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The business of audiology: unbundling

Many professions, such as law, accounting, engineering and some areas of healthcare charge hourly rates in a fee-for-service model. Administratively, this can be a challenge to track hours, bill clients/patients, and collect payment, but this does lend toward greater transparency...

Running a post-COVID smell clinic

Over the past year, much of our effort as a speciality has been directed towards crisis management and keeping services afloat. Our practice has changed in untold ways, but unprecedented numbers of patients with smell disorders will increasingly require our...

Surgical technology and operating room safety failures: lessons from vascular and general surgery

Background – surgical technology and otolaryngology An estimated 234 million major surgical procedures are performed annually worldwide. This requires the interaction of multidisciplinary teams with varying contributions of surgical technology and therefore makes surgical procedures prone to multiple sources of...

Communicating with patients in 
‘Plain English’

Physicians have long been accused of using unnecessarily complicated language and impenetrable jargon as a way of maintaining their status, prestige and high earnings-potential, bamboozling the public and excluding them from meaningful discussion as part of what George Bernard Shaw...

Can telemetry predict sleep apnoea in Pierre Robin sequence?

The aim of this study was to see if telemetry data gathered on patients with Pierre Robin sequence (PRS) correlated with sleep study data. A retrospective review of 46 patients from a tertiary referral centre were included in the study....

Diagnosis of osteonecrosis of the jaw

Although the management of osteonecrosis of the jaw is usually provided by colleagues in maxillofacial surgery, it is essential for ENT surgeons to effectively diagnose the various presentations of this condition. Affected bone that is exposed and necrotic may remain...

Salivary pepsin – a simple test for LPR?

A diagnosis of laryngopharyngeal reflux (LPR) can be made on the basis of characteristic symptoms and nasendoscopy findings. Objective tests exist for this condition; for example, 24-hour dual-channel pH-metry which is considered to be the gold standard. Such tests are,...

How can we manage children with poor speech discrimination but with normal audiogram

We often come across children and young adults brought in for consultation for suspected hearing loss and having hearing difficulty in noisy backgrounds but who often have normal audiograms. Such patients are suspected to have auditory neuropathy. The term auditory...

Elevated intracranial pressure versus migraines versus sinusitis?

This narrative review discusses the challenges faced by an otolaryngologist to differentiate elevated intracranial pressure (eICP), migraines and chronic rhinosinusitis (CRS). Facial pain, pressure, aural fullness, muffled hearing and tinnitus are often common symptoms described by patients with all three...

A funny thing happened on the way to a conference – and other stories

This series of stories is dedicated to those of you with whom some of these moments were shared (or endured) and, above all, to my amazing and long-suffering husband, David Howard. Most of you know him as an exceptional head...

Patient initiated follow-up in head and neck cancer

Is it time for a change in the way we follow up head and neck cancer patients after treatment? Paul Nankivell and Hisham Mehanna explain the rationale for the PETNECK2 trial. After completion of curative intent treatment, clinical follow-up currently...

A ‘smarter’ way to examine the ear?

Otoscopes and endoscopes, essential tools for ENTs, audiologists, and general practitioners, are on the receiving end of a modern twist thanks to smartphone technology. Aimed at adapting smartphones for otoscopic and endoscopic imaging, these reimagined devices might just change the...