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Vestibular paroxysmia, diagnostic controversy clarified?

Historically, the cause of vestibular paroxysmia (VP) had been attributed to neurovascular compression of the eighth cranial despite the observation that such compression is very common in asymptomatic subjects. This paper, part of International Classification of Vestibular Disorders (ICVD) by...

Anticoagulated patients and epistaxis

This systematic review looks at the increasing complexity in this space as anti-thrombotics become more sophisticated and move away from the more well understood management of warfarinised patients. After a thorough search, 29 papers were found to be relevant and...

How do you solve a problem like Dysphagia?

When a patient is referred to a speech and language therapist for the management of swallowing difficulties, multiple options are available to address these issues. The choice is based on a detailed assessment of the patient’s swallowing physiology and function....

What is the optimum duration of voice rest after microlaryngoscopy procedures?

Recent survey data looking at the opinions and practices of otolaryngologists in the US and the UK demonstrate that there is a wide variation in recommendations made for voice rest after vocal fold surgery. In the US, the most common...

Allergen immunotherapy and allergic rhinitis – EAACI guideline 2017

Allergic rhinitis (AR) is a common chronic childhood disease with considerable social burden and impact on quality of life, frequently necessitating treatment with various combinations of antihistamines and corticosteroids. The allergen immunotherapy (AIT), sometimes known as desensitisation therapy, can modify...

The middle way: treating idiopathic facial nerve palsy

Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...

Clinical assessment in OSA

This paper divides the assessment up into anatomical (nasal and oropharyngeal), endoscopic and imaging. It points out the salient features to look out for in OSA patients with regards the nasal valve and also oropharyngeal anatomy, with tonsil hypertrophy grading...

Facial pain and headaches

This paper reviews the present knowledge and the recent publications on the cause, characteristics, course and treatment of chronic and recurring facial pain and headaches. Facial pain should be defined in terms of frequency, duration and severity, and also in...

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...

Great gains in groups: language led dementia

The number of people living with dementia is increasing as our population increases and delivering relevant and timely services can be a challenge. Group intervention provides a method of delivering services to a larger number of people and can have...

How effective and safe is audiologist-led screening of acoustic neuroma in patients with asymmetrical hearing loss and unilateral tinnitus?

About two out of 100 patients presenting with asymmetric hearing and unilateral tinnitus have acoustic neuroma. The traditional method in which these patients first attend a clinician and then undergo screening through an MRI, can be expensive and prolong the...

Eustachian tube function before and after FESS

This is a prospective study from the UK looking at Eustachian tube dysfunction (ETD) in patients with chronic rhinosinusitis (CRS) undergoing surgery. Fifty-seven consecutive patients who had failed medical therapy and were scheduled for endoscopic sinus surgery completed SNOT-22 and...