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Surgery or medicine: when should we stop trying to be conservative?
Although most otolaryngologists would agree that surgery improves the outcomes of patients with CRS when medical treatment has failed, both Cochrane reviews state that there is no proof of improved efficacy of surgery over medicine – however, that was after...
Nasal septoplasty: is it more effective than medical management?
Question1. How do we know that undertaking an operation will benefit a patient? Question 2. How do policy makers / health systems know an operation is effective and ‘good value for money’? As trained professionals, we spend our careers seeking...
Resection margins in head and neck surgery
Although an increasing proportion of head and neck malignancies are treated with non-surgical modalities, when surgery is undertaken an incomplete clearance results in significantly worse prognosis. However, the intraoperative assessment of an adequate margin is difficult. The personal practice of...Coblation tongue channelling
After uvulopalatoplasty, the tendency is to focus on the tongue base as the next anatomical area to address in the management of snoring and sleep-disordered breathing. In this article, Glen Burgess describes the technique of tongue channelling, to reduce the...Rhinology: what does the future hold?
David Kennedy surveys the past, the present and the future of rhinology practice and research. An evolution of understanding in rhinology The dramatic growth of clinical and translational research within the field of rhinology in recent years is illustrated by...Intraoperative nerve monitoring: 2017
Having written the definitive text on laryngeal nerves, Gregory Randolph and Dipti Kamani describe the benefits of intraoperative neural monitoring and, importantly, how to proceed if the nerve is pathologically involved or there is loss of signal. Over the years,...
The degree of barbecue rotation matters in horizontal canal BPPV
Treatment of horizontal canal BPPV (Hc-BPPV) is not without controversy due to the several repositioning manoeuvres advocated for its treatment. Among the many, barbecue rotation (Br) is perhaps the most commonly used for canalithiasis of Hc-BPPV. Should the rotation be...The curse of Sports Illustrated
“Not a supernatural curse, but a basic statistical concept of blinding simplicity.” What is ‘regression to the mean’? I am reliably informed that our former North American colonies publish a periodical known as Sports Illustrated (note, incidentally, the characteristically incorrect...Acoustic shock: definitions and clinical aspects
Acoustic shock, a previously little-known and poorly understood clinical entity, came to the public’s attention in 2019 due to a high-profile legal case of a musician at the Royal Opera House. In this fascinating article, Andrew Parker and William Parker...New Widex Study On Fractal Sound Stimulation in Hearing Aids Shows Positive Effects for Tinnitus Treatment and Overall Well-Being
Widex USA Inc. has published preliminary results of an ongoing study that validates the use of fractal sound stimulation, specifically new Widex SoundRelax tones, in treating tinnitus and supporting relaxation, concentration and well-being for all Widex wearers.
