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Should we be doing earlier MRIs in sudden sensorineural hearing loss?
There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....
An alternative device for obstructive sleep apnoea
Continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnoea (OSA), primarily due to the vast amount of short-term evidence in the medical literature it has accrued. The enduring obstacle to CPAP from becoming a treatment option...
Stapedotomy in osteogenesis imperfecta
Osteogenesis imperfecta (OI) is a rare connective tissue disease caused by a defect in collagen structure. Hearing loss is a characteristic feature of OI. It typically presents with conductive hearing loss initially, followed by a superimposed sensorineural component later in...
X-ray vs. intraoperative testing for determining cochlear implant placement
Most cochlear implant centres confirm electrode position after surgery using X-rays to ensure optimal electrode placement. As well as transorbital view X-rays, this team check placement using impedance measures and neural response telemetry (NRT) performed intraoperatively. The former indicates whether...
Tell me like it is: advice for relatives of people with aphasia
More than a quarter of people who have a stroke present with aphasia immediately post-stroke (approx. 30%) and of these, around 60% experience chronic communication difficulties. Provision of information is seen as one of the top 10 best practice recommendations...
Risks of tracheostomy in head and neck cancer
Tracheostomy is associated with several complications, with rates quoted as high as 8-45%, including: bleeding; displacement; obstruction; surgical emphysema; pneumothorax; fistulae and failure to decannulate. There are now many studies that confirm the increased length of stay and complications of...
Reliability of modified Dix-Hallpike test
Modifications of the Dix-Hallpike (DH) are sometimes necessary when the traditional DH is not feasible. The absence of any formal studies on modified DH was the idea behind this multicentre (three academic centres), prospective, randomised, single blinded and controlled clinical...
A voice as smooth as silk?
A number of materials currently exist for vocal fold injection medialisation. Popular options include calcium hydroxylapatite (CaHA), hyaluronic acid (HA) and polydimethylsiloxane (PDMS). The authors of this paper state that there is an unmet need for an injectable material that...
Home alone with aphasia
Relationships and social networks are known to impact outcome following a stroke. Studies have shown that group-housed animals who have had a stroke show greater neurological recovery than those who are isolated. Similarly, adults who are socially isolated following a...
Intratympanic steroids - to give or not to give?
The treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) is controversial and different modes of steroids have been tried without any universal consensus. Various authors have reported combined oral and intratympanic steroid therapy in SSNHL, with consistent results in several...
Management of frontal sinus fractures
Frontal sinus fractures are uncommon (associated with around 5-15% of facial fractures). The authors divide frontal sinus fractures into isolated anterior table fractures, fractures involving the frontal sinus outflow tract and posterior table fractures, discuss some of the recent relevant...
