Journal Reviews
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...
Patients with auto-immune Meniere’s disease more likely to respond to intratympanic steroids
The authors retrospectively reviewed the duration of symptom control after intratympanic dexamethasone (IT) injections in 27 patients with Meniere’s disease (MD) over a six-year period. The patients received two IT injections of 3.3mg/ml of dexamethasone one-to-two weeks apart. Eleven patients...
Hearing outcomes after mastoid obliteration tympanoplasty
In this study, the authors retrospectively compare hearing outcomes after mastoid obliteration to non-obliterative techniques in cholesteatoma surgery. They have performed canal wall up with mastoid obliteration (bony obliteration tympanoplasty or BOT) since 2013. The procedure has replaced canal wall...
Early results of the Cochlear Osia (active transcutaneous bone-conduction implant) in teenagers
This funded research trial involving 14 adolescents, aged 10 to 17 years, in the Toronto Hospital for Sick Kids was carried out just prior to the new Osia implant obtaining FDA approval for use in the USA. The majority had...
Does vestibular rehabilitation help patients with vestibular migraine? Is this also true if these patients have had a traumatic brain injury?
Vestibular migraine (VM) is a common diagnosis in ENT, and there is growing evidence that vestibular rehabilitation therapy (VRT) is an effective treatment, reducing self-perceived dizziness and improving gait. This is a retrospective review of the outcomes of 93 patients...
Unravelling the Meniere’s vs. migraine conundrum – what does the mastoid contribute?
This is an interesting observational study that attempts to classify subtypes of Meniere’s disease (MD) in relation to the coexistence of migraine. It is well known that the two conditions share common characteristics, making diagnosis and treatment challenging at times....
Treatment options for vestibular neuritis: systematic review and meta-analysis
Vestibular neuritis (VN) is the third most common cause of peripheral vertigo. VN has been postulated to have viral aetiology and historically it was treated with steroids, until 2011 when a Cochrane review demonstrated lack of robust evidence behind this...
Persistent imbalance after traumatic brain injury is central in origin
Several residual symptoms, including dizziness and imbalance, can follow traumatic brain injury, no matter how mild. This study focused on the mechanisms, peripheral and central, underlying the complaint of persistent imbalance in patients with chronic mild traumatic brain injury (mTBI)....
Pulse synchronous tinnitus
This article reviews the most common neurosurgical causes of pulse synchronous tinnitus. Traditionally, tinnitus has been characterised as subjective vs. objective, or vascular vs. nonvascular. The authors observe that, in some cases, pulsatile tinnitus (PT) is not heard by examiners...
Continuous Ambulatory Vestibular Assessment (CAVA)
This article presents initial test findings using a novel system called CAVA - Continuous Ambulatory Vestibular Assessment. Akin to the 24-hour ECG tape to identify cardiac arrhythmias, this system aims to continuously monitor the presence of a nystagmus pattern in...
Non-autologous graft material in paediatric tympanoplasty – is it as good as temporalis fascia and is it cost-effective?
This retrospective case review looks at the experience of a single unit using a variety of autologous (temporalis fascia, n=292) and non-autologous graft material, n=241 (alloderm (human dermis), biodesign (porcine submucosa, $170-$255) and tutoplast (human pericardium, $350). The average patient...
