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Ossicular reconstruction

Ossicular reconstruction often yields disappointing results, even for the most experienced and skilled of otologists. John Dornhoffer and David Walker explain that the most important determinant of outcome is the patient’s middle ear environment, and offer some valuable words of...

Voice after posterior cordotomy: we think voice is bad, patients think it’s better!

Bilateral vocal fold immobility (BVFI) is a condition that can affect voice with an impact on quality of life (QOL). Surgical trauma from damage to bilateral recurrent laryngeal nerves, such as from previous thyroid, parathyroid, or mediastinal surgery are common...

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....

Evidence-based practice: management of sudden sensorineural hearing loss

What is the current evidence for medical management of sudden sensorineural hearing loss? Jessica Choong and Stephen O’Leary present a review of the current evidence of treatments options. Sudden sensorineural hearing loss (SSNHL) causes significant distress and, in many cases,...

ICG in ENT surgery

The use of fluorescence imaging is well established in the medical sphere, forming an essential arm of medical diagnostics with liver function, ophthalmic angiography, and assessment in cell biology with fluorescence microscopy. Fluorescence imaging in surgery, however, is an evolving...

Inter-professional teamwork and hearing care for older adults with cognitive loss

There is growing awareness that hearing loss is linked to dementia [1]. The average first-time hearing aid user is about 70 years old. By this age, approximately 1 in 2 people have hearing loss and 1 in 7 have cognitive...

Advancing the tongue in OSA surgery

This article further delineates the options for hypopharyngeal OSA and describes the technique of genioglossus advancement to improve the tension in the tongue base. The authors take the reader through the relevant anatomy appropriate to the procedure and describe the...

The right to choose: the how-to of practicable supports

Providing all practicable supports to enable a person to participate in decision-making is one of the five key principles of the English and Welsh Mental Capacity Act 2005. This article (set in the Canadian legal framework, which has many similarities...

Sugammadex

Scott Russell is an anaesthetist with an almost unrivalled experience of complex head and neck surgery, and has seen all manner of new ideas come and go. However, in this article he describes a new pharmaceutical agent that is already...

Hearing loss and cognition: something to think about

Irace, Chern and Golub propose causal and non-causal mechanisms for the links between hearing loss and dementia, concluding with a discussion of several proactive measures available to help preserve neurocognitive health in older adults with hearing loss. What is age-related...

Direct intratemporal facial nerve to hypoglossal nerve coaptation for facial reanimation

The hypoglossal nerve is a common axonal source for dynamic facial nerve rehabilitation. In its regular and modified forms of splitting the nerve it is associated with tongue hemiatrophy, speech and swallow dysfunction, facial movement and hyper contracture. This case...

Acute ENT activity in a teaching hospital

This Belgian prospective audit attempted to provide justification for the provision of a 24-hour emergency service at a large 1038-bed teaching hospital (with 31 ENT consultants). The authors looked at a one-month period during which 190 patients were admitted. They...