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A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth

It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...

Does cholesteatoma surgery affect school performance?

While much focus has been placed on short-term complications associated with cholesteatoma, a lack of knowledge remains about the impact suffering from cholesteatoma in childhood may have on educational outcome. The aim of the study was to investigate whether suffering...

Myringoplasty in a bottle?

Management of large traumatic TM perforations can involve observation and water precautions or surgical repair. Closure rates for larger perforations can be 8-12 weeks and occurs for between 38-79%. Animal and human studies have shown that exogenous application of epidermal...

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...

Diagnostic performance of non-echo-planar diffusion weighted MRI in detection of suspected cholesteatoma

Even though a ‘second look’ remains a gold standard for detection of residual cholesteatoma after intact canal wall techniques, non-echo-planar diffusion weighted MRI is considered a reasonable alternative to avoid further surgery. However, to establish or exclude a cholesteatoma de...

Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture

Placement of voice prosthesis at the time of trachea-oesophageal puncture is well described using 20-French prostheses. There is debate about the optimal size of the prosthesis with work in the 1980s and 1990s supporting larger prostheses. The rationale was that...

Hyperbaric oxygen for sudden onset sensorineural hearing loss

Idiopathic sudden onset sensorineural hearing loss (SSNHL) is a relatively common presentation to the ENT emergency department, and can have profound effects on patients’ lives. This retrospective study looked at 15 patients who were treated with hyperbaric oxygen after failure...

Beware of GPA as a cause of subglottic stenosis

Up to 92% of patients with granulomatosis with polyangiitis (GPA) have concurrent ENT manifestations of the disease. Whilst we are familiar with sinonasal and middle ear presentations of GPA, subglottic stenosis (SGS) is another important and potentially life threatening manifestation....

Communication patterns during audiological rehabilitation history taking

Nature of communication among patients, their communication partners and hearing healthcare professionals is an important part of audiological rehabilitation and can have some influence on the patient outcome. As history taking quite often forms the first instance of communication between...

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...

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...

Which cross-over frequency is best for electro-acoustic stimulation?

Advances in technology and improved soft surgical techniques have led to individuals with better hearing thresholds, especially at the low frequencies, becoming candidates for cochlear implants (CI). Surgeons are more confident that residual hearing can be preserved thus making those...