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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...

What are the non-inflammatory causes of a conductive loss?

This retrospective study looked at patients with an intact tympanic membrane with non-inflammatory causes – i.e. otitis media and cholesteotoma. They document their findings based on exploratory tympanotomy. They operated depending on the findings with either a stapedectomy or a...

Robot controlled mastoid surgery!

This is a fascinating piece of work by a Korean team developing a human-robot collaborative control. Their model uses image guidance surgery to locate the drill tip’s position. Important structures can be highlighted – in this case the facial nerve....

Risk factors for post laryngectomy fistula

This is a meta-analysis looking at the postoperative pharyngocutaneous fistula rates following total laryngectomy. The authors ended up with 34 studies with about 2500 patients. The most striking finding was that preoperative radiotherapy was a significant risk factor as well...

The multidisciplinary voice clinic

In his inimitable way, Nick Gibbins tells us why the voice clinic is the highlight of his week – and his very own field of dreams. The voice clinic has come a long way in the last 40 years. The...

Complications in Facial Plastic Surgery

Facial plastic surgery is an increasingly expanding sub-specialty of ENT and it is always welcome news to hear of books related to this sub-specialty, particularly good books, and this book certainly fits into that category. This multi author book is...

How to deliver bad news better

Delivering bad news well takes experience and time. The Ida team recommend the SPIKES protocol; providing structure for relaying bad news, giving confidence to those delivering it, and leaving recipients feeling cared for and informed. It’s among the most distressing...

Subjective tinnitus – adding mutebutton™ to your tinnitus toolbox

Neurophysiologic tinnitus or subjective tinnitus is typically a sound or a number of sounds that originate from the auditory nervous system. They are unwanted sounds that do not exist in the external environment. They can be heard in one or...

Clinical leadership and management: developing world ENT

I have been asked to share some of the initiatives I have been involved with to address ENT-related challenges in Africa and the developing world. Developing countries constitute the majority of the world’s landmass (Figure 1), are home to >50%...

Vestibular Disorders

This is an excellent compendium of vestibular disorders, edited by two of the leading figures in otolaryngology. It is also a tribute to one of the most extraordinary colleagues, David Pothier, plucked tragically in his prime after a heroic battle...

Your voice and your personality

Variations of vocal effort are a normal adaptation to difficult communication situations. However, persistence of these abnormal strategies can lead to various functional dysphonias. In this experiment, the authors tested 41 females aged 18-52. The subjects were asked to instruct...

Complex Cochlear Implant Cases – Management and Troubleshooting

When working with cochlear implant (CI) recipients who are not responding as well as expected or their case incorporates new challenges for the audiologist, the common response is a quick panic, closely followed by a question: what do we do...