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Emerging antimicrobial resistance in ENT outpatients

Given the recent statement from the UK Prime Minister on this issue, it would appear timely to assess the ‘time bomb’ of antibiotic resistance in otology. Comparison of ear swabs over twelve months from 2007 and 2012 demonstrates an increasing...

The missing link: how migraine neurophysiology amplifies tinnitus

This article discusses an emerging hypothesis linking bothersome tinnitus with migraine-related sensory processing dysfunction. When evaluating patients with tinnitus, a range of contrasting experiences are noted, from mild, non-bothersome symptoms to those associated with significant distress – broadly corresponding to...

Facial paralysis revisited

Facial paralysis grading is a confusing issue. Lots of classifications have been proposed but all are subjective. The authors attempted to automate the Sunnybrook Facial Grading System (SFGS) by training a convoluted neural network (CNN) deep learning system. They used...

Erwin Geising and the fall of the Third Reich

It’s mid 1944. The allies have landed at Normandy, the Germans have abandoned Rome and are retreating from the Russians on the eastern front. The Fuhrer was in way over his head and out of his depth. Watching this series...

Facial pain and headaches

This paper reviews the present knowledge and the recent publications on the cause, characteristics, course and treatment of chronic and recurring facial pain and headaches. Facial pain should be defined in terms of frequency, duration and severity, and also in...

Vestibular migraine or BPPV?

There are close similarities between benign paroxysmal positional vertigo (BPPV) and vestibular migraine (VM) as both can be presented by positional nystagmus. Though BPPV remains the commonest cause of pure positional vertigo, VM can mimic this condition. This study is...

Cervicogenic vertigo, a view from the experts

Many readers would be familiar with the term ‘cervicogenic vertigo’ to mean neck-related vertigo or dizziness. In simple terms, this disorder has been defined as dizziness/vertigo caused by neck pain and/or stiffness. By implication, the vertigo/dizziness should resolve by treating...

Dizziness: confusion, issues and considerations

Douglas L Beck gives his unique take on the difficulties involved in diagnosing dizzy patients and the importance of well-founded research acting as the basis for any diagnosis and treatment decisions. Dizziness. Uh-oh. We really have a very limited understanding...

Assessment in ENT: Intra-operative videos

An article examining the reliability and validity of remote scoring; a video assessment of myringotomy and grommet insertion. The primary outcome measures were to determine construct validity (differentiating between different grades of surgeons) and reliability of video scoring. Unfortunately, the...

ENT In This Issue - Trainee Takeover

Jonathan Lee, ST3, MRCS, Department of Ear, Nose and Throat Surgery, Warwick Hospital, University Hospitals of South Warwickshire NHS Foundation Trust, UK. ENT training has undoubtedly taken a significant hit since the COVID-19 pandemic. Crises, however, often lead to collaboration...

Can we tell the difference between benign recurrent vertigo, migraine and Menière’s disease?

I chose to review this article as it reminds us of the difficulties in diagnosing dizzy patients accurately and the significant crossover of symptoms between the diagnoses. Does Benign Recurrent Vertigo (BRV) even exist as a separate entity? BRV is...

Using cVEMPs to distinguish between vestibular migraine and from Ménière’s

Vestibular migraine (VM) and Ménière’s disease (MD) could overlap or mimic each other. Since the use of cVEMPs became routine, attempts have been made by researchers to explore its clinical utility in these two conditions. In this prospective study, the...