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Medialisation laryngoplasty can relieve pain related to voice use

Odynophonia, or pain associated with voice use, is a relatively uncommon manifestation of glottal insufficiency related to vocal fold motion impairment (VFMI). Its incidence is approximately 15% in patients with vocal fold paresis. Medialisation laryngoplasty (ML) was popularised by Isshiki...

Gardasil vaccination – an effective adjuvant therapy for RRP?

The clinical manifestations of recurrent respiratory papillomatosis (RRP) can vary hugely from individual to individual. Whilst some affected children will outgrow the disease, a subset of patients will experience frequent recurrences and require multiple surgical procedures over the course of...

Possibility of noise induced hearing loss during middle ear suction for secretory otitis media

Emission of high intensity sound is dangerous to the cochlea and can result in noise induced hearing loss (NIHL). Removal of middle ear fluid is common in everyday practice and the possibility of inducing NIHL is seldom considered and not...

The anatomy and actual number of branches of the sphenopalatine artery: surgical implications

Endoscopic sphenopalatine artery ligation or cauterisation is nowadays the main treatment for epistaxis unresponsive to medical therapy. However, on review of the literature, there appears to be confusion relating to the anatomical nomenclature of the sphenopalatine artery branches and more...

CT and intraoperative nerve monitoring to identify non-recurrent laryngeal nerve during thyroid surgery

A non-recurrent laryngeal nerve (NRLN) is a rare (incidence 0.3% to 1.3%) anatomical variant that results in a higher rate of vocal cord palsy following thyroid surgery. This team from China examined the utility of preoperative CT and intraoperative nerve...

Sound localisation after bilateral cochlear implantation

Limited information is known about the localisation skills of paediatric cochlear implant patients who were good hearing aid users before their hearing deteriorated. As localisation is a skill often associated with good natural hearing, there is a worry that implants...

Cerebrospinal fluid leaks after vestibular schwannoma surgery

This study analyses 30-day readmission data after vestibular schwannoma surgery using a multicentre longitudinal State of California dataset. The authors studied risk factors, and timing of readmission in 6820 patients over 15 years. Of these, 490 readmissions were reported for...

Vascularised tissue in salvage total laryngectomy

Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...

Is there a role for facial nerve decompression in Ramsay Hunt syndrome?

This is an interesting paper. The authors recommend a transmastoid facial decompression for patients with complete facial nerve paralysis with House Brackman HB 5/6 who do not show any sign of recovery after two weeks of treatment following a diagnosis...

Eustachian tube function before and after FESS

This is a prospective study from the UK looking at Eustachian tube dysfunction (ETD) in patients with chronic rhinosinusitis (CRS) undergoing surgery. Fifty-seven consecutive patients who had failed medical therapy and were scheduled for endoscopic sinus surgery completed SNOT-22 and...

Socially appropriate part II: therapy for people with TBI

Social communication is a complex behaviour comprising social and cognitive communication skills. Providing speech and language therapy (SLT) interventions for people with social communication difficulties following traumatic brain injury (TBI) requires the clinician to understand how ingredients from an evidence-based...

Diagnostic criteria for haemodynamic orthostatic dizziness

Over the past several years, the Bárány Society has been developing an International Classification of Vestibular Disorders (ICVD) in order to standardise diagnosis and nomenclature for both clinical and research purposes. Many in vestibular practice would be familiar with the...