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1171 results found

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,...

The medially-invasive cholesteatoma: a case series

In this small case series, Casazza et al describe their management of seven cases of complex cholesteatoma presenting during a 16-year period. Patients were included if imaging confirmed restricted diffusion and an endophytic, medially-destructive disease involving the otic capsule, petrous...

Radiology of referred otalgia

Otalgia is a common presenting complaint to Ear Nose and Throat Departments. Otalgia is either primary or secondary (referred) [1]. Referred otalgia is a ‘red flag’ symptom and can be a diagnostic challenge for clinicians and radiologists as the pathology...

To monitor the nerves or not?

Whilst intraoperative nerve monitoring has become the standard of care for mastoid and parotid surgery, its benefit in thyroid surgery remains unclear. In the UK NICE was agnostic on the subject in 2008, stating that it was potentially helpful and...

Fluorescein use during parotidectomy

The authors of this study retrospectively reviewed the surgical charts of seven patients who underwent parotidectomy for tumour resection. In all these patients, Fluorescein sodium was used to enhance the contrast between parotid tumour tissue and the facial nerve. Using...

Stimulation for a good night’s sleep

This article was an interesting read. It is an update from the authors’ original paper printed in the NEJM in 2014 regarding the results of an implantable pulse generator (IPG) for stimulating the hypoglossal nerve in response to respiration. This...

Robot controlled mastoid surgery!

This is a fascinating piece of work by a Korean team developing a human-robot collaborative control. Their model uses image guidance surgery to locate the drill tip’s position. Important structures can be highlighted – in this case the facial nerve....

Righting the paralysed lip

Many surgical procedures that otolaryngologists perform put the facial nerve at risk of injury, a complication that the surgeon and patient fear alike. Unfortunately, injuries to the nerve can and do happen despite adequate precautions, and facial paralysis may be...

Endoscopic approach to the internal auditory canal (IAC)

The otoendoscope, with its wide-angle visualisation, has made it an increasingly popular tool to perform outer, middle and even inner ear surgery. Approaches to the IAC with the endoscope have been described by several authors. In this paper, Valente et...

Lip sensory disturbance in osteotomy patients

Neurosensory disturbance resulting from inferior alveolar nerve injury during a sagittal split osteotomy (BSSO) is a well-recognised complication. This paper from Türkiye looked at 20 patients with neurosensory disturbance >12 months after a bimaxillary osteotomy including a BSSO surgery and...

Taking a fresh look at otoacoustic emissions

So what has changed in four decades of OAEs? Do we now have all the answers? Have we reached our optimum recording ability? Professor Kemp explains what we know, what we don’t know and what’s to come. In the 40...

Auditory brainstem implant results in adults and children

Background The auditory brainstem implant (ABI) has been developed from cochlear implant (CI) technology and is indicated for people who have anatomical abnormalities of the cochlea or dysfunction of the auditory nerve. The majority of people who have received an...