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Can smaller cancer centres deliver high quality care for patients with laryngeal cancer?

There is a continuing conflict between treating patients as close to their homes as possible and centralising specialised services, taking into consideration the critical mass and the multi-disciplinary expertise available. This is a report of outcomes in the treatment of...

Hearing loss in the contralateral ear after mastoid drilling

It is difficult to conceive that most of the noise generated by drilling the mastoid would not be conveyed to the contralateral cochlea, by direct transmission through the skull bone, where the attenuation factor is only 5-10 dB. Only a...

Cochlear implantation in the over 85s

An ageing population globally, means that the individuals of some countries are now living longer and, as hearing loss is commonly associated with the elderly, there will be more elderly people eligible for cochlear implantation. Hearing loss itself is associated...

Gastrostomy tube dependence following TORS

Transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC) is now a well-established treatment modality for early (T1-T2) disease. Accumulating evidence suggests that one of its main benefits relative to conventional chemoradiotherapy is superior long-term functional outcome, especially with...

Predicting the nature of swallowing deficits caused by surgical resection of the tongue?

Patients treated surgically for cancer of the tongue are expected to have difficulty in eating, drinking and swallowing. The authors of this paper report on a cohort of 106 patients in their practice who had surgical resection as primary treatment....

Non-autologous graft material in paediatric tympanoplasty – is it as good as temporalis fascia and is it cost-effective?

This retrospective case review looks at the experience of a single unit using a variety of autologous (temporalis fascia, n=292) and non-autologous graft material, n=241 (alloderm (human dermis), biodesign (porcine submucosa, $170-$255) and tutoplast (human pericardium, $350). The average patient...

Unravelling the Meniere’s vs. migraine conundrum – what does the mastoid contribute?

This is an interesting observational study that attempts to classify subtypes of Meniere’s disease (MD) in relation to the coexistence of migraine. It is well known that the two conditions share common characteristics, making diagnosis and treatment challenging at times....

Cochlear implants in the over 80s

The UK has an ageing population. Seven percent of the over 80s population have bilateral severe to profound hearing loss which can lead to associated negative outcomes (social isolation, depression and reduced quality of life). Cochlear implantation (CI) can successfully...

Is endoscopic stapes surgery safe and are outcomes comparable to microscopic stapes surgery

Endoscopic techniques for visualisation of the middle ear were described in 1967 by Mer and colleagues, and the use of transcanal endoscopic ear surgery (TEES) has since expanded to a wider range of otologic applications including tympanoplasty and excision of...

Pulsatile tinnitus, one more piece in the jigsaw

Pulsatile tinnitus (PT) is a common ENT symptom. It can generally be divided into venous and arterial. Arterial PT might be investigated with a CT scan while a venous one with an MRI or an MRV (MRI Venogram). Anecdotally, arachnoid...

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....

Access to and uptake of cochlear implants in the UK

Assessing demands on cochlear implant (CI) services is very important for both commissioners and clinicians in anticipating clinical need and funding requirements. Commercial CI’s were introduced in the late 1980s. Initial funding was from charitable sources. The first major advance...