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The double-half bilobed flap or traditional bilobed flap: which is better?

Reconstruction of the nasal tip following ablative surgery can be taxing. The nasal tip is a very visible area with largely immovable skin and reconstruction needs an appreciation of the various subunits to achieve best results. The traditional superiorly based...

To monitor the nerves or not?

Whilst intraoperative nerve monitoring has become the standard of care for mastoid and parotid surgery, its benefit in thyroid surgery remains unclear. In the UK NICE was agnostic on the subject in 2008, stating that it was potentially helpful and...

Are vascular loops at the CPA of any clinical significance?

Neurotologists have grappled with this question for many years. The aim of the study was to determine the clinical relationship of vertigo symptoms with vascular loop compression syndrome using 3D T2WI turbo spin echo high-resolution MRI. The study included 417...

Single sided deafness and cochlear implants

Cochlear implants (CI) can restore hearing in the profoundly deaf ear. Risk/ benefit and cost considerations dictate strict criteria that must be met for patients to be eligible. People with single-sided deafness are not eligible to receive a cochlear implant...

Tinnitus Treatment: Clinical Protocols Second Edition

When asked to review the second edition of the popular Tinnitus Treatment: Clinical Protocols, I had high expectations. The first edition, published in 2005, has been a trusted resource for students and clinicians alike, and this second edition does not...

Sublingual house dust mite immunotherapy

House dust mite immunotherapy in allergic rhinitis was shown to be effective in trials with a relatively small number of participants. The authors of this study performed a multicentre double-blind randomised controlled trial to investigate effects of house dust mite...

Ego-resiliency and tinnitus

Adults with tinnitus are 2.5 more likely to suffer with depression and anxiety. Ego-resiliency is the ability of a person to adapt to change and cope in difficult situations. This study aimed to determine whether ego-resiliency is related to perceived...

Surgery or medicine: when should we stop trying to be conservative?

Although most otolaryngologists would agree that surgery improves the outcomes of patients with CRS when medical treatment has failed, both Cochrane reviews state that there is no proof of improved efficacy of surgery over medicine – however, that was after...

Medical control of allergic rhinitis in children

The authors of this randomised trial aim to answer an important question – which is better: daily versus on demand use of intranasal steroids (fluticasone probionate) or antihistamines (levocetirizine dihydrochloride) for symptomatic control of allergic rhinoconjunctivitis secondary to pollen? The...

Should we do oesophagoscopy during panendoscopy?

Panendoscopy entails a complete evaluation of the upper aerodigestive tract, and consists of oral inspection, direct laryngoscopy, bronchoscopy, oesophagoscopy, or some combination of these procedures. Despite many advances in imaging over the years, a skilled surgeon’s eyes remain superior in...

Surgery for class III malocclusions pharyngeal airway and sleep apnoea effects

Thirty-three patients from Brazil were assessed for obstructive sleep apnoea and hypopnoea syndrome pre- and six months postoperatively. The 33 patients were made up of nine having mandibular set back surgery, six maxillary advancement and 18 bi-maxillary surgery. They identified...

Paper patching for aural fullness

This Belgian prospective study reported on the effect of paper patching on aural fullness of unknown aetiology. It looked at 22 patients who complained of aural fullness without any middle ear pathology. The patients were divided into a treatment group...