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Otoacoustic emissions in the diagnostic test battery for hearing loss
So, they are great for screening, but how can otoacoustic emissions be integrated into the diagnostic test battery? Beth Prieve examines the role of diagnostic OAEs by asking three simple questions. Audiologists and otolaryngologists are familiar with otoacoustic emissions (OAEs)...
Endoscopic stapes surgery - pearls and pitfalls
Endoscopic ear surgery has gained popularity in recent years with wide panoramic visualisation of the operative field one of its key strengths. This article summarises the approach, set-up and outcomes of patients undergoing endoscopic stapes surgery. A key step during...
Neuromodulation in drug resistant epilepsy
Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...
Pharmacologic treatment options for tinnitus
This article summarises potential medications that could be used to treat tinnitus and the evidence behind their use. Effective medications to eliminate tinnitus remain elusive but treatment could be divided into two broad categories: treatment to reduce perception of tinnitus...
Prolactinomas: when to operate
Prolactinomas are the most common functional pituitary adenomas, comprising 40% of all pituitary adenomas. There are consensus guidelines and several common management pathways. This article discusses the role of surgery for these patients. Following diagnosis, the goals of treatment are...
Advances in neural stimulation of the auditory pathway
This article reviews the use of neuroprosthetic devices such as cochlear and auditory brainstem implants (ABI) to stimulate the auditory pathway, discussing the successes, limitations and advances in this area. Currently, neuroprosthetic devices deliver electrical impulses to the cochlear nerve...
What to do if adenotonsillectomy does not cure sleep apnoea in children?
This article reviews the management of children with persistent obstructive sleep apnoea (OSA) following adenotonsillectomy (AT). Risk factors for patients to have persistent disease include obesity, being Afro-Caribbean and existing co-morbidities such as craniofacial and neuromuscular disorders. Initial assessment of...
3D endoscopy in pituitary adenoma surgery
Endoscopic approach for pituitary adenoma surgery is well recognised. There has been recent refinement of 3D endoscopy technology which improves on the depth of vision offered and more compact delivery. This may improve visualisation of the critical structures involved in...
Peripheral nerve stimulation for chronic refractory pain
Peripheral nerve stimulation (PNS) plays an important role in treating chronic refractory pain syndromes that manifest in limited distributions and overlap with areas of neurologic innervation. The process is generally thought to capitalise on the inhibition and activation of pain-related...
Surgical management of permanent facial paralysis
This article explores the management of flaccid facial palsy focusing on weakness less than one to two years’ duration. As a general rule, primary nerve repair produces the best outcome and should be performed where possible. For long-standing paralysis of...
Button batteries – how can we reduce harm to children?
This article explores the history of button batteries and how clinicians and industries alike could reduce the harm to children following ingestion. Following ingestion, if lodged, button batteries cause an alkaline reaction leading to necrosis of mucosa. Significant oesophageal injury...
