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Detecting postoperative cholesteatoma with diffusion weighted magnetic resonance imaging

Middle ear cleft cholesteatoma is an inflammatory disease that erodes local bony structures and can cause otorrhea, hearing loss, vertigo and intracranial complications. It is usually treated with surgery, typically canal wall up (CWU) or canal wall down (CWD) surgery....

The modern management of Ménière's disease

In this article, John Phillips considers the evolution of management options for Ménière’s disease. Treatment options past and present are discussed, together with an insight into future developments regarding the role of intratympanic steroids. Ménière's disease can be the source...

What’s new in implantable devices? New indications in cochlear implantation

For over 40 years, cochlear implant procedures have steadily increased. Outcomes for patients are improving as a result of modified surgical techniques, a wider portfolio of electrode arrays, advances in programming strategies, access to improved technology and a better understanding...

Intratympanic treatments for subjective idiopathic tinnitus

Direct application of medication into the ear is long established, going back as far as written records. In the modern era, greater understanding of aural anatomy revealed that drugs instilled in the middle ear could potentially diffuse into the cochlea...

Bipolar microdebrider turbinoplasty

There are a variety of ways to reduce the bulk of hypertrophied turbinates. Kimberley Lau and Showkat Mirza describe their technique which can be used in difficult cases and with minimal morbidity. As ever, one aim should be to avoid...

A shifting landscape of otitis media

In light of pneumococcal vaccination programmes, is otitis media evolving to have a different natural history? Acute otitis media (AOM) is a major public health problem in children worldwide, as it is the leading bacterial infection and first cause of...

Changing perceptions in head and neck cancer management caused by quality of life issues

Sir Felix Semon was an outstanding clinician and exceptional laryngologist. The money raised by donations from his colleagues on his retirement in 1909 was used to establish the London University’s Semon Lecture. Semon’s Obituary in the BMJ, reads: “In Semon's...

Combined use of a hearing aid and a cochlear implant: a case study

When multi-channel cochlear implants (CIs) were first introduced in the 1980s, their use was restricted to people who derived no benefit from conventional amplification. Over the past three decades, however, the criteria for CIs has been relaxed considerably, and it...

A practical approach to tinnitus

Tinnitus is the perception of sound without an external source. The estimated prevalence in adults is between 10-15% [1]. In patients with significant tinnitus, prompting them to seek medical attention, 50% will have improved to mild or no tinnitus by...

Identity: does it affect the training experience?

Our identity can be influenced by many factors, both internal and external to ourselves. One may say that if one has not had to consider one’s own identity at any time, perhaps that in itself is a privilege? Equally, one...

Hidden genetic disorders in children that may present to the otolaryngologist

Background Among the many hundreds of children presenting to the otolaryngology clinic are a few whose symptoms are due to an underlying genetic condition. In most cases the underlying syndrome is obvious and has already been diagnosed, such as the...

Robotic surgery for squamous cell cancer: the new frontiers

Although the da Vinci platform was FDA approved for early-stage oropharyngeal cancers, the indications have expanded. In this article, John Hardman explains how surgeons, with greater understanding of the strengths and limitations of robotic surgery, have systematically set out to...