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Medical information required with requests for CT scans of the temporal bones; a two cycle audit

It is a common experience that radiology reports on the CT scans of the temporal bones do not always reach a diagnosis. Various studies have produced differing results in that detailed information may not be necessary to help reach a...

Association of tinnitus with dementia

In this large case-controlled study, the authors have compared the presence of tinnitus prior to the diagnosis of dementia in the study group with those without dementia. Dementia patients were selected from the National Health Insurance group. The control group...

Screening for hearing aid fittings – an approach for primary care

Introduction The communication difficulties related to hearing loss can lead to ‘depression, social withdrawal and problems with employment and access to information sources’ [1]. Furthermore, unmanaged hearing loss is associated with dementia, a poorer quality of life, depression, anxiety and...

Laryngeal cleft in a 66-year-old man!

This is a fascinating case report of a 66-year-old man who presented with a carcinoma of the piriform sinus. During chemoradiotherapy, he developed dyspnoea, dysphagia and aspiration pneumonia. His chemoradiotherapy was stopped and he underwent a pharygnolaryngectomy. When the surgical...

Prognostic value of neutrophil-to-lymphocyte ratio in HPV-positive oropharyngeal cancer

The authors propose that high neutrophil-to-lymphocyte ratio (NLR) is associated with poor disease-free survival (DFS) in patients with human papillomavirus positive (HPV+) oropharyngeal cancer (OPC). This is a retrospective study that compared the outcomes of 43 patients treated for HPV+...

Blood-sampling prognostic predictors for Bell’s palsy

Bell’s palsy is generally defined as an acute-onset unilateral idiopathic mononeuropathy in the facial nerve. It is of unknown aetiology, however, inflammation is considered a major cause. Electroneurography assessing nerve excitability is the most reliable examination for predicting prognosis of...

Underdiagnosing eosinophilic oesophagitis in food bolus obstruction: a wake-up call for ENT units

The management of FBO has evolved, with most cases now done by upper GI clinicians. Biopsies should be taken routinely to investigate possible eosinophilic oesophagitis. In acute soft food bolus obstruction (FBO), uncovering the root cause is as crucial as...

Advances in speech testing for improved diagnosis and rehabilitation

Measuring an individual’s ability to hear speech in quiet or in the presence of background noise has long been a key component of a comprehensive audiological assessment. Moving beyond the pure-tone audiogram allows us to gain insights that extend far...

Consider PCR testing in culture negative necrotising otitis externa

Necrotising otitis externa (NOE) often does not yield identification of a causative organism to treat although in 90% of cases it is a member of the pseudomonas species. The incidence of fungal NOE is not to be forgotten and this...

Thyroid ultrasound elastography: does nodule stiffness predict malignancy?

Approximately 50% of the general population has a thyroid nodule while 5-15% of these are malignant [1]. A major challenge, therefore, is how to detect the malignant nodules for appropriate, timely treatment and avoid unnecessary, costly investigations for the remainder....

Rotational chair testing: “To rotate, or not to rotate, that is the real question”

Passive whole body rotation tests are widely considered to be the ‘gold standard’ for the identification of bilateral peripheral vestibular disorders (bPVD), but also have a part to play in identifying unilateral disorders (uPVD). In this article Paul Radomskij discusses...

Psychogenic vestibular disorders: understanding and management

‘Psychogenic vestibular disorders’, also known as ‘functional vertigo and dizziness’, are common causes of dizziness and balance difficulty. Although our understanding of their underlying pathophysiology remains incomplete, Drs Diego Kaski and Amy Edwards outline how early identification and positive diagnosis...