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Minimum stimulus strategy for the diagnosis of BPPV

Explore the innovative minimum stimulus strategy (MSS) for diagnosing benign paroxysmal positional vertigo (BPPV), enhancing accuracy while minimising patient discomfort. Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder where canalolithiasis or cupulolithiasis causes sudden episodes of vertigo, triggered...

Prolactinomas: when to operate

Prolactinomas are the most common functional pituitary adenomas, comprising 40% of all pituitary adenomas. There are consensus guidelines and several common management pathways. This article discusses the role of surgery for these patients. Following diagnosis, the goals of treatment are...

Balance and vestibular disorders in children

Discover the world of paediatric vestibular assessment and management from the team at Alder Hey Children’s Hospital, which is revolutionising services in this field. Dizziness and balance problems generate significant morbidity in children of all age groups. Vestibular disorders are...

The role of the maxillo-facial surgeon in the management of skull base malignancy

Whilst ablative surgery remains the principal treatment option for head and neck malignancy, the skull base is the last frontier. The complex anatomy, supreme functionality of the brain, and varied pathology provokes many a detailed discussion in the multidisciplinary team...

Reactive lesions of the contralateral vocal cord – excise or leave?

It is well recognised that benign lesions of one vocal cord can give rise to reactive lesions of the contralateral vocal cord directly opposite to the primary lesion. These contralateral reactive lesions (CRLs) are thought to arise due to impact...

Bones, stones and surgical moans: rethinking PTH dynamics in parathyroid surgery

Intraoperative parathyroid hormone (IOPTH) testing has revolutionised minimally invasive unilateral parathyroidectomy (MIP) as the gold standard treatment for primary hyperparathyroidism, replacing old-timey four-gland exploration. IOPTH testing ensures reliable excision of all hypersecreting glands, including those pesky hard-to-find ones, without relying...

Retrieval of an aspirated voice prosthesis in the awake laryngectomised patient

In this article, the authors describe a simple and effective technique for extracting an aspirated voice prosthesis from within the tracheobronchial tree in the awake laryngectomised patient using the Ambu® aScopeTM 4 Broncho endoscope. Surgical voice restoration remains the dominant...

CT and intraoperative nerve monitoring to identify non-recurrent laryngeal nerve during thyroid surgery

A non-recurrent laryngeal nerve (NRLN) is a rare (incidence 0.3% to 1.3%) anatomical variant that results in a higher rate of vocal cord palsy following thyroid surgery. This team from China examined the utility of preoperative CT and intraoperative nerve...

Identifying congenital CMV: the screening debate

Congenital cytomegalovirus (cCMV) is a significant global public health burden and is the biggest non-genetic cause of childhood hearing loss, as well as being an important cause of neurodevelopmental delay. Despite a study concluding that there was not enough evidence...

Evidence based practice in paediatric audiology

Audiology, like most of the health sciences professions, has been working on integrating evidence-based practice principles since the mid-1990s [1]. Professional organisations and regulatory colleges have produced evidence-based clinical practice guidelines, disseminated them to audiologists and collaborated with practitioners to...

Hunting for the zorse - hybrid learning in the wake of the COVID-19 pandemic

Emma Watts, a West Midlands ENT Registrar and Digital Fellow, gives a witty and concise recollection of ENT training during COVID, and predicts how hybrid learning may be here to stay. *A zorse is the offspring of a zebra stallion...

How trainees can make major contributions to practice

At a time when many of our trainees feel poorly supported and disheartened, the formation of a National ENT Trainee Research Network (Integrate) has been a major advance, enabling them to develop and execute research projects directly relevant to clinical...