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CSF leak – endoscopic or open repair?

Cerebrospinal fluid (CSF) rhinorrhoea is well known to the ENT surgeon. It commonly occurs secondary to a predisposing event such as accidental or iatrogenic trauma. When it occurs spontaneously, it can be associated with benign intracranial hypertension. The commonest CSF...

Budesonide irrigation in polyposis

It is very well known through many RCTs and now meta-analyses that saline-based irrigation is beneficial in patients after sinus surgery. It is also demonstrated that intranasal steroids are beneficial postoperatively but there is also a trend for steroid based...

Adjuvant intratympanic steroid therapy in sudden sensorineural hearing loss

Sudden sensorineural hearing loss (SNHL) means abrupt hearing loss by 30dB affecting three consecutive frequencies within 72 hours. This is treated by high tapering doses of systemic steroids, the role of which is controversial and fraught with possible complications in...

Hearing preservation in cochlear implantation – an American cocktail

There has been an increase in hearing preservation cochlear implant (HPCI) surgery over the last decade. Both steroid and L-N-acetylcysteine (NAC) were used and investigated respectively in the past in HPCI surgery. Authors investigated the role of perioperative NAC and...

Is there any point giving postoperative oral steroids after a FESS?

It is well accepted that when medical treatment fails for chronic rhinosinusitis (CRS), endoscopic sinus surgery (ESS) is more effective than continuing with medical therapy alone. A variety of postoperative care options are available, including saline irrigation, in office debridement,...

Does topical dual steroid therapy improve vertigo in refractory Ménière’s disease?

This prospective study investigated the role of simultaneous application of methylprednisolone and dexamethasone-soaked gelatin sponge to the endolymphatic sac surface and dexamethasone sponge to the short process of incus in 20 patients with refractory Ménière’s disease (MD) undergoing endolymphatic sac...

Audiology in this issue...Amplification 2019

Gareth Smith, MSc, AuD, Consultant Clinical Scientist (Audiology), Southend University Hospital, UK. E: Gareth.Smith@southend.nhs.uk In previous areas of the Audiology Features Section, this theme would have been called ‘Hearing Aids’. With the increased interest in ‘over-the-counter’ or ‘direct-to-consumer’ devices, we...

Functional Endoscopic Sinus Surgery (FESS) - Part 1

In the first of a two-part series, Martyn Barnes and colleagues discuss indications for functional endoscopic sinus surgery (FESS), the surgical objectives and techniques, patient expectations and the risks of surgery. In part two, the authors will discuss how to...

Remote care apps: comparing the options

With much of the world in full or partial lockdown and social-distancing measures in full swing, the COVID-19 crisis has sparked renewed interest in remote teleaudiology services. Modern teleaudiology platforms, now offered by all major hearing aid brands, offer audiologists...

Lies, damned lies and relative risk reduction

Chris Potter has a thing or two to say about the use of statistics and, in doing so, he takes us to a Friday night steak house that is prone to airway disasters and on a short tour of his...

Lost and sound: exploring hyperbaric oxygen therapy for refractory SSNHL

Can hyperbaric oxygen therapy (HBOT) offer a breakthrough for patients with refractory sudden sensorineural hearing loss (SSNHL)? SSNHL is defined as acute hearing loss of ≥30 decibels in three consecutive frequencies within three days. Typically, it’s treated with two weeks...