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The anatomy and actual number of branches of the sphenopalatine artery: surgical implications

Endoscopic sphenopalatine artery ligation or cauterisation is nowadays the main treatment for epistaxis unresponsive to medical therapy. However, on review of the literature, there appears to be confusion relating to the anatomical nomenclature of the sphenopalatine artery branches and more...

Modified subciliary approach to the orbital floor

Fractures involving the lateral midface and orbital floor are routinely treated by maxillofacial surgeons. The surgical management requires access to the facial skeleton to reposition and free the soft tissues. There are three main approaches to the orbital floor: infraorbital;...

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....

‘Acoustic shock’

Development of hearing loss due to traditional and steady state noise in working environments has well defined medical, physical and legal implications in the present times. Organisations not complying with ‘Noise at Work Regulations 1989’ are liable for compensation if...

Do personal listening devices cause cochlear synaptopathy?

Cochlear synaptopathy is a condition in which noise interrupts the synaptic communication between sensory inner hair cells and low spontaneous rate cochlear nerve fibres. Since these nerve fibres are associated with signal coding in noisy backgrounds, their disruption leads to...

Wandering foreign bodies in the upper aerodigestive tract

Fish and chicken bones, along with metal wires, are among the most commonly ingested foreign bodies. Due to their linear shape and sharp edges, they can sometimes migrate beyond the lumen, making conventional endoscopic extraction unsuccessful. This issue is further...

Near-miss in otolaryngology head and neck surgery

It is recommended by John Fenton that we as a specialty need to embrace the concept of, take responsibility for and learn from all near-miss events, rather than our traditional haphazard approach of an occasional educational anecdote or case report....

Thyroid nodules – time for a rational imaging approach

“The more you know, the harder it is to take decisive action. Once you become informed, you start seeing complexities and shades of gray. You realize that nothing is as clear as it first appears. Ultimately, knowledge is paralyzing.” Calvin,...

Global health missions – not just for consultants. A guide for trainees.

Lulu Ritchie is a courageous and driven trainee in London, inspired by humanitarian missions but conscious of the usual requests for consultant level doctors. Lulu didn’t let that hold her back. She found a way and has kindly summarised her...

Internet-based cognitive behavioural therapy for adults with tinnitus

Tinnitus remains one of the most prevalent and distressing audiological symptoms. Although specialist tinnitus services are in high demand, geographical and service constraints result in limited access to these services. Internet-based cognitive behavioural therapy (ICBT) has been developed to provide...

Embracing the changes prompted by lockdown

March 2020 introduced the concept of lockdown to audiology services in the NHS, prompting a rethink of how to best provide hearing care. In this issue, we hear from Hanna Jeffery, a Clinical Scientist working at the Royal Glamorgan Hospital...

When patient choice stands in the way of patient-centredness

In the field of hearing care, there is increasing focus on ensuring patient autonomy and choice. Greater participation in decision making is supposed to result in better patient satisfaction. A study conducted in ENT and audiology clinics paradoxically suggests that...