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The middle way: treating idiopathic facial nerve palsy
Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...
Otolith dysfunction in congenitally deaf adults
This paper helps to further define the profile of ocular and cervical vestibular-evoked myogenic potentials (o and c VEMPs) in patients with congenital profound sensorineural hearing loss (PSHL). It highlights the prevalence of otolith (saccular and utricular) dysfunction that exists...
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...
Management of necrotising otitis externa
Although uncommon, necrotising (previously malignant) otitis externa (nOE) can be very aggressive, particularly if not managed appropriately. In this study the authors perform a retrospective review of 25 patients admitted with nOE over a four year period at a tertiary...
Treating middle ear conditions in developing countries
This month’s journal issue discussed global health in otolaryngology with this paper focusing on the management of chronic middle ear disease in the developing world. Chronic suppurative otitis media (CSOM) is more common in developing countries. The reason for this...
‘Dead ear’ after mastoid surgery
The primary aim of surgery in the management of cholesteatoma is eradication of the disease which can potentially result in serious complications such as intracranial extension, facial nerve weakness and further hearing loss. A profound hearing loss resulting postoperatively considerably...
How has management and outcomes of necrotising otitis externa changed over the past decade?
Necrotising otitis externa (NOE) remains a challenging condition for ENT departments, particularly with the increased prevalence of diabetes mellitus (DM) in the general population. There is no international consensus on treatment, although many institutions now have local guidelines drawn up...
The medially-invasive cholesteatoma: a case series
In this small case series, Casazza et al describe their management of seven cases of complex cholesteatoma presenting during a 16-year period. Patients were included if imaging confirmed restricted diffusion and an endophytic, medially-destructive disease involving the otic capsule, petrous...
Treatment options for vestibular neuritis: systematic review and meta-analysis
Vestibular neuritis (VN) is the third most common cause of peripheral vertigo. VN has been postulated to have viral aetiology and historically it was treated with steroids, until 2011 when a Cochrane review demonstrated lack of robust evidence behind this...
Unravelling the Meniere’s vs. migraine conundrum – what does the mastoid contribute?
This is an interesting observational study that attempts to classify subtypes of Meniere’s disease (MD) in relation to the coexistence of migraine. It is well known that the two conditions share common characteristics, making diagnosis and treatment challenging at times....
A diagnosis-based scoring system to predict outcomes in necrotising otitis externa
Patients admitted with necrotising otitis externa have increased six-fold in the last 10 years. The prognosis is variable and dependent on co-existing morbidities. Charlston Comorbidity Index (CCI) is a weighted comorbidity scoring method, based on the presence or absence of...
