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Endoscopic stapes surgery

Traditionally middle ear surgery, including stapes surgery, has been performed using the operating microscope. In this article the authors describe their experience with endoscopic middle surgery and share some of its advantages. Trans-canal endoscopic ear surgery (TEES) is now a...

ENT and audiology in the Land of a Thousand Hills

Rwanda is a beautiful country known as the ‘Land of a Thousand Hills’. It is located in the Great Rift Valley in East Africa and shares borders with Uganda, Tanzania, Burundi, and the Democratic Republic of Congo, all offering direct...

Random-pattern skin flaps: part 4 - transposition flaps

In the final part of our series on local skin flaps (see Part 1, Part 2 and Part 3) in ENT, the authors describe the usefulness of the transposition-type flap and highlight some examples. Rotational advancement flap Useful for defects...

Thyroid nodules – time for a rational imaging approach

“The more you know, the harder it is to take decisive action. Once you become informed, you start seeing complexities and shades of gray. You realize that nothing is as clear as it first appears. Ultimately, knowledge is paralyzing.” Calvin,...

Paranasal sinus osteoma management

The authors aimed to determine the best approach to paranasal osteoma excision. They conducted a retrospective study of 41 patients with paranasal sinus osteoma (PNSO) at a tertiary centre in Turkey. PNSO was present in: the frontal sinus in 26...

How do you solve a problem like Dysphagia?

When a patient is referred to a speech and language therapist for the management of swallowing difficulties, multiple options are available to address these issues. The choice is based on a detailed assessment of the patient’s swallowing physiology and function....

SPECT-CT imaging improves surgical efficiency in sentinel lymph node biopsy in melanoma

Sentinel lymph node biopsy is used in clinically lymph node negative, primary cutaneous melanoma. A combination of planer lymposcintigraphy using a radiolabelled colloid detected intra-op by gamma probe, and cutaneous injection of blue dye is used. However, with lymphoscintigraphy spillage...

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...

Beware of GPA as a cause of subglottic stenosis

Up to 92% of patients with granulomatosis with polyangiitis (GPA) have concurrent ENT manifestations of the disease. Whilst we are familiar with sinonasal and middle ear presentations of GPA, subglottic stenosis (SGS) is another important and potentially life threatening manifestation....

High dose betahistine as effective as, but slower acting compared to intratympanic dexamethasone in intractable Meniere’s disease

The management of intractable Meniere’s disease poses a complex conundrum to otolaryngologists. The focus of treatment is decreasing the severity and frequency of vertigo and tinnitus whilst trying to preserve hearing. Betahistine has been used for many years in the...

Do steroids improve outcome in acute vestibular neuritis?

The role of steroids in short and long-term recovery from acute vestibular neuritis has been a subject of debate for several years. The authors reported findings of a prospective randomised trial in 60 adult patients. Inclusion criteria were acute vertigo...

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,...