Subtypes of vestibular migraine

The authors argue that the current Barany criteria (ICVD) for vestibular migraine (definite and probable – dVM and pVM) are too restrictive. For instance, whereas a category of chronic migraine with or without aura is recognised in ICHD-3, ‘chronic VM’...

Temporal bone drilling using artificial versus cadaveric specimens - does the specimen precipitate altered drilling techniques?

Hochman et al set an ambitious goal in their study analysing drilling strokes of eight otolaryngology residents (junior: PGY 1-3; senior: PGY 4-5) during temporal bone (TB) drilling practice using cadaveric and artificial specimens. Each trainee dissected one cadaveric and...

A twitch in time with a flicker of knowledge

The middle ear muscles can be seen as one of the ear’s safety mechanisms, and the interplay between eyes and ears has been established; think vestibular ocular reflex (VOR) or semi-circular canal dehiscence (SCCD). But can this protective mechanism be...

Pulsatile tinnitus, one more piece in the jigsaw

Pulsatile tinnitus (PT) is a common ENT symptom. It can generally be divided into venous and arterial. Arterial PT might be investigated with a CT scan while a venous one with an MRI or an MRV (MRI Venogram). Anecdotally, arachnoid...

Electrocochleography and speech-perception in cochlear implant (CI) patients

It is difficult to predict the speech perception outcomes of cochlear implantation. Previous studies showed that total response electrocochleography (ECochG-TR) may explain the variance in CI performance better than biographic, audiometric, and surgical factors combined. The authors’ objectives were to...

Vascular vertigo and dizziness: diagnostic criteria

This diagnostic criteria is one of the latest produced by The Bárány Society. It is a useful addition to previous ones for vestibular disorders. Vascular vertigo/dizziness by definition is caused by stroke, transient ischaemic attack (TIA), isolated labyrinthine infarction/haemorrhage and...

Impact of COVID-19 on ear surgeries

The authors review the impact of the coronavirus pandemic on the practice of ear surgeries in this article. The pandemic has changed how we practise medicine and introduced new guidelines to ensure safety of healthcare personnel. Studies have demonstrated COVID-19...

Ramifications of the pandemic on acute paediatric mastoiditis: a national UK audit

Acute mastoiditis is a common presentation in the paediatric population across ENT services worldwide. An initial expectation of a rise in the numbers of acute mastoiditis associated with the initial findings of SARS-CoV-2 (COVID-19) virus presence in middle ear in...

International consensus paper on implantable devices for conductive or mixed loss

This is a weighty but insightful ‘Special Feature’ paper in the June edition of Otology and Neurotology. It has the broad aim to gather current opinion from otologists, audiologists, manufacturers and health-economists from around the world on unilateral hearing implantation...

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...

Corticosteroid prescribing in ENT - are we at risk of being sued?

Of medications leading to malpractice claims, corticosteroids comprise the third most common. They are used widely and have a significant side-effect profile: hypertension, lipodystrophy, diabetes, avascular necrosis of the femoral head, peptic ulceration and psychiatric reactions to name but a...

Cochlear implants in the over 80s

The UK has an ageing population. Seven percent of the over 80s population have bilateral severe to profound hearing loss which can lead to associated negative outcomes (social isolation, depression and reduced quality of life). Cochlear implantation (CI) can successfully...