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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...

Achieving consensus on candidacy for cochlear implantation

The British Cochlear Implant Group’s candidacy working group recently ran a national exercise, working towards a consensus on candidacy for cochlear implantation in the UK. Padraig Kitterick and Debi Vickers were instrumental in this exercise, and in the article below,...

Recent changes in vestibular science and assessment

Clinical assessment of the dizzy or imbalanced patient is all about the patient’s history. History, history, history. But what about puzzling cases when we feel we need more information? Sally Rosengren gives us a rundown of the vestibular tests which...

Dizziness: confusion, issues and considerations

Douglas L Beck gives his unique take on the difficulties involved in diagnosing dizzy patients and the importance of well-founded research acting as the basis for any diagnosis and treatment decisions. Dizziness. Uh-oh. We really have a very limited understanding...

Otosclerosis - to scan or not to scan?

In an era of insidiously reducing thresholds for investigating patients, Maxwell and colleagues pose an important question: is high-resolution computed tomography (HRCT) prior to stapes surgery for otosclerosis worthwhile? Their practice typically considers HRCT for cases of suspected otosclerosis presenting...

The future: brain imaging for aphasia rehabilitation

Technology offers our patients vast potential, yet the research literature in this area is often technical and difficult to translate to the day-to-day clinical setting. This article aims to review structural and functional imaging methods and discuss how they are...

Role of sentinel lymph node biopsy in managing papillary thyroid cancer

Although studies have shown that the presence of lymph nodes metastases in papillary thyroid carcinoma does not alter survival, other studies have shown that it increases morbidity and mortality and that the presence of cervical lymph node metastasis at diagnosis...

CT and intraoperative nerve monitoring to identify non-recurrent laryngeal nerve during thyroid surgery

A non-recurrent laryngeal nerve (NRLN) is a rare (incidence 0.3% to 1.3%) anatomical variant that results in a higher rate of vocal cord palsy following thyroid surgery. This team from China examined the utility of preoperative CT and intraoperative nerve...

Medical information required with requests for CT scans of the temporal bones; a two cycle audit

It is a common experience that radiology reports on the CT scans of the temporal bones do not always reach a diagnosis. Various studies have produced differing results in that detailed information may not be necessary to help reach a...

Practical training courses for otolaryngology trainees

In this extended Trainee Matters, it’s a pleasure to present a trio of excellent articles with a theme of practical training courses for otolaryngology trainees. Miss Rachel Edmiston, Professor Nirmal Kumar and colleagues have written a valuable guide to setting...

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...

Thyroid nodules – time for a rational imaging approach

“The more you know, the harder it is to take decisive action. Once you become informed, you start seeing complexities and shades of gray. You realize that nothing is as clear as it first appears. Ultimately, knowledge is paralyzing.” Calvin,...