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From a dysphagia clinical trial to a multidisciplinary head and neck clinical pathway – the road to implementation
This paper describes the barriers and facilitators to establishing a structured and coordinated multidisciplinary care pathway for patients with head and neck cancer at a medical centre in the USA. The initiative was set in motion by the roll out...
A trial of house dust mite sublingual tablet in children with allergic rhinitis
The house dust mite (HDM) is one of the commonest causative agents in allergic rhinitis (AR), affecting patients across all demographics. Recently, sublingual immunotherapy (SLIT) has been shown in clinical trials and meta-analysis to be effective compared to placebo in...
The continued evolution of surgical techniques for bone anchored hearing devices
This paper is not the first, and is unlikely to be the last, to look at a variation on the current technique for inserting the percutaneous titanium bone-anchored component of a bone conduction hearing device. In less than a decade,...
Which graft is better for type 1 tympanoplasty in elderly patients?
Type 1 tympanoplasty is a procedure performed to repair tympanic membrane perforations, primarily to reduce otorrhoea. This may subsequently lead to improvement of hearing. The common graft materials used are temporalis fascia and cartilage from tragus or concha. The authors...
Peripheral nerve stimulation for chronic refractory pain
Peripheral nerve stimulation (PNS) plays an important role in treating chronic refractory pain syndromes that manifest in limited distributions and overlap with areas of neurologic innervation. The process is generally thought to capitalise on the inhibition and activation of pain-related...
Auditory deprivation and single-sided deafness
In cases of bilateral auditory deprivation, there is clear evidence of an inverse relationship between performance after cochlear implantation and the length of severe to profound deafness prior to implantation (i.e. the longer the deprivation the poorer the outcome on...
Is virtual reality the future of vestibular rehabilitation?
The use of virtual reality (VR) in vestibular rehabilitation is gaining some popularity but availability is hampered by cost. One VR system in use in some centres is the Hybrid VR unit which incorporates motion trackers and force platforms. This...
Management of frontal sinus fractures
Frontal sinus fractures are uncommon (associated with around 5-15% of facial fractures). The authors divide frontal sinus fractures into isolated anterior table fractures, fractures involving the frontal sinus outflow tract and posterior table fractures, discuss some of the recent relevant...
How to train adults with single-sided deafness and cochlear implants
Cochlear implantation (CI) in patients with single-sided deafness (SSD) has been carried out in Perth, Australia from 2008. It poses challenges to clinicians and patients who are trying to tune in the poorer ear while still having a normally hearing...
The debate: endoscopic vs microscopic ear surgery – meta-analysis of outcomes
Although the endoscopic approach to ear surgery has become more common in clinical practice, the debate about its role versus the traditional microscopic approach continues in many ENT units. This meta-analysis from the Mount Sinai ENT department in New York...
Stapedotomy in osteogenesis imperfecta
Osteogenesis imperfecta (OI) is a rare connective tissue disease caused by a defect in collagen structure. Hearing loss is a characteristic feature of OI. It typically presents with conductive hearing loss initially, followed by a superimposed sensorineural component later in...
