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Evidence-based practice: management of sudden sensorineural hearing loss

What is the current evidence for medical management of sudden sensorineural hearing loss? Jessica Choong and Stephen O’Leary present a review of the current evidence of treatments options. Sudden sensorineural hearing loss (SSNHL) causes significant distress and, in many cases,...

Combination PPI and intralesional steroid treatment for recurrent laryngeal granuloma

The existence of a wide range of treatments for recurrent laryngeal granulomas (repeat surgery, high-dose proton pump inhibitor (PPIs), surgery with botulinum toxin injection, botulinum toxin injection alone, etc) is a testament to the refractory nature of this condition, with...

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...

Sinus implants to treat recalcitrant polyps

It is well established that the burden of chronic rhinosinusitis on healthcare costs and patients’ quality of life is high, and that current mainstream treatment options of oral or topical steroids are not without problems. This paper compares two RCTSs...

Hearing preservation in cochlear implantation – an American cocktail

There has been an increase in hearing preservation cochlear implant (HPCI) surgery over the last decade. Both steroid and L-N-acetylcysteine (NAC) were used and investigated respectively in the past in HPCI surgery. Authors investigated the role of perioperative NAC and...

Budesonide irrigation in polyposis

It is very well known through many RCTs and now meta-analyses that saline-based irrigation is beneficial in patients after sinus surgery. It is also demonstrated that intranasal steroids are beneficial postoperatively but there is also a trend for steroid based...

Aetiology, investigation and acute management of sudden sensorineural hearing loss

The cause of a single sided sensorineural hearing loss has a wide variety of aetiologies. This review, by Edwin Halliday, looks specifically at the differential diagnostic causes of a sudden sensorineural hearing loss, the relevant investigations and the management should...

Pharmacological treatment of glue ear in children

Otitis media with effusion (OME), also known as glue ear, is a common cause of hearing loss in children. Most cases resolve spontaneously within three months. Early and proper management of OME can help avoid hearing and speech impairment that...

Benefits of combined antiviral and corticosteroid therapy in Bell’s palsy and the role of decompression surgery

Early use of steroids has been established as standard management in Bell’s palsy but simultaneous use of antiviral agents has variable acceptance. This review article analyses statistically based evidence to settle the issue. High quality evidence from a 2009 Cochrane...

Does stress and anxiety worsen idiopathic sudden hearing loss outcomes?

There have been suggestions that the natural course of the idiopathic sudden sensorineural hearing loss (ISSNHL) is not affected by intensive therapy. There is speculation as to whether unknown factors affect the treatment prognosis. This is a retrospective study of...

Method of delivery: all topical nasal corticosteroids are not made equal

There is an increasing body of evidence that the role of surgery for chronic rhinosinusitis is to facilitate the delivery of topical medical treatment – most notably, topical corticosteroids. Two recent studies, one using flow dynamics and another one examining...

Complications associated with intra-tympanic steroid injections for sudden sensorineural hearing loss

Around 15,000 people in the UK experience a sudden sensorineural hearing loss (SSNHL) each year, and in the majority of cases the cause is unknown. Treatment options for idiopathic SSNHL include various modalities of steroid treatments which have known limitations...