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The effects of hormonal changes across menstrual cycle on high frequency auditory thresholds

Physiological changes during the menstrual cycle are well documented; do these changes extend to the auditory system? Lalsa Shilpa Perepa and Rewa Indurkar delve into the literature to find the evidence. Menstrual cycle refers to a series of changes that...

Anaesthesia for free-flap surgery

Adel Hutchinson is one of those calm and controlled anaesthetists for whom nothing seems too difficult. In this article, she describes the key perioperative factors for one of the highest complexity operations in ENT; free-flap surgery. It makes good reading...

Allergy – what’s in a name?

Allergy is defined as an “abnormal immune reaction to an ordinarily harmless substance” [1], however the meaning of the word has taken many forms since its introduction in 1906 by Austrian Paediatrician and Immunologist, Clemens von Pirquet [2]. Combining his...

Singing and COVID-19 – research on aerosols and singing

Early in the COVID-19 pandemic, clusters of disease occurred in choirs. This led to an assumption that singing was inherently ‘dangerous’ and governments around the world rapidly banned singing. The ban was then extended to...

Surgical approach to trigeminal neuralgia

This article provides a summary of the operative techniques available for treating patients with trigeminal neuralgia who have medication resistant pain or medication intolerance. Microvascular decompression is performed via suboccipital craniotomy to find and resolve the underlying nerve compression. The...

Transnasal endoscopic repair of CSF leaks

This Italian study was a retrospective review of 110 consecutive patients who underwent repair of their CSF leak via the transnasal endoscopic approach from 2003 to 2013. All surgery was performed by the same primary surgeon and patients with a...

Associated findings in MRI used for detecting acoustic neuroma

Presently, gadolinium enhanced magnetic resonance imaging is the ‘gold standard’ for investigating acoustic neuroma. There are often ‘incidental’ findings that may or may not be significant. In this study of 109 scans, the authors noted an uptake of 0.9% for...

The video head impulse test: an aid to the diagnosis of spinocerebellar ataxias

Spinocerebellar and Friedreich ataxias (SCA and FA) by their nature present in neuro-otology clinics. The diagnosis is ultimately genetic but the authors investigated the characteristics of the VOR using the video head impulse test (vHIT) in order to distinguish between...

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...

Facial reconstruction with polyethylene implants

Planning reconstructive surgery for complex craniofacial defects challenges even the most experienced of surgeons. In most cases surgery is undertaken to improve anatomical functioning. However the anatomical structure of these regions is also critical to facial aesthetics and patient satisfaction...

Gardasil vaccination – an effective adjuvant therapy for RRP?

The clinical manifestations of recurrent respiratory papillomatosis (RRP) can vary hugely from individual to individual. Whilst some affected children will outgrow the disease, a subset of patients will experience frequent recurrences and require multiple surgical procedures over the course of...

Lower respiratory involvement in allergic rhinitis and chronic sinusitis

The recent ARIA (Allergic Rhinitis and its Impact on Asthma) project has generated interest in simultaneous involvement of the lower respiratory airway in cases of chronic rhinosinusitis and allergic rhinitis. This study takes into account the extent of pulmonary function...