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A place for everything and everything in its place: the practicalities of randomised clinical trials

Will this pill cure tinnitus? Bonnie Millar describes one trial that has investigated the possibility whilst describing the path of drug trials in the UK. Background In the last quarter of 2014, a clinical trial (QUIET-1; ClinicalTrials.gov Identifier: NCT02315508) commenced...

Audiological monitoring in ototoxicity - Are we doing enough?

In this article Ghada Al-Malky explores the dichotomy of life-saving, yet hearing loss-causing medication, and questions whether the hearing healthcare community is doing enough to prevent preventable hearing loss. Ototoxicity is the damage to hearing and / or balance functions...

The benefits of early voice therapy for unilateral vocal cord paralysis

This retrospective review of voice outcomes following a diagnosis of unilateral vocal fold paralysis divided patients into three groups according to the time of initiation of voice therapy following the onset of paralysis. The ‘early’ group started voice therapy within...

Using evidence and international consensus to guide treatment of thyroid nodules

The authors of this practical review paper highlight a growing issue within thyroid surgery, where high-quality ultrasound has increased the detection of subclinical nodules: what do we do with the patient presenting with an ‘incidental’ thyroid nodule? This has both...

What is the right balance to strike in the management of anaplastic thyroid cancer?

This is a pragmatic article on a difficult and much debated subject. Management of anaplastic thyroid cancer (ATC) can feel like making decisions between a rock and a hard place, and this article suggests one path to help navigate some...

The importance of s-ABR in auditory disorders

S-ABR is a method of recording speech-evoked-potentials, but where does it fit in the clinical and research test battery? Here, the authors examine the opportunities for s-ABR. The integrity of the neural transmission of acoustic stimuli is evaluated by auditory...

Pediatric Endoscopic Endonasal Skull Base Surgery

Published in 2020, this book, edited by professors of neurosurgery and otolaryngology, approaches the narrow field of paediatric endoscopic skull base surgery with a wealth of knowledge and expertise that the authors have achieved practising in adult and paediatric joint...

The middle way: treating idiopathic facial nerve palsy

Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...

Scalp reconstruction a new algorithm

Reconstruction of the scalp after acquired defects remains a common challenge for the reconstructive surgeon, especially in light of a history of radiation to the area. Wound healing by secondary intention or with a wound vacuum assisted closure are viable...

Measuring the ‘impact’ of preoperative immunonutrition

Using preoperative nutritional supplements as part of ‘enhanced recovery’ in surgical patients is not a new concept. This interesting paper looks at the latest development in optimising patients undergoing head and neck oncological surgery. Immunonutrition (Nestle’s ‘Oral Impact’ in this...

Factors affecting the occurrence of salivary fistula after total laryngectomy

It is generally believed that patients should be fed by nasogastric tube for 7-10 days after undergoing total laryngectomy or laryngopharyngectomy to avoid the occurrence of post-operative salivary fistula. This study challenges this belief and looks into various factors that...

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...