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Management of patients with advanced otosclerosis
This paper discusses the management options of advanced otosclerosis. There are several definitions for advanced otosclerosis in the literature but, more recently, the diagnosis of advanced otoscletosis has been reserved for patients who have less than 30% aided speech discrimination...
Surgical approach to trigeminal neuralgia
This article provides a summary of the operative techniques available for treating patients with trigeminal neuralgia who have medication resistant pain or medication intolerance. Microvascular decompression is performed via suboccipital craniotomy to find and resolve the underlying nerve compression. The...
Associated findings in MRI used for detecting acoustic neuroma
Presently, gadolinium enhanced magnetic resonance imaging is the ‘gold standard’ for investigating acoustic neuroma. There are often ‘incidental’ findings that may or may not be significant. In this study of 109 scans, the authors noted an uptake of 0.9% for...
Prevention better than cure?
This systematic review looks at methods of ‘barrier protection’ or ‘barrier-enforcing’ to minimise allergic rhinitis symptoms, using 15 RCTs. Whilst the authors admit that patient numbers were small in a number of these studies, generally it seems that barrier techniques...
Biologicals for severe chronic rhinosinusitis with nasal polyps. Any use?
Recent advances and knowledge of inflammatory endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP) led to introduction of biological agents such as monoclonal antibodies targeting IgE (omalizumab) and Interleukins (ILs) such as IL4R alpha (dupilumab) and IL5. The European Academy...
Prognostic value of vascular ultrasonographic findings in patients with idiopathic sudden sensorineural hearing loss
Sudden sensorineural hearing loss is often idiopathic. Although the aetiology of idiopathic sudden sensorineural hearing loss (ISSNHL) is unclear, vascular compromise is one of the frequently proposed hypotheses to explain its pathophysiology. Existing studies have shown an association between ISSNHL...
Should we be doing earlier MRIs in sudden sensorineural hearing loss?
There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....
Diagnosis and management of acute sensorineural hearing loss: a Japanese perspective
In this paper, the authors set out the clinical guidelines to standardise diagnosis and treatment of acute sensorineural hearing loss in Japan. They categorised acute sensorineural hearing loss into five disorders: idiopathic sudden sensorineural hearing loss (iSSNHL), acute low-tone sensorineural...
How rare is vocal fold paralysis after spinal and epidural anaesthesia – should we be more concerned?
The authors present an unusual case of right vocal fold paralysis. Their patient was a 38-year-old woman who experienced new onset dysphonia following neuraxial anaesthesia (NA) for a caesarean section. Flexible nasendoscopy showed a right VFP with fixation in the...Salivary duct clipping for drooling
Drooling can be a challenging problem to manage in paediatric ENT. The variety of medical and surgical treatments suggests that there is no gold standard treatment. Nicola Stobbs and Ravi Thevasagayam describe an approach to ligating the salivary ducts. Drooling...What has NAIROS taught us about septoplasty?
Septoplasty is a commonly performed procedure worldwide for nasal obstruction associated with a deviated nasal septum. In the UK, with long waiting lists for septoplasty, there is a large and unexplained variation in the incidence of this procedure between individual...
