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When should revision FESS leave you reaching for the script pad?

This very interesting work from the professorial team in London seeks to define a group of patients with CRSwNP who may benefit from early biological treatment since they are at risk of failure of surgical and conventional medical management. Approximately...

The basis of auditory processing disorder: what can we learn from corticals?

Auditory processing disorder (APD) is a poorly understood, heterogenous and surprisingly common condition. It manifests as a perceptual difficulty in centrally processing auditory information. Diagnosis is usually based on a variety of behavioural tests involving verbal and non-verbal assessments. In...

Effect of COVID-19 on hearing and balance

Rhinological symptoms are cardinal features of COVID-19. However there have only been anecdotal reports on the involvement of the ear, the closest neighbour to the nose and throat. The aim of this study was ‘to assess the presence of persistent...

Reduction in recurrent cholesteatoma rates with bony obliteration tympanoplasty technique

This large retrospective study from the Erasmus Medical Centre in Rotterdam compares outcomes in traditional canal wall up (CWU) and canal wall down (CWD +/- partial obliteration of mastoid bowl) mastoid surgery for cholesteatoma with bony obliteration tympanoplasty (BOT, which...

Cochlear implantation in asymmetric hearing loss

Criteria for cochlear implantation (CI) is a constant topic of debate. The UK traditionally had relatively restrictive guidance, although this has been greatly improved by more recent guidance released in 2019. Nevertheless, because of the lack of evidence for cost-effectiveness,...

Persistent imbalance after traumatic brain injury is central in origin

Several residual symptoms, including dizziness and imbalance, can follow traumatic brain injury, no matter how mild. This study focused on the mechanisms, peripheral and central, underlying the complaint of persistent imbalance in patients with chronic mild traumatic brain injury (mTBI)....

Biologics for deafness

Cochlear implants and hearing aids are inherently limited in their ability to restore ‘natural’ hearing. Biological therapy to treat inner ear pathology still is evolving rapidly with several ongoing clinical trials, though none are available for clinical practice to date....

Prophylactic gastrostomy tubes in advance of chemoradiotherapy for advanced head and neck malignancies – are they worthwhile?

It is well recognised that radical chemoradiotherapy (CRT) for head and neck cancers can significantly affect swallowing, especially if radiotherapy is delivered to the hypopharynx and/or both sides of the neck. As such, prophylactic gastrostomy tubes are often advocated in...

Steroid use in acute acoustic trauma

Acute acoustic trauma (AAT) injuries include noise-induced damage to inner and middle ear presenting as hearing loss, tinnitus and vertigo. Classic presentation is sensorineural hearing loss with an intact tympanic membrane. The authors carried out a case-control study in military...

Temporal bone drilling using artificial versus cadaveric specimens - does the specimen precipitate altered drilling techniques?

Hochman et al set an ambitious goal in their study analysing drilling strokes of eight otolaryngology residents (junior: PGY 1-3; senior: PGY 4-5) during temporal bone (TB) drilling practice using cadaveric and artificial specimens. Each trainee dissected one cadaveric and...

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...

Subtypes of vestibular migraine

The authors argue that the current Barany criteria (ICVD) for vestibular migraine (definite and probable – dVM and pVM) are too restrictive. For instance, whereas a category of chronic migraine with or without aura is recognised in ICHD-3, ‘chronic VM’...