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A new modified double-flap technique for cochlear implant surgery

The authors retrospectively assessed 342 implantees with a minimum of five years’ follow-up who had been implanted using a lazy S-shaped post auricular incision with a modified double-flap technique. From the notes, postoperative wound complications and any other adverse events...

A modification of the crescentic flap for nasal skin reconstruction

Non-melanoma skin cancers are the most frequent skin tumours and in over 25% of cases affect the nose. Following excision, the reconstruction may be challenging. Reconstruction aims to preserve the anatomical units, nasal functions and also an aesthetic final outcome....

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...

Hearing loss in the workplace

It is probably accurate to say that most jobs today can be effectively performed by people who have hearing loss. In this article Dr Sam Trychin outlines some of the major issues which should be considered in regard to hearing...

Practising surgery in a war zone: an interview with Dr Volodymyr Melnyk

It is now nine months since the full-scale Russian invasion of Ukraine commenced in late February 2022, with Putin announcing a “special military operation” to “denazify and demilitarise” Ukraine. The rest of the world, however, saw it for what it...

A systematic review of adjunctive probiotic therapy in the management of chronic rhinosinusitis

It is generally understood that administering substances containing live microbiologically active micro-organisms (probiotics) enhances the treatment of chronic rhinosinusitis. Probiotics manipulate and rebalance the alterations occurring in the local microbiome in chronic rhinosinusitis patients. This results in propagation of healthy...

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...