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What is the right balance to strike in the management of anaplastic thyroid cancer?

This is a pragmatic article on a difficult and much debated subject. Management of anaplastic thyroid cancer (ATC) can feel like making decisions between a rock and a hard place, and this article suggests one path to help navigate some...

What about the older adults?

The authors of this paper propose that significant changes in the delivery of services, including speech and language therapy management of swallowing difficulties, may be required. Among the most common causes of dysphagia in older adults are stroke, progressive neurological...

The never-ending vertigo

The authors comment on the Barany Society guidelines for bilateral vestibulopathy (BV). This is one of the murky entities of vestibulogy. By definition, patients will eventually lose vestibular function and don’t experience any vertigo. However, some patients still get recurrent...

Healthcare economics and device approvals

We use several FDA-approved devices in our clinical practice but are rarely aware about the stringent procedures followed by manufacturers, as well as the FDA, before the devices become commercially available. The authors of this paper undertook a comprehensive review...

Discharge planning

For a specialty such as ENT in which so many procedures are performed as day case surgery, there is a pressing need for objective discharge criteria to facilitate safe decision making post-op. This review strikes a good balance between prescriptive...

Indication and timing of electrodiagnostic tests in facial palsy

This excellent review describes the benefits and limitations of electrodiagnostic testing for patients with facial paralysis. Tests such as Schirmer, stapedial reflex and electrogustometry have been largely replaced by neurophysiologic tests like nerve excitability test (NET), electroneuronography (ENoG), surface electromyography...

A move away from bony free flaps in reconstruction

Techniques for facial reconstruction have come on in leaps and bounds since the world wars. The use of titanium implants is more recent and the technology for manipulating the metal and how we use it is rapidly developing. Here the...

Vestibular schwannoma surgery and inner ear injuries

Iatrogenic inner ear injury during vestibular schwannoma (VS) surgery ranges between 20% and 30% in the literature. However, there is no up-to-date quantification of such injuries, hence this study. The authors conducted a US-multicentre database search looking for patients who...

Surgical anatomy for central auditory device implantation

This cadaveric study by researchers in the USA and Japan examined the cerebellopontine angles with the aid of the surgical microscope and 45o endoscope via the retrosigmoid and translabyrinthine approach. Using fibre dissection technique, the ascending auditory pathways between the...

Cognitive Behavioral Therapy for Tinnitus

I was sceptical when I read that Cognitive Behavioral Therapy for Tinnitus was aimed at both clinicians and people with tinnitus. All too often, books intended for such a wide readership end up being too academic to appeal to patients...

3D-printed temporal bone models - how good can they be?

In the era of increasingly difficult and expensive-to-come-by cadaveric temporal bones with which to practise drilling and learn the complex 3D anatomy of the temporal bone, decent alternatives would be welcome. McMillan et al report a prospective comparison study in...

Finding the elusive parathyroid glands

While reading in the literature about new advances in knowledge and surgical techniques, it is often easy to lose track of the longstanding knowledge that we all acquired during our training. This is why this article on the anatomy and...