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Genomic testing for deafness and its implications
Gene therapies for hearing loss are rapidly advancing and will be transitioning to clinical practice. Here, the authors explain why clinicians involved in managing these disorders need to be aware of these advances. Genomic testing in England was significantly reconfigured...
Parathyroid pearls
This article serves to deliver some pearls of wisdom in parathyroid surgery for the ‘low volume parathyroid surgeon’. They have been divided into those relating to the preoperative diagnosis, imaging and localisation techniques and surgical difficulties. Recognised sources of error...
The video head impulse test: an aid to the diagnosis of spinocerebellar ataxias
Spinocerebellar and Friedreich ataxias (SCA and FA) by their nature present in neuro-otology clinics. The diagnosis is ultimately genetic but the authors investigated the characteristics of the VOR using the video head impulse test (vHIT) in order to distinguish between...
Otolith dysfunction in congenitally deaf adults
This paper helps to further define the profile of ocular and cervical vestibular-evoked myogenic potentials (o and c VEMPs) in patients with congenital profound sensorineural hearing loss (PSHL). It highlights the prevalence of otolith (saccular and utricular) dysfunction that exists...
Milestones profile for children with cochlear implant
Over the last eight years, Nottingham auditory implant programme have developed and validated a profile of auditory milestones for use with children receiving bilateral cochlear implants under the age of two years. The structure of the Nottingham Auditory Milestones profile...
Bamboo nodes – a case series
Bamboo nodes are band-like, cream-coloured submucosal deposits affecting the middle third of the vocal cord. They are reported to affect women exclusively and are frequently bilateral but can be asymmetrical. They are distinct from vocal cord nodules but can be...
Imaging of the parathyroid glands in primary hyperparathyroidism: where do we stand?
Primary hyperparathyroidism (PHPT) refers to an intrinsic parathyroid gland abnormality that produces excessive secretion of parathyroid hormone. PHPT is diagnosed biochemically, and surgical excision of the abnormal parathyroid tissue represents the only definitive cure. Historically, the standard operative management of...
Risks of tracheostomy in head and neck cancer
Tracheostomy is associated with several complications, with rates quoted as high as 8-45%, including: bleeding; displacement; obstruction; surgical emphysema; pneumothorax; fistulae and failure to decannulate. There are now many studies that confirm the increased length of stay and complications of...
Treatment of incus lysis with hydroxyapatite bone cement
Middle ear implants provide a suitable alternative for some patients with a certain degree of sensorineural or mixed hearing loss, not wanting a hearing aid. Vibrant SounBridge® (VSB) middle ear implant (MEI), of Med-El®firm, is one such implant. In this...
Diagnostic criteria for superior semicircular canal dehiscence syndrome
The latest Bárány Society’s consensus document on diagnostic criteria for vestibular disorders is one for superior semicircular canal dehiscence syndrome (SCDS). There are three major categories: (A) Symptoms consistent with a third mobile labyrinthine window; (B) Physiologic tests – clinical...
Robotic insertion of electrode array in cochlear implantation
Cochlear implants (CIs) are commonly used for profound bilateral hearing loss. They have specific national guidance for their insertion, however patients with a substantial residual acoustic hearing are potential CI candidates. Preservation of this residual hearing can be sought with...
