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A new criterion for diagnosing chronic tonsillitis?

It is essential to establish the diagnosis of recurrent tonsillitis in patients undergoing tonsillectomy. This is based mainly on history which itself can be inaccurate and is supported by clinical findings which are not truly specific. There seems to be...

When things go wrong

The new-age, Paediatric Surgeon, Ray Clarke, (fear uasal, íseal), eloquently demands throwing off the shackles of the past and welcomes the dawning of an era of openness, transparency and candour, preferably suffused with compassion for both the patient and the...

Botulinum toxin injection in spasmodic dysphonia

Spasmodic dysphonia is a rare neurological voice disorder, which is often missed by the inexperienced ear. There is no laboratory test or investigation to diagnose this condition therefore, it is best diagnosed by listening to the patient’s voice. Laryngeal endoscopy...

Neck dissection in adenoid cystic carcinoma is a risk worth taking?

This paper from Stanford University presents impressive figures to guide the debate on the extent of surgical management in adenoid cystic disease. Adenoid cystic carcinomas present a particular problem in that they can recur even after 20 years. They have...

eSRTs versus eCAP: Which is better?

Electrically evoked compound action potentials (eCAP) and electrically evoked stapedius reflex threshold (eSRT) techniques were compared to establish how well the two techniques correlated and which yielded quicker results in a group of paediatric cochlear implant (CI) users. This team...

Cerebrospinal fluid leaks after vestibular schwannoma surgery

This study analyses 30-day readmission data after vestibular schwannoma surgery using a multicentre longitudinal State of California dataset. The authors studied risk factors, and timing of readmission in 6820 patients over 15 years. Of these, 490 readmissions were reported for...

Management of patients with advanced otosclerosis

This paper discusses the management options of advanced otosclerosis. There are several definitions for advanced otosclerosis in the literature but, more recently, the diagnosis of advanced otoscletosis has been reserved for patients who have less than 30% aided speech discrimination...

Can and should vestibular schwannoma surgery be carried out via the endoscopic transcanal approach?

The extent and scope of endoscopic ear surgery has rapidly progressed in recent years, and this paper, from one of the leading proponents of this technique, reports on the outcomes of a case series of patients who have had total...

Recording of electrode voltages (REVS) to determine extra-cochlear electrodes

Determining whether electrodes are sitting within the cochlea can be difficult as the checks run by the programming software cannot always determine this. In some cases, patients may be unable to give the audiologist detailed feedback which can complicate the...

Impedance for different electrode types

Measuring cochlear implant (CI) electrode impedances is common in CI programming appointments to measure the integrity of the implant e.g. whether there are any open or short electrodes. This is because impedance measures the flow of current between intra and...

Extracapsular dissection alone for low-grade malignancies of the parotid gland – oncologically sound?

The general treatment strategy advocated for a primary carcinoma of the parotid gland is surgical resection +/- adjuvant radiotherapy. A selective neck dissection is usually recommended in all cases of parotid malignancies, except for small, low-grade tumours. In this paper,...

Hearing preservation in CI, any predictors?

The electrically evoked compound action potential (eCAP), obtained non-invasively from cochlear implant (CI) recipients, represents a population response of the auditory nerve to electrical stimulation. The eCAP characteristics include threshold (the lower the better), growth of response (the steeper the...