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Chronic rhinosinusitis – a pre-malignant condition?

Nasopharyngeal carcinoma (NPC) is a relatively uncommon diagnosis in the West but is prevalent in Southeast Asia. Several factors have been established to be associated with a higher risk of developing NPC, including salted fish consumption, smoking, alcohol, and Epstein...

Evidence based guidelines for ONS treatment in occipital neuralgia

Occipital neuralgia (ON) can flummox otolaryngologists especially when it follows mastoid surgery. The paroxysms of sharp, electrical pain originating from the occiput can extend along the posterior aspect of the scalp and even up to the mastoid. Although the aetiology...

Open septorhinoplasty approach for closure of medium sized septal perforations

Septal perforations are difficult problems to treat. There are various causes described in literature such as trauma, inflammatory, cocaine abuse but most often they are due to iatrogenic cause (such as septoplasty) or due to trauma. The symptoms due to...

Mentorship and its role in surgical training

Is there a principle which could help address multiple challenges in surgical training? One which has potential to improve recruitment and retention of staff to our specialty, quality of patient care and surgeon morale? Harry Spiers, an Academic Foundation Doctor...

Cognition and hearing – you can’t test one with the other!

Cognitive Psychologist, Boaz M Ben-David, provides insights into the import of considering cognitive factors when assessing speech perception ability to maximise intervention success. Failing to do so, he suggests, is “ageist”, a predisposition healthcare professionals must avoid. Cognitive performance is...

A practical approach to tinnitus

Tinnitus is the perception of sound without an external source. The estimated prevalence in adults is between 10-15% [1]. In patients with significant tinnitus, prompting them to seek medical attention, 50% will have improved to mild or no tinnitus by...

CIICA’s new resources: summaries of the CI information from the WHO World Report on Hearing

The new global network, CI International Community of Action (CIICA) has produced four summaries from the exciting and comprehensive World Report on Hearing 2021. These summarise the information and evidence about cochlear implants (CIs) included in the report which are...

A ‘smarter’ personal amplification device

The hearing aids available on the market today are undeniably impressive, particularly when compared to their clunky and squeaky predecessors. At a most basic level, hearing aids sample the surrounding auditory signal in real-time, breaking sounds down into frequency-specific channels....

Balloon dilatation of the eustachian tube - largely very safe but not entirely without risk

Consent is a fundamental part of our daily working lives. This is something as simple as consent to examine a patient, consent to undertake a procedure as minor as taking blood, through to consent for a major operation. Whatever the...

Hyposalivation: a review of current and future treatments

Hyposalivation remains a stubbornly difficult condition to treat, but novel therapies may not be far away. Saliva has many essential functions, including aiding digestion and swallowing, lubrication, maintaining tooth integrity and antibacterial activity. When patients experience reduced saliva production (hyposalivation),...

Targeting the microbiome in chronic rhinosinusitis

Researchers at St Paul’s Sinus Centre and UBC in Vancouver are testing a novel treatment for CRS: transferring mucus from a healthy donor into a patient’s sinuses. Chronic rhinosinusitis (CRS) is one of the most common diseases managed by otolaryngologists...

Have we reached our limits in endoscopic skull base surgery?

As being an anterior skull base surgeon becomes the aspiration of many ENT trainees, Professor Nicolai gives his personal insights into the future for this exciting subspeciality. Having been directly involved in the evolution of transnasal endscopic surgery (TES) since...