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Neuromodulation in drug resistant epilepsy

Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...

Earplugs fit for purpose

The aim of occupational audiology is to prevent hearing loss caused by occupational sound exposure which can exacerbate the long-term effects of central presbyacusis as employees age. To provide the best noise protection over time, research suggests that best practice...

Imaging and embolisation of paragangliomas

Paragangliomas are rare tumours within the head and neck and any article which succinctly jogs the memory with respect to their existence and subsequent accurate diagnosis is welcome. This article concisely explains the imaging techniques used to diagnose these tumours...

In conversation with Dr Peter Belafsky

Dr Peter Belafsky. Peter – tell us about your background I was born in Philadelphia and went on to study at Vassar College which is a small liberal arts school in upstate New York. I then attended Medical School in...

Communicating with patients in 
‘Plain English’

Physicians have long been accused of using unnecessarily complicated language and impenetrable jargon as a way of maintaining their status, prestige and high earnings-potential, bamboozling the public and excluding them from meaningful discussion as part of what George Bernard Shaw...

Tongue tie – just a snip?

This article regarding ankyloglossia raises an eyebrow; surely it’s just a snip isn’t it? Seemingly not. The authors describe two types of tongue tie – the first being posterior, with the frenulum being short and tight, the second being anterior,...

Peptest Q&A

Untreated reflux can cause inflammation, scarring, narrowing and precancerous changes in the oesophagus and larynx, and may increase the risk of asthma and sleep apnoea.

Barotrauma

Barotrauma is an injury which is due to the effects of pressure upon an air-containing space. Healthy middle ear cavities and paranasal sinuses are normally in equilibrium with the atmospheric pressure, but if an individual moves away from the surface,...

In conversation with Miss Romola Dunsmore “ENT training in my day”

Emma Stapleton is an ST8 in Otolaryngology at Doncaster Royal Infirmary, UK. For her first Trainee Matters article, Emma and her colleague, Ruth Capper (Department of Otolaryngology Head and Neck Surgery, Doncaster Royal Infirmary), spoke to 92-year-old ENT surgeon Romola...

Tinnitus in middle-age: prevalence and incidence

Population-based studies of tinnitus provide crucial underpinning evidence which highlights the need for further research on the effective diagnosis and clinical management of this heterogenous condition. Furthermore, such studies provide evidence of the burden of this condition both on the...

Voice change after total thyroidectomy with intact laryngeal nerves – a common but temporary problem

It has been reported that up to 87% of patients have a degree of voice dysfunction after thyroidectomy, even when the laryngeal nerves are preserved. Postoperative inflammation, laryngeal oedema due to vascular congestion, direct damage to the cricothyroid muscles and...

One anastomosis or two

This is a cumulative meta-analysis from Hong Kong reviewing 27 articles and a total of 7,389 flaps. The authors, at the outset, acknowledge that the number of anastomoses is not the only factor of venous compromise and flap failure. Nonetheless...