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Destination unknown

We as doctors do not always know the answer. Associate Professor Jacqueline Allen guides us through the importance of acceptance of this uncertainty and its complex mental journey. She highlights that, as clinicians, we must embrace the unknown and be...

Physician burnout and resident wellness

Physician burnout and high rates of mental health issues amongst physicians are an important concern today. Several articles on this subject have been published recently. However, few articles have been written about starting life balance training early during residency. This...

Nothing about us without us: a how-to guide

Participatory design is an approach that is built around collaboration with users through a process of coproduction, design and creation. Most interventions are designed with the expert clinician researcher as the starting point, who looks at theory, evidence and their...

Concussion and vestibular processing deficits

It is well known that patients with mild traumatic brain injury (mTBI), also referred to as concussion, display longstanding vestibular symptoms but often clinical signs and objective vestibular function test abnormalities are lacking. The aim of the study was to...

Age and the SSCC

This is a radioanatomical study on the CT scans of 385 temporal bones to measure some parameters of the superior semicircular canals (SCCC) including bony thickness, diameter and projection into the middle cranial fossa. All measurements were performed on a...

Surgical management of permanent facial paralysis

This article explores the management of flaccid facial palsy focusing on weakness less than one to two years’ duration. As a general rule, primary nerve repair produces the best outcome and should be performed where possible. For long-standing paralysis of...

Allergic rhinitis, the usual suspects

Allergic rhinitis (AR) is characterised by allergen binding to IgE on mast cells and basophils and subsequent histamine, prostaglandine D2 (PGD2) and cysteinyl leukotrienes (cysLTs) release causing early-phase response. This is followed by late-phase response mediated by eosinophils. Other cells,...

Rhinotillexomania - how bad can nose picking get?

This is a fascinating first case report of rhinotillexomania associated with empty nose syndrome (ENS). Rhinotillexomania encompasses compulsive, pathological nose picking and is a variant of self-harm. Tranchito and Chhabra describe an elderly patient presenting with longstanding symptoms of nasal...

Role of intratympanic corticosteroid for treatment of Bell’s palsy and Ramsay Hunt syndrome

Acute peripheral facial palsy occurs annually in 30 in 1,000,000 individuals in the general population. Bell’s palsy and Ramsay Hunt syndrome account for about 70% of cases of peripheral facial palsy. They are believed to be caused by viral reactivation...

THRIVE: redefining airway management in endoscopic oesophageal surgery

Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) is no longer just a tool to help anaesthetists secure a difficult airway. Thanks to the work of authors like Yang and colleagues, it is being revolutionised to provide apnoeic oxygenation during endoscopic...

Supporting patients with chronic dizziness and investing in vestibular research

The Ménière’s Society is the UK’s leading vestibular charity. Their team is available to help patients access reliable information, source a vestibular specialist or talk to someone who understands what they’re going through.