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Treating benign positional paroxysmal vertigo

Benign positional paroxysmal vertigo (BPPV) is one of the most common causes of dizziness. Its treatment is the repositioning of displaced otoliths by the canalith repositioning manoeuvre (CRM). Post manoeuvre restrictions are commonly given to the patient. Their benefit has...

Consider PCR testing in culture negative necrotising otitis externa

Necrotising otitis externa (NOE) often does not yield identification of a causative organism to treat although in 90% of cases it is a member of the pseudomonas species. The incidence of fungal NOE is not to be forgotten and this...

Canal wall down with obliteration of cavity for paediatric cholesteatoma

The authors present evidence that canal wall down (CWD) surgery with primary obliteration is an effective way to treat paediatric cholesteatoma. Fifty-eight ears were operated on and follow-up was for five years on average. Residual cholesteatoma rate was 9.9% with...

Hearing loss in the contralateral ear after mastoid drilling

It is difficult to conceive that most of the noise generated by drilling the mastoid would not be conveyed to the contralateral cochlea, by direct transmission through the skull bone, where the attenuation factor is only 5-10 dB. Only a...

The paediatric dilemma of one ear in and one ear out of NICE criteria

The auditory implant team in Manchester have implanted a cohort of children where audiological thresholds meet the NICE guidance for cochlear implantation (CI) in one ear only, and the other falls into moderate, severe or sloping loss. These children are...

Oral versus oral and intratympanic corticosteroid treatment for sudden sensorineural hearing loss

The 2012 American Academy of Otolaryngology- Head and Neck Surgery Foundation (AAO-HNSF) clinical practice guidelines on sudden sensorineural hearing loss (SNHL) have two statements that address steroid use. Statement eight indicates an option to offer corticosteroid as initial treatment for...

Recurrent seroma in cochlear implanted patients

Little is known about why some patients experience recurrent seromas over the implant package and in the absence of any cause, antibiotics are frequently prescribed as a precaution to protect the implant from infection. A tertiary referral centre selected five...

Long-term voice outcomes following transoral laser surgery versus radiotherapy for early laryngeal cancers

The oncological outcomes of transoral laser microsurgery (TOLM) for early laryngeal cancers are well-known to be very similar to radiation therapy (RT). The functional outcomes associated with each treatment modality are therefore of significant interest. This study is reported to...

Hypoglossal nerve stimulation for OSA

Hypoglossal nerve stimulation has been lauded as the great new surgical treatment panacea for obstructive sleep apnoea (OSA). This meta-analysis includes 12 studies with a total of 350 patients, including the five-year follow-up data from the STAR trial which was...

Sarcopenia and dysphagia in older community-dwelling adults

The prevalence of dysphagia in community-dwelling older adults is reported to be around 15%. Outside of common neurological causes such as stroke, Parkinson’s disease and dementia, recent studies have suggested that sarcopenia may be an independent risk factor for the...

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....

Increasing tongue strength to reduce dysphagia: what is the potential benefit of a device driven exercise?

Weakness in tongue muscle strength and laryngeal elevation is known to have an adverse impact on swallowing function. Various swallowing exercises are often recommended to improve function of these important structures with the goal of preventing aspiration and improving swallow...