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Demystifying laryngology in the era of examination and collaboration

In the field of laryngology, perhaps more than in any other area of ENT, there has been a philosophical shift (as well as a technological one) in the approach of clinicians caring for patients. Albert Merati explains. Progress in laryngology...

Treating voice disorders in singers

There are few ENT surgeons who have as much insight into singers’ problems as Nick Gibbins. A good knowledge of working patterns, repertoire and the physiology of ‘vocal athletes’ is essential. He shares a few thoughts with us. When deciding...

Successful laser treatment of a laryngeal cause of dizziness

Dizziness is often considered to be a condition that is best managed by physicians or otologists. This case report describes an unusual cause of presyncope successfully treated by a laryngologist. The patient in question was a 45-year-old member of the...

Indication and timing of electrodiagnostic tests in facial palsy

This excellent review describes the benefits and limitations of electrodiagnostic testing for patients with facial paralysis. Tests such as Schirmer, stapedial reflex and electrogustometry have been largely replaced by neurophysiologic tests like nerve excitability test (NET), electroneuronography (ENoG), surface electromyography...

Tympanometry with cochlear implants

Multifrequency and multicomponent tympanometry enables evaluation of minute changes in the middle ear system as well as changes in resonant frequency. Change in resonant frequency would indicate a change in the natural characteristics of the middle ear, such as mass...

Alcohol and the vestibulo-ocular reflex (VOR)

I was drawn to this paper initially for slightly unscientific reasons but in fact it proved a worthwhile read. It describes the effect of alcohol consumption on the VOR of eight healthy subjects as measured using video head impulse testing...

Fifteen years of vestibular implant research in humans

Implants: it’s all in the balance! Prof Guyot and his team give us an update on their research in addressing bilateral vestibular deficits via an implant. Doctors are often unaware that people, even young, may lose vestibular function on both...

Alternobaric vertigo: asymmetrical vestibular function due to asymmetrical middle ear pressures (Iron Man’s archenemy)

The Marvel Cinematic Universe could certainly be deemed an ‘extreme environment’ and yet very rarely do we see the Avenger’s popping to the clinic for a check-up. Hee-Young Kim has wondered how they cope with extreme pressure changes and discusses...

aVOR – An Educational Tool

As anyone who has tried to learn the anatomy and physiology of the vestibular system can attest, understanding and visualising the structures and their functions can be quite challenging. Thankfully, there is now a free app called aVOR (iOS, iTunes...

Do personal listening devices cause cochlear synaptopathy?

Cochlear synaptopathy is a condition in which noise interrupts the synaptic communication between sensory inner hair cells and low spontaneous rate cochlear nerve fibres. Since these nerve fibres are associated with signal coding in noisy backgrounds, their disruption leads to...

Can laryngeal sensitivity testing predict aspiration and pneumonia in dysphagic patients?

The laryngeal adductor reflex (LAR) is characterised by brief vocal cord closure in response to laryngeal stimulation. It is important in swallowing physiology as it represents a mechanism for airway protection. The authors of this study examined whether the absence...

The making of a paediatric airway surgeon: In conversation with David Albert

Michael Kuo interviews David Albert to find out what drew him to paediatric airway surgery, the mentors who shaped his surgical approach, and to ask his advice for budding young paediatric airway surgeons. David Albert. When did you first get...