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The middle way: treating idiopathic facial nerve palsy

Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...

Clinicopathological features of follicular variant of papillary thyroid carcinoma

The follicular variant (FV) of papillary thyroid carcinoma (PTC) is characterised by the presence of nuclear features of PTC together with a follicular growth pattern. It is currently reported to make up 11.8% to 53.3% of all PTC cases. It...

Treatment algorithm for olfactory disorders

The purpose of this paper is to review the current evidence in diagnosing olfactory disorders and suggest an algorithmic approach to patients with relevant complaints. Age-associated olfactory loss is often multifactorial and requires a careful history and physical exam. A...

Practical Neurotology and Skull Base Surgery

The introduction describes this text as being useful for a wide readership including the medical student, physician assistant, nurse practitioner and physical therapist dealing with dizziness. I would be of the opinion as indicated in the preface that this is...

Supporting the definitive diagnosis of LPR

Voice disorders affect one in 25 people in the UK, and laryngopharyngeal reflux (LPR) is a common culprit. LPR occurs when the stomach contents – including strong digestive enzymes like pepsin – flow back up into the throat, causing inflammation...

Is it time for cone-beam CTs to replace the traditional orthopantomogram in the primary diagnosis of temporomandibular joint disorders?

Cone-beam CT requires a lower dose of radiation compared to the multidetector CT and provides much more detailed information in 3D about the bony structures of the temporomandibular joint (TMJ) when compared to the traditional orthopantomogram (OPG). In this article...

Fungal rhinosinusitis

Allergic fungal rhinosinusitis (AFRS) has been defined by the following characteristics: presence of nasal discharge, nasal obstruction, decreased sense of smell or facial pressure for 12 weeks, mucin within the sinus cavity containing fungal hyphae and degranulating eosinophils, endoscopic evidence...

Application of paper patching in patulous eustachian tube

The condition of patulous eustachian tube, as opposed to dysfunctional eustachian tube, is less frequently diagnosed. Symptoms related to this, such as autophony, aural fullness, ‘being under water’, ‘hearing their own breathing’, and hearing sensitivity (varying in either direction) can...

Bones, stones and surgical moans: rethinking PTH dynamics in parathyroid surgery

Intraoperative parathyroid hormone (IOPTH) testing has revolutionised minimally invasive unilateral parathyroidectomy (MIP) as the gold standard treatment for primary hyperparathyroidism, replacing old-timey four-gland exploration. IOPTH testing ensures reliable excision of all hypersecreting glands, including those pesky hard-to-find ones, without relying...

Auditory brainstem response patterns are neural signatures

Through examples, this article describes how particular aspects of auditory brainstem responses can portray certain kinds of language or communication impairments – a characteristic pattern or ‘neural signature’. A reduction in processing of the fundamental frequency is seen commonly in...

Tinnitus treatment device from concept to commercialisation

Innovation in the field of healthcare is fraught with nearly insurmountable challenges. Bringing a novel product to the market requires a new (patentable) idea that can be reduced to practice, manufactured at scale, and can pass all regulatory barriers. In...

Hyposalivation: a review of current and future treatments

Hyposalivation remains a stubbornly difficult condition to treat, but novel therapies may not be far away. Saliva has many essential functions, including aiding digestion and swallowing, lubrication, maintaining tooth integrity and antibacterial activity. When patients experience reduced saliva production (hyposalivation),...