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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...
Does vestibular rehabilitation help patients with vestibular migraine? Is this also true if these patients have had a traumatic brain injury?
Vestibular migraine (VM) is a common diagnosis in ENT, and there is growing evidence that vestibular rehabilitation therapy (VRT) is an effective treatment, reducing self-perceived dizziness and improving gait. This is a retrospective review of the outcomes of 93 patients...
Does pre-op intratympanic gentamicin improve balance control after vestibular schwannoma surgery?
This retrospective study was based on data from 44 patients selected from a cohort of 153 who had undergone surgical resection of vestibular schwannoma over a 10-year period. The aim was to evaluate the dynamics of the postural control system...Phineas Fletcher and The Purple Island
The Reverend Phineas Fletcher was a 17th century poet whose epic poem, The Purple Island describes the anatomy of the human body. Not only poets, but contemporary anatomists believed in two important concepts, correspondences and signatures. They thought that when...A legendary ‘parotid adenoma’: teaching aid or trophy? & The stapes: a classical heresy
A legendary ‘parotid adenoma’: teaching aid or trophy? A wander through the glass cases of the newly refurbished Hunterian Museum at the Royal College of Surgeons in London presents a particularly impressive sight to any ENT surgeon. The salivary adenoma...Middle ear muscle disorders: presentation, diagnosis and management
Patients often report symptoms relating to disorders of the middle ear muscles. Prof Bance gives us an overview of the anatomy and function, as well as guides our diagnosis and management. The middle ear muscles (MEMs) are a mystery, both...Global health missions – not just for consultants. A guide for trainees.
Lulu Ritchie is a courageous and driven trainee in London, inspired by humanitarian missions but conscious of the usual requests for consultant level doctors. Lulu didn’t let that hold her back. She found a way and has kindly summarised her...Unexplained dizziness in elderly patients
How do we explain unexplained dizziness in elderly patients? How far should we go with investigations? And most importantly, how should we manage this challenging and expanding group of patients whose balance affects their safety? Richard Ibitoye and Diego Kaski...
How can we improve outcomes for patients with acute vestibular neuritis?
Vestibular neuritis is a common disorder that can leave up to 50% of patients with persistent vertigo symptoms for months to years following the acute insult. Often their first contact with ENT or balance specialists is many months after the...
Concussion and vestibular processing deficits
It is well known that patients with mild traumatic brain injury (mTBI), also referred to as concussion, display longstanding vestibular symptoms but often clinical signs and objective vestibular function test abnormalities are lacking. The aim of the study was to...
