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The artificial eardrum: how an eggshell membrane fed a German ENT family

In the pre-antibiotic era, purulent otitis media often resulted in a permanent eardrum perforation with hearing loss. In addition to pig or fish bladders, eggshell membranes and cigarette paper were used as eardrum prostheses. I have vivid personal boyhood memories...

Absorbing the hurt

In this article, taken from his blog, ENT surgeon John McGarva reminds us that while we can’t fix everything, we may still be able to help. It was a long time ago. I was a scarily young Houseman, barely 22,...

Deep space neck infections and their management

This article explores the approach to managing patients with deep space neck infections. Clearly, an understanding of the fascial planes within the neck is required which then provides an understanding of the route of spread in these cases. The authors...

MRI scanning patients with cochlear implants and auditory brainstem implants

In the last five to six decades, MRI scanning has gone from physics experiments in Nottingham University through to Nobel prize-winning work by Sir Peter Mansfield and Paul Lauterbur, to a ‘routine’ imaging modality with an estimated 60 million MRI...

Post tonsillectomy recovery in thermal welding method compared with recovery in cold steel method

Many different methods for tonsillectomy have emerged but whether they provide an improvement over the traditional cold steel tonsillectomy is another matter. Thermal welding is a recent method of tonsillectomy in which the tissues are simultaneously coagulated and divided. In...

To endo or to micro, that is the question: the musculoskeletal paradigm

Endoscopic ear surgery is a newer concept compared with the microscopic one. Both could lead to musculoskeletal pain due to the long static posture of surgeons during otologic procedures. The authors conducted a study on eight otolaryngologists, four attendings and...

Surgical approach to trigeminal neuralgia

This article provides a summary of the operative techniques available for treating patients with trigeminal neuralgia who have medication resistant pain or medication intolerance. Microvascular decompression is performed via suboccipital craniotomy to find and resolve the underlying nerve compression. The...

Radiofrequency for tonsillectomy

This Turkish study compared the use of radiofrequency (RF) tonsillectomy to the more traditional cold steel dissection (CD) technique. The authors enrolled 114 patients undergoing tonsillectomy for chronic tonsillitis and tonsil hypertrophy (causing upper airway obstruction) over a 4-month period....

The video head impulse test: an aid to the diagnosis of spinocerebellar ataxias

Spinocerebellar and Friedreich ataxias (SCA and FA) by their nature present in neuro-otology clinics. The diagnosis is ultimately genetic but the authors investigated the characteristics of the VOR using the video head impulse test (vHIT) in order to distinguish between...

IV dexamethasone versus LA infiltration during paediatric tonsillectomy

Postoperative nausea and vomiting following tonsillectomy is important to control for improved oral intake and satisfaction following surgery. Optimal management is still debated. This team from Beirut conducted a randomised double blind clinical trial comparing the effect of intravenous dexamethasone...

How long after head and neck cancer diagnosis do patients need opioids?

With the advances in the management of head and neck cancer (HNC), patients tend to survive longer after their diagnosis. These people face the burden of chronic pain management which is strongly associated with HNC. A HNC team in Portland...

Medical trends in sleep disordered breathing

This duo provide an eloquent outline of sleep disordered breathing in general, with particular emphasis on the medical impact and associations of the condition. The increasing prevalence of the condition is described, with increasing worldwide obesity, increased association of cardiac...