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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...

New MRI technique assesses treatment response in skull base osteomyelitis

This paper describes another useful imaging technique to monitor Necrotising Otitis Externa (NOE). Echoplanar diffusion weighted magnetic resonance (DW MR) shows high signal on the ‘ADC map’ with active disease and this reduces in signal intensity as symptoms improve. This...

From patient to performer

Peter Cawrey lives in Harpenden, Hertfordshire, with his wife Dorothy. He had a salvage laryngectomy for squamous cell carcinoma in 2015, three years following his initial radiotherapy. Due to complications and a complex recovery, he has elected not to have...

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...

20th ‘Anniversary’ National ENT Masterclass®

The faculty this time consists of some of the leading stars of ENT in the UK, including eleven past-presidents of the Royal Society of Medicine ENT sections. The programme includes 32 state-of-the-art lectures and three panel discussions on a range of topics in otolaryngology and head & neck surgery.

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...