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Otosclerosis - to scan or not to scan?
In an era of insidiously reducing thresholds for investigating patients, Maxwell and colleagues pose an important question: is high-resolution computed tomography (HRCT) prior to stapes surgery for otosclerosis worthwhile? Their practice typically considers HRCT for cases of suspected otosclerosis presenting...
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,...
Managing hearing preservation expectations of adult CI patients
This paper is a single-centre review of adult cochlear implants in patients with preserved low-frequency hearing, focusing on the outcomes at 10 months post-implantation, and the rates of electroacoustic stimulation actually used in this group of patients. The centre identified...
Multiple surgeries for RRP – does a greater number of operations result in a worse voice outcome?
Recurrent respiratory papillomatosis (RRP) of the larynx remains a challenging condition to treat, with a number of affected patients requiring multiple operations to remove recurrent disease over the course of their lifetime. At the most severe end of the spectrum,...
Effect of stimulation levels on speech recognition and auditory threshold performance
When programming a Cochlear® device, two measurements are normally assessed. T levels relate to the quietest sound the CI user can hear i.e. thresholds, and C levels are comfortable levels which are tolerable for the CI user. If these levels...
Early cochlear implant activation and its effects on the cochlea
In this article, Alhabib et al consider the changes to electrode impedance with early device activation (day one) compared to conventional activation (day 30). Activation at day 30 is a cautious approach, which has been popular for many years. However,...
Bringing aged care back
Worldwide, our older population is increasing, and thus a need for the provision of care to older people is also increasing. Aged care may be informal, provided by unpaid carers; or formal, provided or subsidised by government or other organisations....
3D-printed temporal bone models - how good can they be?
In the era of increasingly difficult and expensive-to-come-by cadaveric temporal bones with which to practise drilling and learn the complex 3D anatomy of the temporal bone, decent alternatives would be welcome. McMillan et al report a prospective comparison study in...
An inherited platelet disorder in a post- tonsillectomy haemorrhage
Unexplained bleeding after any surgery is least desirable and to identify a cause for this preoperatively can be a very useful safeguarding measure. By looking for inherited platelet disorders in patients who bled after tonsillectomy, the authors of this publication...
Telepractice in COVID-19 and beyond
COVID-19 has suddenly forced health professionals to switch from face-to-face to remote video conferencing to deliver many or most of their services. This article considers the current state of this service delivery model (also called telepractice) for speech and language...
Reducing the risk of Frey’s syndrome after parotidectomy – which methods are best?
Gustatory sweating or Frey’s syndrome is a well-recognised complication of parotid surgery. The reported incidence is highly variable, from 4% to 96%, with around 30% of patients reporting symptoms. A number of intraoperative techniques can be used to reduce the...
