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CT and intraoperative nerve monitoring to identify non-recurrent laryngeal nerve during thyroid surgery

A non-recurrent laryngeal nerve (NRLN) is a rare (incidence 0.3% to 1.3%) anatomical variant that results in a higher rate of vocal cord palsy following thyroid surgery. This team from China examined the utility of preoperative CT and intraoperative nerve...

Vascularised tissue in salvage total laryngectomy

Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...

Nasal polyps, does size matter?

This study from Germany investigates the correlation between nasal polyp size and return of olfactory function following endoscopic sinus surgery. Olfaction is affected more in patients with CRSwNP than with CRSsNP and the best chance of smell recovery occurs in...

Does endoscopic sinus surgery for chronic rhinosinusitis improve COPD?

Chronic rhinosinusitis (CRS) can be associated with asthma, with a reported frequency of asthma in patients with CRS of up to 44%. COPD is another lung condition that can be associated with CRS. This longitudinal study reviewed the nasal and...

Pharmacologic treatment options for tinnitus

This article summarises potential medications that could be used to treat tinnitus and the evidence behind their use. Effective medications to eliminate tinnitus remain elusive but treatment could be divided into two broad categories: treatment to reduce perception of tinnitus...

Prolactinomas: when to operate

Prolactinomas are the most common functional pituitary adenomas, comprising 40% of all pituitary adenomas. There are consensus guidelines and several common management pathways. This article discusses the role of surgery for these patients. Following diagnosis, the goals of treatment are...

How can we improve outcomes for patients with acute vestibular neuritis?

Vestibular neuritis is a common disorder that can leave up to 50% of patients with persistent vertigo symptoms for months to years following the acute insult. Often their first contact with ENT or balance specialists is many months after the...

Should we be doing earlier MRIs in sudden sensorineural hearing loss?

There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....

Diagnostic criteria for haemodynamic orthostatic dizziness

Over the past several years, the Bárány Society has been developing an International Classification of Vestibular Disorders (ICVD) in order to standardise diagnosis and nomenclature for both clinical and research purposes. Many in vestibular practice would be familiar with the...

Socially appropriate part II: therapy for people with TBI

Social communication is a complex behaviour comprising social and cognitive communication skills. Providing speech and language therapy (SLT) interventions for people with social communication difficulties following traumatic brain injury (TBI) requires the clinician to understand how ingredients from an evidence-based...

Eustachian tube function before and after FESS

This is a prospective study from the UK looking at Eustachian tube dysfunction (ETD) in patients with chronic rhinosinusitis (CRS) undergoing surgery. Fifty-seven consecutive patients who had failed medical therapy and were scheduled for endoscopic sinus surgery completed SNOT-22 and...

Is there a role for facial nerve decompression in Ramsay Hunt syndrome?

This is an interesting paper. The authors recommend a transmastoid facial decompression for patients with complete facial nerve paralysis with House Brackman HB 5/6 who do not show any sign of recovery after two weeks of treatment following a diagnosis...