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The challenge of disrupting the hearing care market in the USA

Barry Freeman, an Audiology Consultant of extensive global experience, examines the business model of hearing care service delivery in America. He discusses the challenges the profession has faced, and proposes some food for thought on learning from other health care...

In conversation with Miss Sujata De: Chair of the ESPO 2023 Local Programme Committee

Su De is one of the UK’s most prominent paediatric ORL surgeons, and has a leading role in planning ESPO 2023. Hannah Emerson caught up with Su recently to explore some of her thoughts and her plans for ESPO. You’ve...

A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth

It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...

Transmastoid facial nerve decompression for persistent traumatic facial nerve paralysis

Facial nerve paralysis (FNP) can occur following trauma, with a small number of these patients requiring facial nerve decompression (FND) to aid recovery. The authors shared their experience in decompressing the facial nerve for persistent severe FNP via a transmastoid...

The medially-invasive cholesteatoma: a case series

In this small case series, Casazza et al describe their management of seven cases of complex cholesteatoma presenting during a 16-year period. Patients were included if imaging confirmed restricted diffusion and an endophytic, medially-destructive disease involving the otic capsule, petrous...

The Graham Fraser Foundation

Graham Fraser (1936-94) was a pioneering otolaryngologist, in whose memory the Graham Fraser Foundation was set up, and an eponymous annual lecture and a travelling fellowship in otology were established. It’s an honour to profile the Foundation in this extended...

The outer ear in the visual arts

The ear is an exceptional organ, and quite rightly takes its place in the visual arts, as described by Albert Mudry, who takes us on a whistle-stop tour of the appearance of the ear and its depictions in art throughout...

Endoscopic CSF leak repair using nasoseptal flap

Many of us during training or in established practice will have encountered the complication of anterior skull base CSF leak. This can be a challenging problem to deal with and in this article the authors describe their favoured approach. Cerebrospinal...

Clinical value of 3 T magnetic resonance imaging after intratympanic gadolinium injection in cases of delayed endolymphatic hydrops

Recurrent vertigo can continue after severe unilateral or bilateral hearing loss. This is a condition similar to Ménière’s disease, the diagnosis of which can be difficult. In this study intratympanic injection of gadolinium-diethylenetriamine penta-acetic acid dimeglumine was done in 25...

Armageddon and surgical outcomes

In the excitement of the festive season I am sure many of you will have omitted to commemorate the 60th anniversary of a highly significant world event. According to a small apocalyptic cult led by a Chicago housewife named Dorothy...

Do endonasal approaches for meningiomas have more CSF leaks?

Rarely, patients presenting to the ENT surgeon with anosmia may have an anterior skull base neoplasm such as a meningioma. Historically, the traditional approaches have focused on several transcranial, external routes, including the pterional craniotomy, and the subfrontal craniotomy. The...

Endoscopic Transnasal Anatomy of the Skull Base and Adjacent Areas

This book is a well-designed colour atlas of sinus surgery which is up to date with all the modern techniques used in endoscopic sinus surgery. The multiple authors include well-established and renowned surgeons. It is divided into distinct chapters, with...