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Why is a Raven like a writing desk? Some reflections on countertenors and castrati

The countertenor voice has seen a resurgence in popularity in the last 50 years. Nicholas Clapton is one of the foremost performers and teachers of his generation, and he tells us here about the link between countertenors and the (fortunately...

Laryngeal transplantation: is it a thing?

Few organs could be said to be more complex than the larynx when it comes to transplantation. Martin Birchall looks at past challenges, current issues and future prospects. I am not clear exactly why I chose to spend a life...

Laryngopharyngeal reflux - would mucolytics help?

With laryngopharyngeal reflux (LPR) being such a common presenting complaint to ENT clinics, who would not want to have more, effective treatment options for patients suffering with this annoying condition? In their small randomised, controlled trial, Chae et al put...

Facial reconstruction with polyethylene implants

Planning reconstructive surgery for complex craniofacial defects challenges even the most experienced of surgeons. In most cases surgery is undertaken to improve anatomical functioning. However the anatomical structure of these regions is also critical to facial aesthetics and patient satisfaction...

American Thyroid Association Thyroid Cancer Management Guidelines: utilising risk stratification to optimise patient care

The steep rise in thyroid surgery around the globe, has led to the development of risk stratification to define the indications for surgery and the extent of surgery as well as adjuvant therapies for papillary carcinoma, to avoid over treatment....

Persistent postural-perceptual dizziness: a functional neuro-otologic disorder

Persistent postural-perceptual dizziness (PPPD) is a neuro-otological disorder that is the most common cause of chronic vestibular syndrome. It is not a purely structural or psychiatric disease but a functional disorder. The authors reviewed the literature to summarise the diagnostic...

Benefits of combined antiviral and corticosteroid therapy in Bell’s palsy and the role of decompression surgery

Early use of steroids has been established as standard management in Bell’s palsy but simultaneous use of antiviral agents has variable acceptance. This review article analyses statistically based evidence to settle the issue. High quality evidence from a 2009 Cochrane...

Military noise induced hearing loss and the Lost Voices report: the evolution of earshot

Brigadier Robin Garnett gives us a snapshot of the 2014 Royal British Legion report on hearing problems of Service personnel and veterans. The difficulties in assessing and managing hearing loss are reiterated in this article, with an introduction to how...

Rhinology: what does the future hold?

David Kennedy surveys the past, the present and the future of rhinology practice and research. An evolution of understanding in rhinology The dramatic growth of clinical and translational research within the field of rhinology in recent years is illustrated by...

Active middle ear implants and bone-anchored hearing systems

The implantable hearing device market has grown significantly over recent years. But as conventional hearing aids improve and cochlear implant candidacy widens, what is the role for active middle ear implants and bone anchored hearing systems, and how should we...

A Treatise on Otosclerosis and its Treatment

Rinze Tange and I were co-authors for the otosclerosis chapters of both the seventh and eighth editions of Scott-Brown’s Otorhinolaryngology which he references in his book. It was particularly exciting therefore to receive this beautiful 363-page treatise on all that...

Is endoscopic approach more precise in addressing failed ventilation system in chronic mucosal ear disease?

Chronic mucosal disease, as opposed to cholesteatoma, is more directly related to failure of the ventilation system involving three channels. Isthmus anticus and isthmus posticus are channels in front and behind the long process of the incus and there is...