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What is the evidence for contralateral tonsillectomy in TORS for known unilateral tonsil malignancy?
The concept of field changes by carcinogens within the upper aerodigestive tract is well established with reported rates of synchronous tumours of 4% and second primaries of 36%. The tonsil in particular has the highest rate of synchronous tumours, postulated...
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...
Age and the SSCC
This is a radioanatomical study on the CT scans of 385 temporal bones to measure some parameters of the superior semicircular canals (SCCC) including bony thickness, diameter and projection into the middle cranial fossa. All measurements were performed on a...
Method of delivery: all topical nasal corticosteroids are not made equal
There is an increasing body of evidence that the role of surgery for chronic rhinosinusitis is to facilitate the delivery of topical medical treatment – most notably, topical corticosteroids. Two recent studies, one using flow dynamics and another one examining...
Rhinotillexomania - how bad can nose picking get?
This is a fascinating first case report of rhinotillexomania associated with empty nose syndrome (ENS). Rhinotillexomania encompasses compulsive, pathological nose picking and is a variant of self-harm. Tranchito and Chhabra describe an elderly patient presenting with longstanding symptoms of nasal...
Compress to suppress the venous tinnitus
This interesting retrospective case series analyses the effectiveness of a modified surgical technique with retromastoid reconstruction of the sigmoid sinus by mechanical compression with Surgicel and bone wax packing under local anaesthesia for patients with venous pulsatile tinnitus related to...
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...
Diagnostic features of acute invasive fungal sinusitis
Acute invasive fungal sinusitis (AIFS) is a rare but frequently lethal condition, commonly associated with a high morbidity among those that survive. It has gained recent media attention on account of its increased incidence following infection with (and treatment for)...
Gadolinium enhanced MRI and the diagnosis of Ménière’s disease
Despite various criteria applied over the years to diagnose Ménière’s disease since the concept of endolymphatic hydrops was first observed in postmortem examinations of patients in 1938, the diagnosis still remains mainly clinical. To visualise endolymphatic hydrops in MRI imaging,...
Parapharyngeal space tumours – is the transoral approach effective?
Several approaches are described to the parapharyngeal space to permit resection of tumours in this region, with the most commonly employed approach being the transcervical route. The transoral approach remains somewhat controversial as it is felt that this approach can...
Choosing instrumental assessments of swallowing for children
Swallowing disorders in children are increasingly common due to advances in medical care allowing them to survive prematurity or complex health conditions. Careful assessment of eating and drinking is necessary to ensure that children are managed both safely and with...
