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Semicircular canal dehiscence and cochlear implantation

Semicircular canal dehiscence (SCD) is thought to occur in 3% of the population, it is mostly asymptomatic, but patients may present with sound-induced vestibular symptoms, low-frequency conductive hearing loss, autophony, hyperacusis and aural fulness. With the increasing utilisation of cochlear...

Reflux, a pre-disposing factor in paediatric OME?

It is almost 20 years since the Lancet publication by Tasker et al describing gastric juice in the glue ear of children. This paper attempts to look at the body of literature which has focused specifically on the clinical association...

The medially-invasive cholesteatoma: a case series

In this small case series, Casazza et al describe their management of seven cases of complex cholesteatoma presenting during a 16-year period. Patients were included if imaging confirmed restricted diffusion and an endophytic, medially-destructive disease involving the otic capsule, petrous...

3D-printed temporal bone models - how good can they be?

In the era of increasingly difficult and expensive-to-come-by cadaveric temporal bones with which to practise drilling and learn the complex 3D anatomy of the temporal bone, decent alternatives would be welcome. McMillan et al report a prospective comparison study in...

Otosclerosis - to scan or not to scan?

In an era of insidiously reducing thresholds for investigating patients, Maxwell and colleagues pose an important question: is high-resolution computed tomography (HRCT) prior to stapes surgery for otosclerosis worthwhile? Their practice typically considers HRCT for cases of suspected otosclerosis presenting...

Neuromodulation in drug resistant epilepsy

Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...

Managing hearing preservation expectations of adult CI patients

This paper is a single-centre review of adult cochlear implants in patients with preserved low-frequency hearing, focusing on the outcomes at 10 months post-implantation, and the rates of electroacoustic stimulation actually used in this group of patients. The centre identified...

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...

A predictor of successful treatment of posterior canal BPPV

Reversal of nystagmus on returning to the upright sitting position from the Hallpike position is a common observation. However, its relevance as a predictor of a successful canal repositioning manoeuvre (CRM) is not known, hence this study. The retrospective study...

Do we need contrast MRI when screening for vestibular schwannoma?

Gadolinium contrast enhanced T1-weighted (gT1w) MRI images of the internal acoustic meati have long been considered the gold standard in the diagnosis of vestibular schwannoma (VS). However, the addition of contrast to the MRI examination increases the cost and time...

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...

Gender inequality across medical specialties in the United States

The authors of this study collected and evaluated 4222 surveys of patient satisfaction ratings of male and female residents across subspecialties in the United States. Half of the evaluated residents were females, with first and second year residents being evaluated...