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Anatomic guidelines to endolymphatic sac in transmastoid approach – a cadaveric study

This study involved cadaveric dissection using transmastoid approach in cadaveric embalmed five half heads and posterior fossa approach in fourteen. The sac was identified by electron microscopy. The relatively consistent measurements were the relationship of the operculum to the internal...

Stereotactic radiosurgery for pituitary adenomas

Residual and recurrent functioning pituitary adenomas can be difficult to delineate on postoperative MRI scans, making them difficult targets for stereotactic radio surgery. In such cases radiation delivery to the entire sellar has been utilised as a radio surgical equivalent...

Endolymphatic sac surgery for Ménière’s disease

This is a very useful meta-analysis for those that perform surgery for Ménière’s disease. It specifically looked at differences in various forms of endolymphatic sac surgery (ESS). A total of 36 papers were included. The results: ESS controls vertigo in...

Cochlear implants in Ménière’s disease

This retrospective review firstly reminds us that a cochlear implant (CI) is possible with Ménière’s disease (MD) and provides a good account of what can be expected with a CI in patients with MD. Twenty MD patients who underwent cochlear...

Thyroid nodule update

This excellent article summarises the current diagnostic difficulties with an endocrine gland that frequently produces nodules, some of which may harbour malignancy. At 50 years of age and over there is about a 50% chance of having a nodule; at...

Thyroid cancer: to dissect the neck or not?

This is a good review of the much-debated management of the neck in thyroid cancer. It discusses oncological goals that must be achieved whilst maintaining voice, swallowing and parathyroid function. A clear description is made of the common nodal basins...

Earplug use in clubbers

Past studies show that there is a low frequency of use of earplugs at music events. In this research article produced by the National Acoustic Laboratories, Australia, a group of 51 regular attendees at music events were recruited and given...

Passive smoking and rhinosinusitis

One would expect that subjects exposed to more passive smoke would have a significantly increased level of rhinosinusitis. This study looked at a reasonable number of sinusitis and control subjects (404 and 165) using hair nicotine as an assessment of...

Primary ossicular chain reconstruction in open-cavity mastoidectomy

The authors performed a retrospective analysis of 21 patients who had undergone primary reconstruction of the ossicular chain during canal-wall-down mastoidectomy. The ossiculoplasty technique used consisted of removal of the malleus head and division of tensor tympani, and rotation of...

Risk factors for post tonsillectomy bleeds

This paper reviews post-tonsillectomy bleeding in 692 patients and attempts to tease out risk factors. The overall bleed rate of 11.6% seems very high. The return to theatre rate was 2.6%. The paper identifies male patients and adult patients as...

Emerging antimicrobial resistance in ENT outpatients

Given the recent statement from the UK Prime Minister on this issue, it would appear timely to assess the ‘time bomb’ of antibiotic resistance in otology. Comparison of ear swabs over twelve months from 2007 and 2012 demonstrates an increasing...

The unknown primary again

In this retrospective study of 35 patients, the authors followed a systematic protocol for the detection and management of malignant cervical lymph nodes without an apparent primary lesion. Although their one, three and five year survival results are consistent with...