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Update on the development of an implantable vestibular prosthesis

Cochlear implants have revolutionised the management of profound hearing loss. Might vestibular implants be the future for the treatment of bilateral vestibular failure? James Johnston and Neil Donnelly explore. The vestibular system is highly complex, integrating visual, labyrinthine and proprioceptive...

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...

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...

Oscar Wilde’s Final Irony

The celebrated writer and poet, Oscar Fingal O'Flahertie Wills Wilde was born on 16 October 1854 in Dublin. He distinguished himself as a classicist at Trinity College Dublin before, earning a scholarship to Oxford University, where he gained a double...

Disorders of the Vestibular System: Diagnosis and Management

This book is aimed at specialist trainees and consultants with an interest in improving their knowledge and understanding of this traditionally obscure area of otolaryngology. There are very comprehensive chapters on anatomy and physiology of the vestibular system along with...

Rapid Interpretation of Balance Function Tests

I read the title with some concern as I would prefer my test interpretation to be ‘accurate’ rather than ‘rapid’, nevertheless the content of the book delivers what one would anticipate is intended, which is an easy to read outline...

Rotational chair testing: “To rotate, or not to rotate, that is the real question”

Passive whole body rotation tests are widely considered to be the ‘gold standard’ for the identification of bilateral peripheral vestibular disorders (bPVD), but also have a part to play in identifying unilateral disorders (uPVD). In this article Paul Radomskij discusses...

Random-pattern skin flaps: part 2 - rhomboid and bilobed flaps

In the second of our series on local skin flaps (see Part 1 here, Part 3 here and Part 4 here), the authors describe more techniques and examples of various skin flaps that trainees should find very interesting. Rhomboid flap...

Surgical challenges in advanced or recurrent thyroid malignancy

The management of thyroid malignancy and extent of surgery is controversial, especially considering the limitations of preoperative diagnosis. Neil Tolley provides guidance and reminds us of our responsibility not to over-treat. In the UK, 16% of thyroidectomies are performed for...

Persistent imbalance after traumatic brain injury is central in origin

Several residual symptoms, including dizziness and imbalance, can follow traumatic brain injury, no matter how mild. This study focused on the mechanisms, peripheral and central, underlying the complaint of persistent imbalance in patients with chronic mild traumatic brain injury (mTBI)....

Obstructive sleep apnoea in common vestibular disorders

The importance of getting a good night’s sleep is often acknowledged but may be particularly difficult to achieve for those with obstructive sleep apnoea (OSA). In addition to high blood pressure, increased risk of stroke and depression, balance problems may...

Subtypes of vestibular migraine

The authors argue that the current Barany criteria (ICVD) for vestibular migraine (definite and probable – dVM and pVM) are too restrictive. For instance, whereas a category of chronic migraine with or without aura is recognised in ICHD-3, ‘chronic VM’...