Management of metastatic neck disease

This article publishes the findings of a recent expert-led evidence based management symposium in the UK with recommendations according to the SIGN level of evidence and grading. The article neatly summarises the key points, and its clarity despite the complexity...

Cost effectiveness and vestibular schwannoma surgery

This is the first cost effectiveness modelling study looking at the three main treatment options for small to medium sized vestibular schwannomas. This study uses the widely accepted cost per quality adjusted life year (QALY) outcome measure to evaluate three...

Sham controlled trial: BPPV

I was drawn to this study and it proved an enlightening read; it also is a good example of where recommendations of a Cochrane review for long-term evidence of benefit have been acted upon! The study looked at the efficiency...

Cochlear implantation in elderly candidates and effect on quality of life

The authors aimed to assess the improvement in quality of life (QoL) of cochlear implant patients over 60 and its relation to audiometric benefits. An observational retrospective study was conducted on 26 individuals older than 60. The outcome was compared...

How can we assess children with complex needs?

In the early days of cochlear implantation, children with additional disorders were being excluded as poor candidates whereas today a large number of children with complex needs are being referred for cochlear implant assessment. However, the related problems include difficulties...

Sublingual immunotherapy

This paper reviews the recent European studies on sublingual immunotherapy (SLIT). SLIT is currently widely used in Europe and is gaining popularity in the United States. It is known that longer treatment is needed with SLIT compared with subcutaneous immunotherapy...

Endoscopic myringoplasty: a promising alternative to microscopic surgery

Endoscopes have revolutionised otitis media surgery in recent years and are increasingly used in the surgical management of cholesteatoma, sinus tympani pathology and facial nerve surgery. Despite this, the development of endoscopic myringoplasty and how this compares to its microscopic...

The sentinel lymph nodes revisited

The concept of sentinel lymph node sampling has been around for some time. However, its acceptability in routine head and neck practice has yet to be established. This article presents the authors’ experience in 10 patients with Merkel cell carcinoma...

Polydioxanone in septal reconstruction

Septal reconstruction is a challenging problem and is undertaken for functional or cosmetic reasons, or a combination of both. Either autologous cartilage, commonly auricular, or other alloplastic material can be used. The authors describe the use of a Polydioxanone (PDS)...

Techniques in Facial Plastic Surgery: Discussion and Debate part 2

This edition of this popular journal is dedicated to ‘panel discussion’ on some of the most common controversies associated with ‘bread and butter’ facial aesthetic procedures. The procedures included are relevant and the aspects discussed are of practical importance to...

Auditory processing in children with unilateral hearing loss

It is a common assumption that unilateral hearing loss (UHL) in children is of little consequence because appropriate development of speech and language can still occur with one normal hearing ear. Recent studies, however, suggest that there are significant differences...

Tinnitus in patients on therapy with PPI and in PPI non–users

Tinnitus is a chronic and debilitating condition and approximately 10% of the population is afflicted. A myriad of pharmacological treatments for tinnitus are available but only a few controlled studies have shown positive results. The relationship between proton pump inhibitors...