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Canal wall down with obliteration of cavity for paediatric cholesteatoma
The authors present evidence that canal wall down (CWD) surgery with primary obliteration is an effective way to treat paediatric cholesteatoma. Fifty-eight ears were operated on and follow-up was for five years on average. Residual cholesteatoma rate was 9.9% with...
Benign oesophageal strictures: overview and management strategies
Benign oesophageal strictures may have several attributable causes including caustic injuries, long-term acid reflux, eosinophilic oesophagitis, anastomotic strictures and endoscopic therapy. Endoscopic dilation via bougies or balloon dilators may treat most strictures successfully and satisfactorily. However, in some situations treatment...
Corticosteroid prescribing in ENT - are we at risk of being sued?
Of medications leading to malpractice claims, corticosteroids comprise the third most common. They are used widely and have a significant side-effect profile: hypertension, lipodystrophy, diabetes, avascular necrosis of the femoral head, peptic ulceration and psychiatric reactions to name but a...
Immunosuppresants and ototoxicity
There is a wide range of immunosuppressant drugs ranging from calcineurin inhibitors (e.g. cyclosporine), anti-folic agents (e.g. methotrexate) to anti-TNF and monoclonal antibodies, many of which could be ototoxic. The authors performed a systematic review assessing ototoxicity secondary to immunosuppressant...
Balloon eustachian tuboplasty and inferior turbinectomy
This Taiwanese prospective case-control study looked at concurrent inferior turbinectomy (via submucosal turbinectomy) and balloon eustachian tuboplasty on symptoms related to eustachian tube dysfunction. A total of 50 patients who underwent inferior turbinectomy with balloon eustachian tuboplasty were recruited prospectively...
Multiple surgeries for RRP – does a greater number of operations result in a worse voice outcome?
Recurrent respiratory papillomatosis (RRP) of the larynx remains a challenging condition to treat, with a number of affected patients requiring multiple operations to remove recurrent disease over the course of their lifetime. At the most severe end of the spectrum,...
Does balloon tuboplasty work in the long term, and how can we measure outcomes?
There is much interest and debate at ENT conferences and within current literature about the role of balloon dilatation techniques for Eustachian tube dysfunction (ETD), a condition which we still only have limited understanding of, and which can be challenging...
Peripheral nerve stimulation for chronic refractory pain
Peripheral nerve stimulation (PNS) plays an important role in treating chronic refractory pain syndromes that manifest in limited distributions and overlap with areas of neurologic innervation. The process is generally thought to capitalise on the inhibition and activation of pain-related...
What we need to know about the new frontier of inner ear therapies
This is an interesting and topical review of the emerging biotechnology and pharmaceutical solutions for hearing loss and related conditions such as tinnitus. This paper suggests we are on the cusp of a very large step-change in the way we...
Modified subciliary approach to the orbital floor
Fractures involving the lateral midface and orbital floor are routinely treated by maxillofacial surgeons. The surgical management requires access to the facial skeleton to reposition and free the soft tissues. There are three main approaches to the orbital floor: infraorbital;...
Management of patients with advanced otosclerosis
This paper discusses the management options of advanced otosclerosis. There are several definitions for advanced otosclerosis in the literature but, more recently, the diagnosis of advanced otoscletosis has been reserved for patients who have less than 30% aided speech discrimination...
