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The modern management of Ménière's disease

In this article, John Phillips considers the evolution of management options for Ménière’s disease. Treatment options past and present are discussed, together with an insight into future developments regarding the role of intratympanic steroids. Ménière's disease can be the source...

The future of inner ear drug delivery

The techniques for delivering drugs to the inner ear system are evolving. Jeffrey Harris considers the myths, the facts and the potential for drug delivery innovations and how they can improve tomorrow’s hearing outcomes. The inner ear’s delicate membranous structure,...

Endolymphatic sac surgery: controversial procedure for the treatment of Ménière’s disease

Landmark Paper: Thomsen J, Bretlau P, Tos M, Johnsen NJ. Ménière’s disease: endolymphatic sac decompression compared with sham (placebo) decompression. Ann N Y Acad Sci 1981;374:820-30. Of all of the chapters in the Landmark Papers book, the chapter that discussed...

Precision and personalised genomic and epigenomic medicine in audiology/hearing loss

A detailed look at the pathogenesis of acquired hearing loss due to exposure to ototoxicity during pregnancy or shortly after birth. Insights from genomic medicine have shown that, along with environmental factors causing epigenetic alterations, hearing loss may be caused...

Protheses for patients with severe bilateral vestibular loss

In February 2003, I met a patient with severe bilateral vestibular loss due to gentamicin toxicity, and I felt disheartened. Despite the fantastic diagnostic vestibular lab we had at Maastricht University Hospital, what could I truly offer her? She had...

Staying safe during endoscopic ear surgery

There is growing interest in using rigid endoscopes rather than traditional operative microscopes to perform transcanal middle ear surgery. Rigid endoscopy provides a high resolution, wide-angle view of the tympanic cavity through minimally invasive surgical portals. In this article, Elliott...

Anaesthesia for excision of vestibular schwannomas

The ‘shared airway’ relationship between ENT surgeons and anaesthetists is well documented. But ENT surgery and anaesthesia interact in numerous other ways, particularly in complex skull base surgery. What do our anaesthetic colleagues want us to know about vestibular schwannoma...

Intratympanic treatments for subjective idiopathic tinnitus

Direct application of medication into the ear is long established, going back as far as written records. In the modern era, greater understanding of aural anatomy revealed that drugs instilled in the middle ear could potentially diffuse into the cochlea...

Clinical utility and practical interpretation of the video head impulse test

The head impulse test (HIT) is an essential bedside test to detect peripheral vestibular deficits. The video head impulse test (vHIT) is a new tool quantifying the HIT. In this article Maria Heuberger and colleagues point out the clinical utility...