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Alternobaric vertigo: asymmetrical vestibular function due to asymmetrical middle ear pressures (Iron Man’s archenemy)
The Marvel Cinematic Universe could certainly be deemed an ‘extreme environment’ and yet very rarely do we see the Avenger’s popping to the clinic for a check-up. Hee-Young Kim has wondered how they cope with extreme pressure changes and discusses...Congenital cytomegalovirus causing deafness in children: an update
Congenital CMV is the leading non-genetic cause of sensorineural hearing loss in children. Keith Trimble draws our attention to this and gives a comprehensive guide on diagnosis and treatment. Congenital cytomegalovirus (cCMV) infection is common, affecting 1% of all newborns,...Malignant lesions and reconstruction of the pinna
External ear reconstruction can be challenging. Baskaran Ranganathan and Amr Abdelhamid describe how careful assessment, planning and surgery following the subunit principles and reconstructive ladder will ultimately lead to good aesthetic outcomes with restored form and function. The external ear,...Acupuncture for tonsillectomy pain in children
The challenge: tonsillectomy pain Tonsillectomy is a uniform surgical insult which results in a 10-day recovery for children. Severe pain can occur which can give rise to poor oral fluid intake, dehydration and potentially the need for intravenous fluid resuscitation....
Post-thyroidectomy vocal cord palsy: are there long-term sequelae?
This is a well written paper utilising the Hospital Episode Statistics dataset for all thyroidectomies performed in England between 2004 and 2012. The study had a very impressive 43,515 participants and only included young, fit patients undergoing thyroidectomy once for...
Predicting life-threatening complications in deep neck space infections
Deep neck space infections, arising usually from tonsils and lymph nodes in children and dental source and salivary glands in adults can be life threatening. It is therefore important to recognise the variables which indicate immediate intervention to prevent fatalities....
Aerosols and polypi
Infection in the operative cavities after endoscopic sinus surgery for sinonasal polyposis leads to recurrence of symptoms and mucopurulent discharge. The usual therapies include systemic antibiotics sometimes with steroids. The authors hypothesised that the use of a topical antimicrobial (tobramycin...
Cochlear implantation in immunosuppressed patients. Is it feasible?
The effectiveness of cochlear implantation has led to a relaxation of the candidate criteria. Patients who had been rejected in the past may now be accepted and their outcomes are encouraging. However, the acceptance of immunosuppressed patients as cochlear implant...
The stigma of HPV in oral cancer
The increase of oropharyngeal carcinoma (OPC) in the developed world seems to be largely caused by infection with the human papillomavirus (HPV). HPV is a group of 150 DNA viruses that are common and most people will be infected at...
Nasal decongestants don’t improve Eustachian tube function
Prescribing nasal steroids and decongestants. It’s something most of us do routinely, in an effort to reduce chronic middle ear effusion in an adult by trying to improve eustachian tube (ET) patency. This study used clever devices (tube manometry and...
A new criterion for diagnosing chronic tonsillitis?
It is essential to establish the diagnosis of recurrent tonsillitis in patients undergoing tonsillectomy. This is based mainly on history which itself can be inaccurate and is supported by clinical findings which are not truly specific. There seems to be...
