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Decreased sound tolerance in autism: understanding and distinguishing between hyperacusis, misophonia, and phonophobia

Decreased sound tolerance (DST) affects a significant proportion of autistic people throughout their lifetime and, as Zachary J Williams explains, it is important that clinicians are aware of the three distinct subtypes of DST when making a diagnosis. Autism spectrum...

AOT Conference 2024

Shared Knowledge, Built Community Anita Sedghi FY1, Northwick Park Hospital, London Northwest NHS Trust The AOT Conference this year focused on a diverse range of presentations, catering to trainees at all levels. The program started with a thought-provoking talk by...

Scary Cases in Otolaryngology

When I was first presented with the Halloween-like graphic that is displayed on the cover of this 230-page book, I wondered what scary stories may lie ahead. To my delight, by the time I’d turned over the first few pages,...

Anterolateral thigh cutaneous flap or radial forearm free flap for tongue defect reconstruction?

Free flap reconstruction is the gold standard in tongue reconstruction, aiming to restore function such as swallowing, cosmesis and speech. The anterolateral thigh cutaneous flap and the radial forearm free flap are among the most popular free flaps used for...

What is the evidence for contralateral tonsillectomy in TORS for known unilateral tonsil malignancy?

The concept of field changes by carcinogens within the upper aerodigestive tract is well established with reported rates of synchronous tumours of 4% and second primaries of 36%. The tonsil in particular has the highest rate of synchronous tumours, postulated...

Laser for active mucosal chronic otitis media

Active mucosal chronic otitis media (COM) is a condition characterised by otorrhoea secondary to chronic inflammation of the middle ear and mastoid mucosa associated with granulations and a tympanic membrane perforation. Surgical intervention is often required, but concurrent mastoidectomy with...

Managing high flow head and neck arteriovenous malformations (AVM)

Vascular malformations are lesions where the traditional network of capillaries linking arteries and veins are lacking. Patients usually present with bleeding, pain, disfigurement and tissue expansion and destruction. High flow lesions can be challenging to manage in the head and...

Salivary gland blues…

Intravenous methylene blue is a well-described method to assist in intraoperative localisation of parathyroid glands. The technique does come with challenges as anybody will know who has had to run adjacent to a theatre-bound trolley to ensure that the infusion...

Sialendoscopy assisted excision of parotid stones

This is a retrospective paper from China that looks to assess the efficacy and safety of sialendoscopy with a combined transoral or transcutaneous approach for the removal of parotid stones. Sialolithiasis is known to be a cause for obstructive parotid...

Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture

Placement of voice prosthesis at the time of trachea-oesophageal puncture is well described using 20-French prostheses. There is debate about the optimal size of the prosthesis with work in the 1980s and 1990s supporting larger prostheses. The rationale was that...

Bone anchored hearing devices in very young children

This paper presents results of BC devices in very young children and helps inform an honest discussion of risks / benefit with prospective parents. The authors of this article from Starship Children’s Hospital, Auckland, New Zealand have a series of...

When should we decompress the facial nerve in Bell’s Palsy?

It has been over three decades since Fisch popularised facial nerve (FN) decompression for Bell’s Palsy. Studies further exploring this have been few since, partly due to the major complications that can occur following this type of surgery. The current...