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The keystone island perforator flap – expanding the toolbox for aesthetic nasal reconstruction

The complexity of nasal reconstruction lies in its dual objective: restoring structural integrity while preserving subtle contours and symmetry that define facial aesthetics. This retrospective cohort study from a single centre in the United States evaluated the effectiveness of the...

Superior semicircular canal dehiscence syndrome

In this article, Hannah North and Simon Lloyd give us an overview of the complex condition of superior semicircular canal dehiscence (SSCD) syndrome, including diagnosis, treatment and management. Superior semicircular canal dehiscence (SSCD) is a bony defect of the otic...

When should that child’s wet ear be operated on?

The team from Birmingham have provided a meta-analysis to answer the question of when to perform a type 1 tympanoplasty on chronic paediatric perforations (under 18 year olds). Forty-five studies were included which resulted in 2609 cases. Closure rate at...

Lower respiratory involvement in allergic rhinitis and chronic sinusitis

The recent ARIA (Allergic Rhinitis and its Impact on Asthma) project has generated interest in simultaneous involvement of the lower respiratory airway in cases of chronic rhinosinusitis and allergic rhinitis. This study takes into account the extent of pulmonary function...

Robotic insertion of electrode array in cochlear implantation

Cochlear implants (CIs) are commonly used for profound bilateral hearing loss. They have specific national guidance for their insertion, however patients with a substantial residual acoustic hearing are potential CI candidates. Preservation of this residual hearing can be sought with...

When you regret an implant!

Cochlear implants (CIs) offer a solution to hearing loss not helped by conventional hearing aids. CIs help in improving speech recognition scores. While significant, it is not sufficient to provide satisfaction in some implantees. Alignment between expectations and realistic outcomes...

Predicting aspiration pneumonia in adults

Aspiration occurs when oropharyngeal or gastric contents are inhaled into the larynx and lower respiratory tract. When the aspirated material is colonised by pathogenic microorganisms, this may result in aspiration pneumonia. In contrast, aspiration of sterile gastric contents may lead...

The effects of polypharmacy in the elderly

Another pill to cure the ill? Alec Lapira discusses the warning signs of polypharmacy in the elderly population. Polypharmacy in the elderly Polypharmacy – defined as the use of five or more medications – occurs in 20–37% of older people...

All about velopharyngeal dysfunction

The velopharynx functionally separates the oral from the nasal cavities. Inadequate or abnormal function of this muscular valve affects speech and swallow. Velopharyngeal dysfunction can be subdivided into insufficiency, incompetence and mislearning. This is a review paper and indeed a...

Vestibular migraine – the story so far and the work still to do

This interesting discussion paper begins with an overview of the background to the development of vestibular migraine as a separate diagnostic category. It discusses in some depth the diagnostic uncertainties in the context of an entity without a biomarker and...

The right ear advantage in noise

Relatively little is known about the right ear advantage, particularly in noise. The speech-in-noise performances were assessed in a group of 37 participants with normal hearing via a Matrix Test. Participants were tested binaurally, in a right-ear condition and a...

Endolymphatic duct, a bit more than what meets the eye

It is theorised that the endolymphatic duct (ED) and the endolymphatic sac (ES) system play a role in both the production and absorption of endolymph. This system could be responsible for development of endolymphatic hydrops (EH). Recently, the presence of...