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Oral versus oral and intratympanic corticosteroid treatment for sudden sensorineural hearing loss
The 2012 American Academy of Otolaryngology- Head and Neck Surgery Foundation (AAO-HNSF) clinical practice guidelines on sudden sensorineural hearing loss (SNHL) have two statements that address steroid use. Statement eight indicates an option to offer corticosteroid as initial treatment for...
The degree of barbecue rotation matters in horizontal canal BPPV
Treatment of horizontal canal BPPV (Hc-BPPV) is not without controversy due to the several repositioning manoeuvres advocated for its treatment. Among the many, barbecue rotation (Br) is perhaps the most commonly used for canalithiasis of Hc-BPPV. Should the rotation be...
Intratympanic steroids - to give or not to give?
The treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) is controversial and different modes of steroids have been tried without any universal consensus. Various authors have reported combined oral and intratympanic steroid therapy in SSNHL, with consistent results in several...
Should we be doing earlier MRIs in sudden sensorineural hearing loss?
There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....
Tell me like it is: advice for relatives of people with aphasia
More than a quarter of people who have a stroke present with aphasia immediately post-stroke (approx. 30%) and of these, around 60% experience chronic communication difficulties. Provision of information is seen as one of the top 10 best practice recommendations...
Gender inequality across medical specialties in the United States
The authors of this study collected and evaluated 4222 surveys of patient satisfaction ratings of male and female residents across subspecialties in the United States. Half of the evaluated residents were females, with first and second year residents being evaluated...
Does vestibular rehabilitation help patients with vestibular migraine? Is this also true if these patients have had a traumatic brain injury?
Vestibular migraine (VM) is a common diagnosis in ENT, and there is growing evidence that vestibular rehabilitation therapy (VRT) is an effective treatment, reducing self-perceived dizziness and improving gait. This is a retrospective review of the outcomes of 93 patients...
Corticosteroid prescribing in ENT - are we at risk of being sued?
Of medications leading to malpractice claims, corticosteroids comprise the third most common. They are used widely and have a significant side-effect profile: hypertension, lipodystrophy, diabetes, avascular necrosis of the femoral head, peptic ulceration and psychiatric reactions to name but a...
