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Role of oral and intranasal steroids in the management of otitis media with effusion
Inflammation is considered an important factor in the pathogenesis and continuation of otitis media with effusion. Theoretically, this may support the use of steroids, oral or intranasal in the management of this condition. This study comprised three well matched groups...
Can we tell the difference between benign recurrent vertigo, migraine and Menière’s disease?
I chose to review this article as it reminds us of the difficulties in diagnosing dizzy patients accurately and the significant crossover of symptoms between the diagnoses. Does Benign Recurrent Vertigo (BRV) even exist as a separate entity? BRV is...
An app to help display hearing results
Vestibular neuronitis (VN) is a common condition that we treat. Despite this, many of us lack the in-depth knowledge and scientific reasons for doing what we do. Granted, the evidence is lacking in some areas but this paper is worth...
The initial electroneuronography result after temporal bone trauma related facial palsy may be misleading
It is taught that a complete facial nerve (FN) palsy after temporal bone (TB) trauma should be conservatively managed if electroneuronography (ENoG) shows a less than 90% degeneration of response compared to the contralateral side. This small study from the...
Rationales to explore the neck in penetrating injuries
Penetrating neck injuries in the UK are more commonly associated with low velocity objects such as knives and blades as opposed to gunshots. To explore the neck requires careful consideration of the need to do so in line with Burgess...
Associated findings in MRI used for detecting acoustic neuroma
Presently, gadolinium enhanced magnetic resonance imaging is the ‘gold standard’ for investigating acoustic neuroma. There are often ‘incidental’ findings that may or may not be significant. In this study of 109 scans, the authors noted an uptake of 0.9% for...
Personal music systems are causing hearing loss
Sitting next to a teenager on a train with their iPod turned up loud enough for the entire carriage to hear is annoying, most will agree. Perhaps I might educate them about the risks of ‘music’ (if you can call...
The video head impulse test: an aid to the diagnosis of spinocerebellar ataxias
Spinocerebellar and Friedreich ataxias (SCA and FA) by their nature present in neuro-otology clinics. The diagnosis is ultimately genetic but the authors investigated the characteristics of the VOR using the video head impulse test (vHIT) in order to distinguish between...
Use of topical steroids and antibiotics, compared to systemic antibiotics in the treatment of acute rhinusinusitis
Acute rhinusinusitis is mainly initiated by viral infections. Bacterial infection is usually superadded. The inflammatory cascade upregulates the pro-inflammatory mediators resulting in pain, nasal obstruction and nasal discharge. Local application of steroids and antibiotics could provide a higher concentration of...
Posturography in persistent postural-perceptual dizziness (PPPD)
Those in neuro-otology practice will be familiar with PPPD now appearing in the forthcoming beta edition of ICD-11. This condition combines the symptoms of phobic postural vertigo and chronic subjective dizziness in which anxiety plays a part. The underlying hypothesis...
A raised neutrophil / lymphocyte ratio predicts vestibular schwannoma growth
It has long been known that the neutrophil to lymphocyte count ratio (NLR) is a marker of inflammation and that a higher ratio relates to poorer outcomes in some malignant tumours including some head and neck cancers. Neutrophilia (and therefore...
