UK. E: d.costello@nhs.netTW / X: @Voicedoctor_uk Regular readers will know that we have been publishing supplements in different specialties every four months; these give us...

Otologic Surgery - 5th Edition

Otologic Surgery 5th Edition, edited by Derald Brackmann, Clough Shelton, Moises Arriaga and Richard Gurgel, is a textbook masterpiece. The book is written in tribute to the editors’ mentors: Drs Howard House, William House and James Sheehy, whose pioneering work...

100 Complications of Otorhinolaryngology & Skull Base Surgery: Each Case Report from Different Surgeons Around the Globe

Dr Narendrakumar and his co-editors, Drs Vinod Felix and Vivek Mariappan, should be credited for putting together such a diverse collection of common and uncommon complications that we as surgeons have faced or may face and manage in our own...