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Steroid use in acute acoustic trauma

Acute acoustic trauma (AAT) injuries include noise-induced damage to inner and middle ear presenting as hearing loss, tinnitus and vertigo. Classic presentation is sensorineural hearing loss with an intact tympanic membrane. The authors carried out a case-control study in military...

An inherited platelet disorder in a post- tonsillectomy haemorrhage

Unexplained bleeding after any surgery is least desirable and to identify a cause for this preoperatively can be a very useful safeguarding measure. By looking for inherited platelet disorders in patients who bled after tonsillectomy, the authors of this publication...

Empty Nose Syndrome: Evidence Based Proposals for Inferior Turbinate Management

To cut or not to cut, that is the question… The authors of Empty Nose Syndrome emphatically implore the reader to spare the inferior turbinate, lest they cause patients this undue misery! This book is a thought-provoking journey through the...

Labour rights violations in the manufacture of healthcare goods

Every year trillions of dollars are spent on medical supplies globally. The operating theatre is a significant proportion of this spend, typically accounting for a third of a hospital’s supply costs. When making purchasing decisions consideration is given to value...

Ultrasonic bone aspirators for internal auditory meatus ‘drilling’ in retrosigmoid vestibular schwannoma resection

In this article, the authors describe the retrosigmoid approach to a vestibular schwannoma, using an ultrasonic bone aspirator as an alternative to the standard drill. Vestibular schwannomas (VS) are benign, usually slow-growing tumours of the vestibular nerve. Management of VS...

Random-pattern skin flaps: part 1 – advancement flaps

In the first of a short series covering random pattern skin flaps and their use in clinical practice (see Part 2 here, Part 3 here and Part 4 here), Christopher Thompson and Miles Bannister describe in some detail their techniques...

Adult hearing screening: consideration for a holistic model

Background Adult-onset hearing impairment is a highly prevalent and undertreated chronic problem that poses a significant burden of disease worldwide [1]. It is usually gradual and diagnosed and managed approximately 10 years after adults have first experienced hearing difficulties [2]....

Objective versus subjective – again!

The use of objective measurements of nasal airflow has a long history; however, its clinical application remains, at most, patchy. The main reason for that has been the lack of convincing studies showing a good correlation between the findings of,...

Predictors of postoperative improvement after endoscopic sinus surgery in patients with chronic rhinosinusitis

Improvement after endoscopic sinus surgery in patients with chronic rhinosinusitis varies considerably. If elaborate preoperative and intraoperative data could be used to predict the postoperative course, management and length of the follow-up could be adjusted to provide optimal care. Two...

Allergic rhinitis, the usual suspects

Allergic rhinitis (AR) is characterised by allergen binding to IgE on mast cells and basophils and subsequent histamine, prostaglandine D2 (PGD2) and cysteinyl leukotrienes (cysLTs) release causing early-phase response. This is followed by late-phase response mediated by eosinophils. Other cells,...

Should we be doing earlier MRIs in sudden sensorineural hearing loss?

There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....

Do endonasal approaches for meningiomas have more CSF leaks?

Rarely, patients presenting to the ENT surgeon with anosmia may have an anterior skull base neoplasm such as a meningioma. Historically, the traditional approaches have focused on several transcranial, external routes, including the pterional craniotomy, and the subfrontal craniotomy. The...