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Triple semicircular canal occlusion and Meniere’s disease: a rising alternative treatment?

Patients with dizziness form a large part of the workload for ENT surgeons. In the overwhelming majority of cases, management will be medical and successful. However, occasionally some patients present a challenge when they have not responded to conventional treatments....

Imaging of the parathyroid glands in primary hyperparathyroidism: where do we stand?

Primary hyperparathyroidism (PHPT) refers to an intrinsic parathyroid gland abnormality that produces excessive secretion of parathyroid hormone. PHPT is diagnosed biochemically, and surgical excision of the abnormal parathyroid tissue represents the only definitive cure. Historically, the standard operative management of...

Choline PET-CT: an accurate diagnostic tool for the detection of parathyroid adenoma?

Hyperparathyroidism (HPT) is an endocrine disorder characterised by an increase in the secretion of parathyroid hormone (PTH), with a resulting increase in calcium plasma levels, which can cause renal lithiasis, fractures, and osteoporosis, the most frequent symptoms of the disease....

Parathyroidectomy

Many ENT head and neck surgeons are now involved in thyroid surgery. This can also include the need to explore the parathyroids, either to preserve them or indeed to resect parathyroid adenomas. David Smith, a highly experienced endocrine surgeon from...

Parathyroid pearls

This article serves to deliver some pearls of wisdom in parathyroid surgery for the ‘low volume parathyroid surgeon’. They have been divided into those relating to the preoperative diagnosis, imaging and localisation techniques and surgical difficulties. Recognised sources of error...

A rare superior tongue tie

The authors present a very rare case of ankyloglossia superior syndrome: first described in 1911 but with only 14 case reports in English literature it was of sufficient interest to discuss the aetiology, classification and management. As the palatal shelves...

Imaging in hyperparathyroidism

Following their caudal migration at eight weeks of development, the parathyroid glands normally locate posterolaterally to the upper pole of the thyroid gland at the level of the cricoid cartilage (superior parathyroid glands arising from the fourth branchial pouch and...

What’s new in the cochlea?

Prof Furness in this article rounds up the steps and leaps being made by the scientific community to develop therapies to support, rejuvenate and / or replace the cochlear structures. David’s electron microscope images of the cochlear structures are world...

Nuclear heads – and necks

Imaging of the extra-cranial head and neck is challenging due to the anatomic complexity of the region. CT, MRI and ultrasonography (US) are amongst the most frequently utilised radiological modalities in head and neck imaging but do not always provide...

The changing landscape of thyroid and parathyroid surgery

How has clinical practice in the management of thyroid and parathyroid disease has evolved in recent years? I perform very few head & neck operations where the patient tells me just one week following surgery that they ‘feel much better’....

Targeted focal parathyroidectomy

Leanne Hamilton and Louise Clark describe their technique for helping to localise parathyoid adenomas. Surgically this can be difficult, so careful preoperative evaluation using imaging as described can help minimise difficulties intraoperatively when identifying the parathyroid adenoma. Preoperative imaging has...

Using tele-audiology in Zambia’s ear and hearing care desert

Addressing the medical desert with tele-audiology and tele-education. If a ‘medical desert’ is defined as a community that lives more than 60 miles away from the nearest acute care hospital, then try to imagine an appropriate term for a situation...