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The MACRO Trial: defining best management of chronic rhinosinusitis

A major UK trial in The Lancet finds ESS provides greater symptom relief than long-term macrolides for adults with CRS, supporting earlier surgery and fewer antibiotics. The MACRO Programme was established in 2016 when the UK National Institute of Health...

Unexplained dizziness in elderly patients

How do we explain unexplained dizziness in elderly patients? How far should we go with investigations? And most importantly, how should we manage this challenging and expanding group of patients whose balance affects their safety? Richard Ibitoye and Diego Kaski...

What’s new in implantable devices? New indications in cochlear implantation

For over 40 years, cochlear implant procedures have steadily increased. Outcomes for patients are improving as a result of modified surgical techniques, a wider portfolio of electrode arrays, advances in programming strategies, access to improved technology and a better understanding...

ENT registrar national selection: how can we advise aspiring candidates?

With the aim of creating fair selection into the few available training numbers, ENT was one of the first surgical specialties to move to a national selection process for selecting new registrars in England. Since 2013 the selection process has...

Migration and training: a British-Nigerian surgeon’s perspective

Less than 4% of doctors on the UK’s medical register describe their ethnicity as African or part African, yet there are myriad driving forces behind the migration of medical trainees from Africa to the UK and other developed countries. Ekpemi...

The pong of poverty: George Orwell on the problem of olfactory classism

Throughout his fiction and non-fiction, George Orwell incorporated references to olfaction to invoke strong reactions in his readers. For example, in Nineteen Eighty-Four the protagonist Winston describes “the pleasant smell of [Julia’s] hair”. Orwell emphasises the invasiveness and emotional force...

The role of public health in addressing age-related hearing loss

Prevention and treatment of hearing loss needs to be viewed through a public health lens, but what does that look like? Kelly Reavis and colleagues explain the steps to addressing hearing healthcare from a public health perspective and why this...

Starkey Hearing Institute - Zambia: Bridging the Hearing Health Access Gap in Sub-Saharan Africa

Here, we continue exploring audiology training routes across the world with a focus on bridging the Hearing Health Access Gap in Sub-Saharan Africa. This article is provided by Alfred Mwamba, AuD, who is the Executive Director for the Starkey Hearing...

From the editor Jan/Feb 2025

Declan Costello, MA, MBBS, FRCS(ORL-HNS),Consultant Ear, Nose and Throat Surgeon, Wexham Park Hospital, Slough, Berkshire, UK. E: d.costello@nhs.netTW / X: @Voicedoctor_uk As we slip seamlessly into the new year, I hope you have all had a good break and that...

What blood tests should be requested to investigate vocal cord paralysis?

Patients who are discovered to have a vocal cord palsy with no obvious cause on history or examination routinely undergo investigations to exclude an underlying pathology. Cross-sectional imaging of the relevant recurrent laryngeal nerve is required, but considerable variability has...

How does the Dizziness Handicap Inventory (DHI) correlate with demographics and symptoms of patients?

The DHI is widely used to assess the self-perceived emotional, functional and physical disability in subjects with dizziness and balance problems. By studying the data of 568 patients retrospectively, the authors sought to determine the gender and age differences in...

The stubborn polyp cases are ‘different’

The widely different behaviour of nasal polyp disease between patients is a major feature of rhinology practice and makes counselling of patients difficult when approaching their first operative intervention. Setting aside aspirin sensitivity (Samter’s triad), which is known to be...