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To monitor or not to monitor

This is a report on an e-mail based survey of 1249 otologic surgeons on their practice regarding facial nerve monitoring during ear surgery. The response rate was very low (6.6%). The majority of responders (92%) stated that they did not...

Single surgery for repair of tegmen defects and superior semicircular canal dehiscence

This retrospective review of 34 patients undergoing repair of the temporal bone defect via the middle cranial fossa approach provides the author’s management strategy for two problems: superior semicircular canal dehiscence and tegmen defects. The incidence of both these pathologies...

Pulse synchronous tinnitus

This article reviews the most common neurosurgical causes of pulse synchronous tinnitus. Traditionally, tinnitus has been characterised as subjective vs. objective, or vascular vs. nonvascular. The authors observe that, in some cases, pulsatile tinnitus (PT) is not heard by examiners...

A twitch in time with a flicker of knowledge

The middle ear muscles can be seen as one of the ear’s safety mechanisms, and the interplay between eyes and ears has been established; think vestibular ocular reflex (VOR) or semi-circular canal dehiscence (SCCD). But can this protective mechanism be...

To scan or not to scan, otosclerosis

Otosclerosis can co-exist with other ear pathologies such as superior semicircular canal dehiscence (SSCD). Stapedectomy in this situation can lead to development of SSCD symptoms. Authors conducted an email-based survey involving active members of the American Neurotologic Society (ANS) and...

How can we treat a patient with aural fullness?

Aural fullness is a common complaint that we often come across in many of our otology patients. Management of this condition can be quite challenging. Common differentials include eustachian tube dysfunction, patulous eustachian tube dysfunction, otitic barotrauma, superior canal dehiscence...

Objective testing for Eustachian tube dysfunction

Eustachian tube dysfunction (ETD) is typically diagnosed based on subjective symptoms and examination leading to wide variation in its diagnosis and management. The search for an objective test has looked at ways of measuring the passage of air through the...

Head and neck cancer recurrence: a prospective analysis

The ‘cancer journey’ is synonymous for many individuals worldwide with frequent post-treatment hospital visits where the spectre of possible recurrence hangs over the consultation. This is a prospective analysis of 401 follow-up visits in Melbourne, Australia looking at follow-up in...

Bilateral medialisation thyroplasty for presbylaryngis

This retrospective case series explores the voice outcomes for 21 patients diagnosed with presbylaryngis who underwent bilateral medialisation thyroplasty at a university medical centre in Portland, Oregon, USA. Silastic was implanted in 17 patients; hydroxyapatite in four. Significant improvements were...

Development and review of a blended service in response to COVID-19

The COVID-19 pandemic has required healthcare services globally to show both resilience and ingenuity in redesigning services to meet the ever-changing needs of our patients. We hear about the redevelopment of clinical pathways within an hearing implant service, and the...

Managing sustainability

Planetary health needs to be addressed at a societal level for any meaningful impact to occur. As the global director of sustainability for a law firm, Marion Palmer provides an overview of the responsibilities of corporate organisations for both a...

Global health missions – not just for consultants. A guide for trainees.

Lulu Ritchie is a courageous and driven trainee in London, inspired by humanitarian missions but conscious of the usual requests for consultant level doctors. Lulu didn’t let that hold her back. She found a way and has kindly summarised her...