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The artificial eardrum: how an eggshell membrane fed a German ENT family

In the pre-antibiotic era, purulent otitis media often resulted in a permanent eardrum perforation with hearing loss. In addition to pig or fish bladders, eggshell membranes and cigarette paper were used as eardrum prostheses. I have vivid personal boyhood memories...

Diaphanoscopy of the paranasal sinuses (Halloween in ENT Practice)

Since time immemorial, humans have tried to enhance the limited capabilities of their sense organs. It would be a clear advantage to be able to see through objects and discern what lies inside or behind them! This concept of transillumination...

Audiovisual antics – now you see it, now you don’t

This series of stories is dedicated to those of you with whom some of these moments were shared (or endured) and, above all, to my amazing and long-suffering husband, David Howard. Most of you know him as an exceptional head...

Robotic surgery for squamous cell cancer: the new frontiers

Although the da Vinci platform was FDA approved for early-stage oropharyngeal cancers, the indications have expanded. In this article, John Hardman explains how surgeons, with greater understanding of the strengths and limitations of robotic surgery, have systematically set out to...

The basis of the bargain: outcomes not inputs

There are international drivers focusing our attention on measuring outcomes; Anthony Hogan looks at the data to see how we are currently measuring up. Introduction A global paradigm change is impacting on the provision of disability services. At its heart,...

Transnasal oesophagoscopy (TNO) and balloon dilatation under a local anaesthesia

Many of us are becoming more and more familiar with the use of transnasal oesophagoscopy. It has a number of well-described uses in the outpatient setting and is well tolerated by our patients. Yakubu Karagama describes taking this technique a...

Unanswered questions in adult ototoxicity associated with platinum-based chemotherapy

Do the potential side-effects on hearing and tinnitus need to be a ‘necessary evil’ of platinum-based chemotherapy? How strong is our evidence base when offering advice to patients and fellow clinicians? David Baguley and his team from the University of...

Octreotide in the medical management of chyle fistula post neck dissection

Chyle leak, although rare (1% and 2.5%), is a well-documented complication following surgical dissection of the neck. Although the left side of the neck is the most common site, chyle fistulas have been reported in the right side of the...

Vocal fold motion impairment following intubation – how likely is it to recover?

Ed’s Choice reviews a timely paper investigating prolonged intubation on vocal fold motion. The current scientific literature is dominated by studies examining COVID-19 and its widespread effects on health and healthcare delivery but will be old news by the time...

Dizziness in OSA patients– is there a link and can CPAP treat it?

This is a small study which proposes an interesting hypothesis - that in patients with both dizziness and OSA, treatment of their sleep disorder can provide resolution of their dizziness symptoms, which were otherwise refractory to standard treatment, particularly in...

Narrow band imaging in the management of carcinoma of unknown primary

This was a retrospective study to assess the utility of narrow band imaging (NBI) in the detection of a primary site in carcinoma of unknown primary (CUP). Patients with CUP who underwent transoral robotic surgery (TORS) and preoperative imaging with...

Well drilling vs. subperiosteal pocket for cochlear implants – comparison of operative time, complications and cost-effectiveness

The choice of method for securing the receiver/stimulator (R/S) package during cochlear implant surgery is usually dependant on several factors, but primarily surgeon preference. The initial recommendation from manufacturers was to drill a bony well (WD technique) and use bony...