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Endoscopic excision of cholesteatoma
In this article Vikranth Visvanathan describes an exciting development on the use of endoscopic technology in complex otological practice. Transcanal endoscopic ear surgery (TEES) is rapidly evolving as a recognised method of addressing middle ear and mastoid pathology. Since its...
Should patients with dysphagia be allowed water freely?
Patients with dysphagia often experience dehydration as a consequence of “nil by mouth” or having to consume thickened fluids due to aspiration of thin fluids. However, not all incidents of aspiration develop into an infection. Factors that contribute to aspiration...
Do you use the evidence or do you just know to do that?
In this day and age we generally consider healthcare practice to be evidence-based. Unfortunately there are not always the plethora of research articles available that address the dilemmas of day-to-day clinical practice. This piece of work considers what factors influence...
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...
Evidence based guidelines for ONS treatment in occipital neuralgia
Occipital neuralgia (ON) can flummox otolaryngologists especially when it follows mastoid surgery. The paroxysms of sharp, electrical pain originating from the occiput can extend along the posterior aspect of the scalp and even up to the mastoid. Although the aetiology...
Prominauris: Which surgical technique to use?
Otoplasty accounted for 3.2% of all plastic surgical interventions, and 2.6% worldwide in 2015. Patient satisfaction ranges above 95% for prominent ear correction despite the myriad of available techniques in the literature associated with highly variable outcomes. The authors split...
Fungal rhinosinusitis
Allergic fungal rhinosinusitis (AFRS) has been defined by the following characteristics: presence of nasal discharge, nasal obstruction, decreased sense of smell or facial pressure for 12 weeks, mucin within the sinus cavity containing fungal hyphae and degranulating eosinophils, endoscopic evidence...
Cochlear implantation in children with congenital long QT syndrome
Jervell and Lange-Neilsen syndrome is a condition where sensorineural deafness coincides with inherited abnormalities of the heart, resulting in prolonged ventricular repolarisation, frequently shown on an ECG with a prolonged QT interval. These children can present at implant centres for...
Diagnosis and management of acute sensorineural hearing loss: a Japanese perspective
In this paper, the authors set out the clinical guidelines to standardise diagnosis and treatment of acute sensorineural hearing loss in Japan. They categorised acute sensorineural hearing loss into five disorders: idiopathic sudden sensorineural hearing loss (iSSNHL), acute low-tone sensorineural...
Management of patulous eustachian tube dysfunction
Idiopathic sudden sensorineural hearing loss (iSSNHL) is defined as a hearing loss of 30 dB or more at three contiguous frequencies within 72 hours, with acute low-tone hearing loss (ALHL) excluded from this category. Despite standard treatment, outcomes vary: one-third...
