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The right to choose: the how-to of practicable supports
Providing all practicable supports to enable a person to participate in decision-making is one of the five key principles of the English and Welsh Mental Capacity Act 2005. This article (set in the Canadian legal framework, which has many similarities...
Temporal bone fractures in children – are we doing enough?
This is a retrospective study which assessed clinical presentation and prognosis in 91 children under the age of 18 who developed temporal bone fractures from trauma, the commonest of which was falls from heights followed by motor vehicle accident. The...
Vascular vertigo and dizziness: diagnostic criteria
This diagnostic criteria is one of the latest produced by The Bárány Society. It is a useful addition to previous ones for vestibular disorders. Vascular vertigo/dizziness by definition is caused by stroke, transient ischaemic attack (TIA), isolated labyrinthine infarction/haemorrhage and...The effects of hormonal changes across menstrual cycle on high frequency auditory thresholds
Physiological changes during the menstrual cycle are well documented; do these changes extend to the auditory system? Lalsa Shilpa Perepa and Rewa Indurkar delve into the literature to find the evidence. Menstrual cycle refers to a series of changes that...
Cuff up or cuff down; to occlude or not to occlude? What effect does tracheostomy tube modification have on swallowing outcomes?
Dysphagia is commonly seen in patients with tracheostomy. The current global pandemic has increased interest in the impact of a tracheostomy on swallowing outcomes. This systematic review is therefore a timely addition to the literature and a useful read for...
Hear me out – tiny steroid implants for fighting meningitis-induced deafness
Sensorineural hearing loss is the most common neurological complication of pneumococcal meningitis. Bacterial infiltration into the inner ear triggers inflammation, leading to cochlear fibrosis and sclerosis – damage that, in over a third of cases, affects both ears. Current Infectious...
How can we manage children with poor speech discrimination but with normal audiogram
We often come across children and young adults brought in for consultation for suspected hearing loss and having hearing difficulty in noisy backgrounds but who often have normal audiograms. Such patients are suspected to have auditory neuropathy. The term auditory...In conversation with Trevor McGill
After more than four decades of paediatric clinical practice, Trevor McGill shares his wealth of experience and knowledge with Pat Bradley. Trevor, as a national and internationally acknowledged Paediatric Oto-Rhino-Laryngologist, Head and Neck Surgeon, to what do you owe this...Audiology in this issue...Psychology (May/Jun19)
Alex Griffiths-Brown, BSc(Hons), MRes, Audiologist, The Shrewsbury and Telford Hospitals NHS Trust, Shrewsbury, UK. E: alex.griffiths-brown@nhs.net@griffithsbrown1 Whether using ‘client centred counselling’ [1] when seeing adult hearing aid patients, employing motivational interviewing [2] during tinnitus consultations or considering the stages of...
A new flap for the perinasal region
Perinasal defects are most commonly caused by tumour extirpation or trauma. There are a number of methods to reconstruct the defect, and the method chosen depends on the size of the defect and other patient considerations. When the defect is...
Can junior doctors provide immediate help in airway and other ENT emergencies?
In the present trends for centralisation of ENT emergency services, availability of immediate middle grade or senior help in acute ENT emergencies does not always exist on site and hence the role of junior doctors in handling this is enhanced...
