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Intraoperative nerve monitoring: 2017

Having written the definitive text on laryngeal nerves, Gregory Randolph and Dipti Kamani describe the benefits of intraoperative neural monitoring and, importantly, how to proceed if the nerve is pathologically involved or there is loss of signal. Over the years,...

Using tele-audiology in Zambia’s ear and hearing care desert

Addressing the medical desert with tele-audiology and tele-education. If a ‘medical desert’ is defined as a community that lives more than 60 miles away from the nearest acute care hospital, then try to imagine an appropriate term for a situation...

Differing outcomes of three Sub-Saharan Africa journeys with the common goal of task sharing in audiology

Task sharing can be designed and implemented specific to the needs of each programme. Foundational principles of global health include developing local leadership as a means to successful sustainable service provision in low- and middle-income countries (LMIC) or regions. It...

Supporting music listening through cochlear implant services – experience from a UK adult clinic on supporting musical engagement

The perception and enjoyment of music is central to many people’s lives. Harriet Crook (herself a cochlear implant recipient) tells us about important work in this area for people using hearing aids and CIs. There is now a wealth of...

Reducing hierarchy for individuals and teams across ENT

Alexander Pope said that “to err is human”, but medical errors can have serious consequences. How can better communication minimise the risk of them occurring in the first place? Allowing all members of the surgical team to feel empowered to...

Intratympanic steroids in Ménière's disease: what’s the evidence?

The days of drastic surgery for Ménière's disease are long gone. We know that intratympanic injections can deliver high doses of medication to the inner ear with minimal discomfort and minimal risk. But how do we choose from the myriad...

Old age is hard to swallow

This article takes us through the diagnosis and management of swallowing problems common in older age. As our global population continues to grow and live longer, dysphagia will continue to be a global problem which needs to be recognised, understood...

Endotypes in chronic rhinosinusitis: clinical relevance

Identifying endotypes enables personalised therapies that target specific pathophysiological processes, potentially resulting in better treatment outcomes for patients. The contemporary model of chronic rhinosinusitis (CRS) pathogenesis revolving around endotype, in combination with an expanding toolbox of diagnostics and therapeutics, enables...

The challenges in the risk stratification of thyroid nodules and cancers: the role of molecular testing

Around the world, molecular testing is becoming more widely used to personalise the management of thyroid nodules. Thyroid nodules are relatively common. They are palpable in ~5% of the population, while high-resolution ultrasound (US) incidentally finds them in 19–68% of...

Three is not a crowd! Involving family members in audiology appointments

Family members currently have minimal involvement in the appointment. Image by Caitlin Grenness. Hearing loss in older adults not only affects the patients themselves, but also their family members. This article outlines the findings of recent research into how family...

Clinical utility and practical interpretation of the video head impulse test

The head impulse test (HIT) is an essential bedside test to detect peripheral vestibular deficits. The video head impulse test (vHIT) is a new tool quantifying the HIT. In this article Maria Heuberger and colleagues point out the clinical utility...

Hidden hearing loss in humans: cochlear synaptopathy is superseded by cognitive effects when listening to speech in noise

Elizabeth Beach presents an overview of the recent research being undertaken at the National Acoustic Laboratories on speech in noise and its relationship to cochlear synaptopathy. Our team at the National Acoustic Laboratories (NAL) has been investigating hidden hearing loss...