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Alternobaric vertigo: asymmetrical vestibular function due to asymmetrical middle ear pressures (Iron Man’s archenemy)

The Marvel Cinematic Universe could certainly be deemed an ‘extreme environment’ and yet very rarely do we see the Avenger’s popping to the clinic for a check-up. Hee-Young Kim has wondered how they cope with extreme pressure changes and discusses...

Subtypes of vestibular migraine

The authors argue that the current Barany criteria (ICVD) for vestibular migraine (definite and probable – dVM and pVM) are too restrictive. For instance, whereas a category of chronic migraine with or without aura is recognised in ICHD-3, ‘chronic VM’...

Pulsatile tinnitus, one more piece in the jigsaw

Pulsatile tinnitus (PT) is a common ENT symptom. It can generally be divided into venous and arterial. Arterial PT might be investigated with a CT scan while a venous one with an MRI or an MRV (MRI Venogram). Anecdotally, arachnoid...

CI music: seeking perfection, accepting reality

Having just read about the challenges cochlear implant technology and music appreciation present, the musician Richard Reed beautifully illustrates the realities of this patient journey. An old friend of mine is an ardent music fan, and completely tone deaf. Long...

The lessons in setting up a community ENT service in the NHS

Sudeb Mandal, a GP with special interest in ENT, talks about the novel approach taken in the community to deliver ENT services in Kent in the UK. The Kent Community ENT service was born with the vision to bring together...

Non-absorbable synthetic material for middle fossa repair using a combined transmastoid/middle fossa approach

Repair of CSF leaks can be a challenging technical undertaking. In this article, the authors describe their use of a synthetic material to help with the successful repair of these leaks from the middle cranial fossa. Erosion of the middle...

The art and science of acoustic ecology

Aki Pasoulas summarises the diverse forms and approaches of the relatively new and expanding area of acoustic ecology, a discipline that studies the relationship between living beings and their sonic environment. Sound Ecology emerged in the late 1960s through the...

ENT clinics – 50 years of progress…?

Cocaine in abundance, eustachian tube catheterisation, and the ever-present threat of a fire in the clinic… How have things changed in the last few decades? Retired ENT surgeon, Douglas MacMillan, tells us of his experiences starting out in the late...

Minimum stimulus strategy for the diagnosis of BPPV

Explore the innovative minimum stimulus strategy (MSS) for diagnosing benign paroxysmal positional vertigo (BPPV), enhancing accuracy while minimising patient discomfort. Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder where canalolithiasis or cupulolithiasis causes sudden episodes of vertigo, triggered...

Impact of outer ear problems in Northern Ethiopia: experiences of a global outreach clinic

Outer ear disease is one of the commonest reasons for attending the ENT clinic in Ethiopia, just as in the UK. Very little has been published on the experiences of ENT clinics in Ethiopia. Here Yilkal Tassew, Seid Temam and...

Robotic insertion of electrode array in cochlear implantation

Cochlear implants (CIs) are commonly used for profound bilateral hearing loss. They have specific national guidance for their insertion, however patients with a substantial residual acoustic hearing are potential CI candidates. Preservation of this residual hearing can be sought with...

Looking forward: incoming RSM presidents preview the year ahead

This November, Professor Simon Lloyd takes over from Patrick Axon as Otology Section President of the Royal Society of Medicine, and Professor Vin Paleri takes over from Michelle Wyatt as President of the Laryngology and Rhinology Section. Both incoming presidents share highlights from their programmes for the forthcoming year.