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Rhinotillexomania - how bad can nose picking get?
This is a fascinating first case report of rhinotillexomania associated with empty nose syndrome (ENS). Rhinotillexomania encompasses compulsive, pathological nose picking and is a variant of self-harm. Tranchito and Chhabra describe an elderly patient presenting with longstanding symptoms of nasal...
Which factors affect the postoperative CSF leak following endoscopic skull base surgery?
Endoscopic skull base surgery is being increasingly performed worldwide for skull base tumours. Common indications include pituitary tumours, rathke cleft cysts, chordomas, craniopharyngiomas and olfactory neuroblastomas. The most common and important complication following endoscopic skull base surgery is postoperative CSF...
Posterior TM perforations carry greater hearing loss: practical pointers for clinic
This single-centre prospective study of 100 adults with central pars tensa perforations examined how perforation size and quadrant relate to hearing loss. Using video-otoscopy to estimate perforation area and pure tone audiometry for thresholds, the authors found hearing loss in...The role of the maxillo-facial surgeon in the management of skull base malignancy
Whilst ablative surgery remains the principal treatment option for head and neck malignancy, the skull base is the last frontier. The complex anatomy, supreme functionality of the brain, and varied pathology provokes many a detailed discussion in the multidisciplinary team...Embracing deafness and the silent world
Brian Kokoruwe shares his journey from growing up during civil war in Nigeria to becoming Director of Deaf UK Athletics and a published author. While I am active in the Deaf BSL community, involved in Deaf sports and the Government...In conversation with Miss Sujata De: Chair of the ESPO 2023 Local Programme Committee
Su De is one of the UK’s most prominent paediatric ORL surgeons, and has a leading role in planning ESPO 2023. Hannah Emerson caught up with Su recently to explore some of her thoughts and her plans for ESPO. You’ve...Head and neck cancer multidisciplinary team
Why do we have MDTs? Do they make a difference to outcomes? Jon Bernstein explores the whys and wherefores of the head and neck cancer MDT, and wonders where things might go from here… Head and neck (upper aerodigestive tract)...In conversation with Paul Lamb
Paul Lamb recently joined a team undertaking a hearing care mission to Armenia with the Starkey Hearing Foundation. Paul took time to discuss the aims and achievements of these missions through his personal experiences with the foundation. Paul Lamb. The...
A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth
It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...
New MRI technique assesses treatment response in skull base osteomyelitis
This paper describes another useful imaging technique to monitor Necrotising Otitis Externa (NOE). Echoplanar diffusion weighted magnetic resonance (DW MR) shows high signal on the ‘ADC map’ with active disease and this reduces in signal intensity as symptoms improve. This...
Canal wall down with obliteration of cavity for paediatric cholesteatoma
The authors present evidence that canal wall down (CWD) surgery with primary obliteration is an effective way to treat paediatric cholesteatoma. Fifty-eight ears were operated on and follow-up was for five years on average. Residual cholesteatoma rate was 9.9% with...
