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The medially-invasive cholesteatoma: a case series

In this small case series, Casazza et al describe their management of seven cases of complex cholesteatoma presenting during a 16-year period. Patients were included if imaging confirmed restricted diffusion and an endophytic, medially-destructive disease involving the otic capsule, petrous...

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...

The outer ear in the visual arts

The ear is an exceptional organ, and quite rightly takes its place in the visual arts, as described by Albert Mudry, who takes us on a whistle-stop tour of the appearance of the ear and its depictions in art throughout...

Surgical outcomes of myringoplasty using platelet-rich plasma

Tympanic membrane (TM) perforations can affect people’s quality of life due to recurrent infections. Management is often by surgical repair. In this study, the authors investigated the outcomes of a minimally invasive approach of patch myringoplasty using an atelocollagen sponge...

Do nasogastric tubes affect aspiration risk?

A nasogastric tube (NGT) is frequently used for patients who are at risk of endotracheal aspiration of oral diet. However, this cannot eliminate the aspiration of saliva. The incidence of aspiration pneumonia in patients with NGT therefore remains high. Some...

Vascular disease and sudden sensorineural hearing loss

Oussoren et al performed a systematic review and meta-analyses of current literature on the above topic: specifically, cardiovascular risk factors for developing idiopathic sudden sensorineural hearing loss (iSSNHL), the presence of white matter hyperintensities in patients with iSSNHL and the...

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...

Endoscopic Transnasal Anatomy of the Skull Base and Adjacent Areas

This book is a well-designed colour atlas of sinus surgery which is up to date with all the modern techniques used in endoscopic sinus surgery. The multiple authors include well-established and renowned surgeons. It is divided into distinct chapters, with...

Do endonasal approaches for meningiomas have more CSF leaks?

Rarely, patients presenting to the ENT surgeon with anosmia may have an anterior skull base neoplasm such as a meningioma. Historically, the traditional approaches have focused on several transcranial, external routes, including the pterional craniotomy, and the subfrontal craniotomy. The...

Endoscopic CSF leak repair using nasoseptal flap

Many of us during training or in established practice will have encountered the complication of anterior skull base CSF leak. This can be a challenging problem to deal with and in this article the authors describe their favoured approach. Cerebrospinal...

Clinical value of 3 T magnetic resonance imaging after intratympanic gadolinium injection in cases of delayed endolymphatic hydrops

Recurrent vertigo can continue after severe unilateral or bilateral hearing loss. This is a condition similar to Ménière’s disease, the diagnosis of which can be difficult. In this study intratympanic injection of gadolinium-diethylenetriamine penta-acetic acid dimeglumine was done in 25...

Associated findings in MRI used for detecting acoustic neuroma

Presently, gadolinium enhanced magnetic resonance imaging is the ‘gold standard’ for investigating acoustic neuroma. There are often ‘incidental’ findings that may or may not be significant. In this study of 109 scans, the authors noted an uptake of 0.9% for...