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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...

The fatal illness of Frederick the Noble

Sir Morell Mackenzie is acknowledged as the ‘Father of British Otolaryngology’. He was the leading throat specialist of his time and one of the founders of the Journal of Laryngology and Otology in 1887. He studied in Paris, Vienna and...

The use of a tactical throat mic guitar amp system to improve communication in theatre in the COVID era

During the COVID-19 (SARS-CoV2) pandemic, current guidelines dictate that surgical teams wear appropriate personal protective equipment (PPE) in theatre. Currently this is, at a minimum, an FFP3 respirator, a visor, fluid repellent gown and gloves [1]. Many surgeons, particularly in...

The ups and downs of overseas research – the inner ear at altitude

Conducting research at extreme altitude presents unique challenges. This study of the inner ear at 5350m navigates setbacks in a quest for scientific discovery. Having completed a diploma in mountain medicine in my foundation years, I decided to undertake a...

OTC hearing aids: where are we now?

The ‘Over-the-Counter Hearing Aid Act’ of 2017 set in motion plans for a long-debated shift in the hearing care market. In 2021, the FDA released draft guidance which will allow hearing aids in the US to be sold direct to...

Superior semicircular canal dehiscence: transmastoid obliteration

Sometimes patients with dizziness turn out to have slightly more unusual causes of their problem. Thomas Milner and Georgios Kontorinis describe their technique for managing patients who have a diagnosis of superior canal dehiscence as an identified cause of their...

Evidence for balloon eustachian tuboplasty

Balloon eustachian tuboplasty is an emerging intervention aimed at the management of eustachian tube dysfunction (ETD) and its sequelae. The authors acknowledge that ETD is a common but frequently ill-defined problem, with no well-established direct treatment. They performed a systematic...

Consequences of tonsillectomy rationing?

This article examines Hospital Episode Statistics and Office for National Statistics data to investigate the change in rates of tonsillectomy and admissions for tonsillitis and its complications, over a 20-year period. Between 1991 and 2011, 44% fewer tonsillectomies were performed....

It is all so COSI…

Something which we have realised for a long time in the UK is the importance of the clinician in the assessment and long-term adoption of hearing aids. This common sense article outlines the need for more individualised patient pathways, thinking...

Virtual educational outreach in the COVID-19 era

Existing surgical outreach programmes to developing countries have been severely curtailed by the COVID-19 pandemic. This has impacted on opportunities for otolaryngologists from the USA and from other developed countries to contribute to education and training of otolaryngologists in developing...

Cambodian Children Surgical Centre: a junior’s perspective

The Children’s Surgical Centre (CSC) is a Non-Governmental-Organisation (NGO) hospital situated in Phnom Penh, the capital of Cambodia. CSC was developed for landmine victims over 20 years ago by Dr Jim Gollogly after the dark period under the Pol Pot...

What do animal models tell us about tinnitus and hyperacusis?

Do animals have tinnitus? The obvious question to ask is: do animals have tinnitus? It is known that tinnitus is a conscious percept and as such affected by attention and not audible during sleep. For it to be demonstrated that...