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Destination unknown

We as doctors do not always know the answer. Associate Professor Jacqueline Allen guides us through the importance of acceptance of this uncertainty and its complex mental journey. She highlights that, as clinicians, we must embrace the unknown and be...

Middle ear reconstruction in children: why, when and how

Every ear in every child is different. Rob Nash discusses the rationale behind reconstructive ear surgery in children and his philosophy on timing and techniques of reconstruction. It is rare for middle ear pathologies to be life threatening. Indeed, it...

Otology, Neurotology and Skull Base Surgery Book Review

This concise pocket-sized textbook aims to provide a practical reference that clinicians can use in every day otological and skull base practice. The senior author, Derald Brackmann, is one of the leading neurotologists of the modern era and, together with...

Manual of Allergy and Clinical Immunology for Otolaryngologists

As a first approach, the book impresses with the hardback cover and the glossy 442 pages. Published in March 2015, the book reflects an effort to deliver the main advances and updates of allergy and clinical immunology relevant to otolaryngology...

Rhinology and Allergy: Clinical Reference Guide

This pocket-sized book aims to provide a clinical reference guide through a series of review chapters. The editors, Brent A Senior and Yvonne Chan, have produced a comprehensive text through the work of predominantly North American and Canadian co-authors of...

Blood-sampling prognostic predictors for Bell’s palsy

Bell’s palsy is generally defined as an acute-onset unilateral idiopathic mononeuropathy in the facial nerve. It is of unknown aetiology, however, inflammation is considered a major cause. Electroneurography assessing nerve excitability is the most reliable examination for predicting prognosis of...

A single blinded RCT comparing triamcinolone with 5-FU treatment for keloid scars

This single blinded RCT compared 43 patients with 50 symptomatic keloids that were randomised to two matched groups of 25 scars, receiving either 5-fluorouracil (5-FU) or current first line treatment, triamcinolone (TAC). The surgeon administering the injectable treatments was unblinded,...

What to do with incidental findings on FDG PET/CT?

18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG PET/CT) is commonly used in head and neck cancer staging. This investigation frequently identifies incidental findings unrelated to the index head and neck cancer. To assess the nature of these incidental findings, notes of...

Is clinical HIT as good as vHIT in the emergency room?

Establishing the cause of acute vestibular syndrome (AVS) is critical in the first few hours of presentation in the emergency department. The first question to ask is, “is it due to a peripheral vestibular pathology or a stroke?” This is...

Voice after posterior cordotomy: we think voice is bad, patients think it’s better!

Bilateral vocal fold immobility (BVFI) is a condition that can affect voice with an impact on quality of life (QOL). Surgical trauma from damage to bilateral recurrent laryngeal nerves, such as from previous thyroid, parathyroid, or mediastinal surgery are common...

Drawing pictures and telling stories: treating tinnitus in childhood

There is increasing awareness that tinnitus is not restricted to adults. Indeed, the available evidence suggests that some experience of tinnitus in children is fairly common [1]. For many, tinnitus has little effect and requires limited or no intervention. For...

In conversation with Duncan Boak, founder of Fifth Sense

Anosmia Our sense of smell is something we take for granted – but imagine if it wasn’t there… We see many patients who struggle with anosmia, but perhaps don’t always appreciate how much of an effect it has on their...