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Are upper respiratory symptoms and macroscopic changes in children always due to gastro-oesphageal reflux?

In children, symptoms such as chronic cough, wheezing, stridor, voice changes, persistent asthma and dental erosion are often presumed to be due to gastro-oesophageal reflux and empirical treatment with PPIs is offered. Usual investigations, such as a barium meal, gastroscopy...

Does teaching affect patient satisfaction?

Teaching practice on real patients has several advantages in terms of lower costs and genuine clinical material but it is often a concern that using real patients for undergraduate teaching may result in patient dissatisfaction and many patients would prefer...

Guidelines for management of orbital infections

Orbital infections predominantly affect the paediatric population and complications can be very serious. The cellulitis can be preseptal or orbital and the abscess can be confined within the periosteum or extend into the orbit. Cavernous sinus thrombosis can complicate the...

Perception of verticality during attacks of Ménière’s

Ménière’s disease (MD) affects the cochlea and all peripheral vestibular receptors. The perception of verticality, a function of the utricle, is evaluated by the subjective visual vertical (SVV) test. The authors studied SVV in two groups of MD patients: a)...

Horizontal nystagmus: vestibular neuritis or lateral canal BPPV?

A horizontal nystagmus due to lateral canal (LSC) BPPV that is present in the upright position, that changes direction with head turn in the horizontal plane has been termed ‘pseudo-spontaneous nystagmus’ (PSN) because it mimics that of vestibular neuritis. The...

Botox application for drooling shrinks salivary glands

The large majority of sialorrhoea (drooling) in paediatric patients is managed conservatively. However in severe cases, often where there is associated developmental delay or a motor disorder, medical and surgical techniques can be used to decrease salivary flow. Botulinum toxin...

How should I excise sinonasal tumours, open or endoscopic? En bloc or piecemeal?

Sinonasal tumours often present late because initial symptoms mimic benign disease. They tend to produce more unilateral nasal symptoms, and patients with advance disease often describe paraesthesia and other cranial neuropathies. They only account for approximately 3% of upper aerodigestive...

The theory of everything (tonsil)?

Tonsil sepsis can manifest as acute tonsillitis, a peritonsillar abscess (PTA) or rarely as an intra-tonsillar (ITA) abscess. Whilst the management of these conditions is familiar to ENT surgeons from early in training, perhaps little attention has been paid to...

Smell and mental health

This national survey from Korea asked questions about many aspects of health and one of these was about sense of smell. The prevalence of olfactory problems was 5% in the adult group surveyed, and other studies would suggest that this...

T1 lip cancer and cervical lymph node metastases

The management of large lip squamous cell carcinoma (SCC) (T2, T3, T4 tumours) or those with nodal disease is well established. However the management of T1N0 tumours is controversial due to the assumed low risk of occult lymph node metastases....

‘FOX’ – a new software programme in cochlear implant fitting for audiologists

Taking into account the complex parameters involved in cochlear implant fitting, it appears that the procedure is becoming more and more difficult and variable across cochlear implant centres. For this reason, a software programme called FOX was designed attempting to...

Outcome measures for hearing loss

This short editorial explores some possible options in measurement of quality of care in audiology. We traditionally tend to use clinician-related outcomes in place of patient-reported outcome measures and so we could miss a wealth of data on the impact...