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Detecting postoperative cholesteatoma with diffusion weighted magnetic resonance imaging

Middle ear cleft cholesteatoma is an inflammatory disease that erodes local bony structures and can cause otorrhea, hearing loss, vertigo and intracranial complications. It is usually treated with surgery, typically canal wall up (CWU) or canal wall down (CWD) surgery....

Intratympanic treatments for subjective idiopathic tinnitus

Direct application of medication into the ear is long established, going back as far as written records. In the modern era, greater understanding of aural anatomy revealed that drugs instilled in the middle ear could potentially diffuse into the cochlea...

What’s new in implantable devices? New indications in cochlear implantation

For over 40 years, cochlear implant procedures have steadily increased. Outcomes for patients are improving as a result of modified surgical techniques, a wider portfolio of electrode arrays, advances in programming strategies, access to improved technology and a better understanding...

Surgical management of congenital nasal pyriform aperture stenosis

Introduction Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of neonatal upper airway obstruction which was first described by Douglas in 1952 [1]. The first radiological description of CNPAS was described by Ey et al in 1988 [2]....

Changing perceptions in head and neck cancer management caused by quality of life issues

Sir Felix Semon was an outstanding clinician and exceptional laryngologist. The money raised by donations from his colleagues on his retirement in 1909 was used to establish the London University’s Semon Lecture. Semon’s Obituary in the BMJ, reads: “In Semon's...

Practical training courses for otolaryngology trainees

In this extended Trainee Matters, it’s a pleasure to present a trio of excellent articles with a theme of practical training courses for otolaryngology trainees. Miss Rachel Edmiston, Professor Nirmal Kumar and colleagues have written a valuable guide to setting...

Imaging tinnitus

Tinnitus is a common sensation with a reported prevalence of 7-32%. The British National Study of Hearing recorded that 10% of adults suffered from prolong spontaneous tinnitus, and approximately a quarter of these are subsequently referred to hospital for investigation...

Surgical management of sleep disordered breathing

Snoring and sleep-disordered breathing are often described as multi-level problems, and different surgical procedures are required to treat the various sites of airway narrowing and/or collapse. Jonathan Hobson gives us an eloquent run-through the various options available to the ENT...

Timing of surgery in chronic rhinosinusitis: does it matter?

While many patients with chronic rhinosinusitis respond to medical treatment, some do not. The next step for these patients is surgery, but how soon should this be offered? Sooner rather than later seems to be the answer, as Claire Hopkins...

Robotic surgery for squamous cell cancer: the new frontiers

Although the da Vinci platform was FDA approved for early-stage oropharyngeal cancers, the indications have expanded. In this article, John Hardman explains how surgeons, with greater understanding of the strengths and limitations of robotic surgery, have systematically set out to...

Olfaction in CRS

Conventional teaching tells us that hyposmia in chronic rhinosinusitis is due to mechanical obstruction of the olfactory cleft. But it might be that the story is slightly more complicated than that. Olfactory dysfunction is a common feature of chronic rhinosinusitis...

Measuring the pitch and loudness of tinnitus

Matching the characteristics of tinnitus Many researchers and clinicians have explored the subjective nature of tinnitus by asking people with tinnitus to adjust a sound so that it matches their tinnitus in some way. This can be useful both for...