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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...

Modified subciliary approach to the orbital floor

Fractures involving the lateral midface and orbital floor are routinely treated by maxillofacial surgeons. The surgical management requires access to the facial skeleton to reposition and free the soft tissues. There are three main approaches to the orbital floor: infraorbital;...

To endo or to micro, that is the question: the musculoskeletal paradigm

Endoscopic ear surgery is a newer concept compared with the microscopic one. Both could lead to musculoskeletal pain due to the long static posture of surgeons during otologic procedures. The authors conducted a study on eight otolaryngologists, four attendings and...

Pulsatile tinnitus, one more piece in the jigsaw

Pulsatile tinnitus (PT) is a common ENT symptom. It can generally be divided into venous and arterial. Arterial PT might be investigated with a CT scan while a venous one with an MRI or an MRV (MRI Venogram). Anecdotally, arachnoid...

Cochlear implants in the over 80s

The UK has an ageing population. Seven percent of the over 80s population have bilateral severe to profound hearing loss which can lead to associated negative outcomes (social isolation, depression and reduced quality of life). Cochlear implantation (CI) can successfully...

Treatment options for vestibular neuritis: systematic review and meta-analysis

Vestibular neuritis (VN) is the third most common cause of peripheral vertigo. VN has been postulated to have viral aetiology and historically it was treated with steroids, until 2011 when a Cochrane review demonstrated lack of robust evidence behind this...

Continuous Ambulatory Vestibular Assessment (CAVA)

This article presents initial test findings using a novel system called CAVA - Continuous Ambulatory Vestibular Assessment. Akin to the 24-hour ECG tape to identify cardiac arrhythmias, this system aims to continuously monitor the presence of a nystagmus pattern in...

Vestibular migraine or BPPV?

There are close similarities between benign paroxysmal positional vertigo (BPPV) and vestibular migraine (VM) as both can be presented by positional nystagmus. Though BPPV remains the commonest cause of pure positional vertigo, VM can mimic this condition. This study is...

How has management and outcomes of necrotising otitis externa changed over the past decade?

Necrotising otitis externa (NOE) remains a challenging condition for ENT departments, particularly with the increased prevalence of diabetes mellitus (DM) in the general population. There is no international consensus on treatment, although many institutions now have local guidelines drawn up...

Surgical management of sleep disordered breathing

Snoring and sleep-disordered breathing are often described as multi-level problems, and different surgical procedures are required to treat the various sites of airway narrowing and/or collapse. Jonathan Hobson gives us an eloquent run-through the various options available to the ENT...

Utilisation of cortical auditory evoked potentials in the paediatric population

Introduction Early identification of hearing loss in infants followed by prompt intervention is well established as the key to maximising the development of speech, language and psychosocial skills. Many countries have already adopted early hearing detection and intervention (EDHI) programs,...

The effects of hormonal changes across menstrual cycle on high frequency auditory thresholds

Physiological changes during the menstrual cycle are well documented; do these changes extend to the auditory system? Lalsa Shilpa Perepa and Rewa Indurkar delve into the literature to find the evidence. Menstrual cycle refers to a series of changes that...