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Botulinum toxin injection for bilateral recurrent laryngeal nerve paralysis

All traditional surgical treatments for bilateral recurrent laryngeal nerve (RLN) paralysis are essentially a balance between maximising airway patency and ensuring adequate phonation / airway protection. This paper highlights the potential role of botulinum toxin (Botox) injection into the cricothyroid...

Role of potassium channel opener in salicylate induced tinnitus

The exact mechanism in the origin of tinnitus is not known. Many pharmacological agents have been tried to to treat tinnitus without great success. Aspirin is a commonly used medicine in the elderly population to reduce the risk of stroke...

An alternative device for obstructive sleep apnoea

Continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnoea (OSA), primarily due to the vast amount of short-term evidence in the medical literature it has accrued. The enduring obstacle to CPAP from becoming a treatment option...

Neuromodulation in drug resistant epilepsy

Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...

Combination PPI and intralesional steroid treatment for recurrent laryngeal granuloma

The existence of a wide range of treatments for recurrent laryngeal granulomas (repeat surgery, high-dose proton pump inhibitor (PPIs), surgery with botulinum toxin injection, botulinum toxin injection alone, etc) is a testament to the refractory nature of this condition, with...

Can diet alone be used to treat laryngopharyngeal reflux?

In this crossover observational study, a low-fat, low-quick-release sugar, high-protein, alkaline, and plant-based diet was investigated as a single treatment for laryngopharyngeal reflux (LPR). Authors recruited 50 participants with demonstrated LPR on hypopharyngeal-oesophageal multichannel intraluminal impedance-pH-monitoring (HEMII-pH), off acid suppressive...

Is Gamma Knife Surgery effective for intracanalicular vestibular schwannomas?

Vestibular schwannomas (VSs) are rare, occurring in approximately five per 100,000 adults a year. In circa 8% of cases, the VS is contained within the internal auditory canal, i.e. intracanalicular (iVS). Although radiosurgery is a recognised treatment modality for VSs,...

Dizziness questionnaire and telemedicine during Covid pandemic

During the initial phases of the Covid-19 pandemic in 2020, delivery of ENT care adapted significantly. Kaleva et al present their findings of telephone balance consultations during the pandemic with a randomised prospective study utilising a dizziness questionnaire in West...

Current AI audiology knowledge

Artificial intelligence (AI) tools are becoming increasingly popular and can be utilised by patients, healthcare professionals and students. The performance of chatbots can be variable between different AIs and, indeed, different topics. There is no current consensus for the best...

An otological cure for globus?

Globus pharyngeus is a common benign condition frequently encountered in ENT practice. Laryngopharyngeal reflux and psychological stressors are often considered to be contributory factors, but globus symptoms do not always respond to antacid medications. Such medications can also be limited...

Endoscopic airway interventions in children

Open surgery for paediatric airway pathologies such as subglottic stenosis was hailed as revolutionary when many of today’s paediatric ORL specialists were in training. Equipment, facilities and training has moved on and the high-quality optics in modern endoscopes, coupled with...

Functional Endoscopic Sinus Surgery (FESS) - Part 1

In the first of a two-part series, Martyn Barnes and colleagues discuss indications for functional endoscopic sinus surgery (FESS), the surgical objectives and techniques, patient expectations and the risks of surgery. In part two, the authors will discuss how to...