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Voice therapy is an effective treatment for presbyphonia

The quality of an individual’s voice often declines with age. This deterioration occurs firstly as a result of vocal fold atrophy secondary to histologic alteration of the vocal fold mucosa as well as atrophy of the laryngeal musculature. Phonatory efficiency...

Darn it! It’s going to take longer to get good at stapes surgery!

Traditionally, it has been said the learning curve for a particular operation lies between 20 and 30 cases. In stapedotomy, a surgeon is deemed successful and perhaps competent if closure of the air-bone gap (ABG) is reached to within 10dB...

Iatrogenic vocal fold paralysis – the time to recovery

Iatrogenic vocal fold paralysis can result from stretching, compression or complete transection of recurrent laryngeal or vagus nerves. These injuries are a significant source of concern for patients and clinicians alike. The question is how long should we wait for...

Can and should vestibular schwannoma surgery be carried out via the endoscopic transcanal approach?

The extent and scope of endoscopic ear surgery has rapidly progressed in recent years, and this paper, from one of the leading proponents of this technique, reports on the outcomes of a case series of patients who have had total...

Should we be doing earlier MRIs in sudden sensorineural hearing loss?

There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....

Biologicals for severe chronic rhinosinusitis with nasal polyps. Any use?

Recent advances and knowledge of inflammatory endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP) led to introduction of biological agents such as monoclonal antibodies targeting IgE (omalizumab) and Interleukins (ILs) such as IL4R alpha (dupilumab) and IL5. The European Academy...

Clinical Practice Guideline on Tympanostomy Tube in Children Update (AAO-HNS)

The American Academy of Otolaryngology–Head and Neck Surgery Foundation’s ‘Clinical Practice Guideline: Tympanostomy Tubes in Children (Update)’ has been recently published - an update of the original 2013 guideline. This article forms an executive summary to accompany the full guideline....

Canal cholesteatoma

This is a retrospective study of patients with external auditory canal cholesteatoma (EACC) managed at a single tertiary centre from 1 January 2010 to 1 January 2021. Ninety patients (100 ears) were included. Mean age at diagnosis was 56+23 years....

Thyroid ultrasound elastography: does nodule stiffness predict malignancy?

Approximately 50% of the general population has a thyroid nodule while 5-15% of these are malignant [1]. A major challenge, therefore, is how to detect the malignant nodules for appropriate, timely treatment and avoid unnecessary, costly investigations for the remainder....

Less Than Full time Training in Otolaryngology

A recent Statement from the Association of Surgeons in Training (ASIT) stated that in 2011 there were 17 otolaryngology trainees in Less Than Full Time training (LTFT) [1]. Otolaryngologists in LTFT posts (17/151) is the largest group after general surgery...

Thyroid cancer – the last decade

Professor Ashok Shaha describes the evolution in the treatment of thyroid cancer that he has witnessed over the last decade and the invaluable progress made by himself and others, from their contributions to staging systems and guidelines. Nuances and paradigm...

Middle ear muscle disorders: presentation, diagnosis and management

Patients often report symptoms relating to disorders of the middle ear muscles. Prof Bance gives us an overview of the anatomy and function, as well as guides our diagnosis and management. The middle ear muscles (MEMs) are a mystery, both...