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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....

The debate: endoscopic vs microscopic ear surgery – meta-analysis of outcomes

Although the endoscopic approach to ear surgery has become more common in clinical practice, the debate about its role versus the traditional microscopic approach continues in many ENT units. This meta-analysis from the Mount Sinai ENT department in New York...

Strength of evidence in otolaryngology research – do women make the difference?

Clinicians around the world understand the need for research and publication of gathered evidence to inform practice and improve patient outcomes. The introduction of the Oxford Centre for Evidence-based Medicine (CEBM) Levels of Evidence guideline in 2011, has been invaluable...

Can and should vestibular schwannoma surgery be carried out via the endoscopic transcanal approach?

The extent and scope of endoscopic ear surgery has rapidly progressed in recent years, and this paper, from one of the leading proponents of this technique, reports on the outcomes of a case series of patients who have had total...

How effective and safe is audiologist-led screening of acoustic neuroma in patients with asymmetrical hearing loss and unilateral tinnitus?

About two out of 100 patients presenting with asymmetric hearing and unilateral tinnitus have acoustic neuroma. The traditional method in which these patients first attend a clinician and then undergo screening through an MRI, can be expensive and prolong the...

Diagnostic performance of non-echo-planar diffusion weighted MRI in detection of suspected cholesteatoma

Even though a ‘second look’ remains a gold standard for detection of residual cholesteatoma after intact canal wall techniques, non-echo-planar diffusion weighted MRI is considered a reasonable alternative to avoid further surgery. However, to establish or exclude a cholesteatoma de...

Role of oral and intranasal steroids in the management of otitis media with effusion

Inflammation is considered an important factor in the pathogenesis and continuation of otitis media with effusion. Theoretically, this may support the use of steroids, oral or intranasal in the management of this condition. This study comprised three well matched groups...

Can we tell the difference between benign recurrent vertigo, migraine and Menière’s disease?

I chose to review this article as it reminds us of the difficulties in diagnosing dizzy patients accurately and the significant crossover of symptoms between the diagnoses. Does Benign Recurrent Vertigo (BRV) even exist as a separate entity? BRV is...

An app to help display hearing results

Vestibular neuronitis (VN) is a common condition that we treat. Despite this, many of us lack the in-depth knowledge and scientific reasons for doing what we do. Granted, the evidence is lacking in some areas but this paper is worth...

The initial electroneuronography result after temporal bone trauma related facial palsy may be misleading

It is taught that a complete facial nerve (FN) palsy after temporal bone (TB) trauma should be conservatively managed if electroneuronography (ENoG) shows a less than 90% degeneration of response compared to the contralateral side. This small study from the...

Rationales to explore the neck in penetrating injuries

Penetrating neck injuries in the UK are more commonly associated with low velocity objects such as knives and blades as opposed to gunshots. To explore the neck requires careful consideration of the need to do so in line with Burgess...

Associated findings in MRI used for detecting acoustic neuroma

Presently, gadolinium enhanced magnetic resonance imaging is the ‘gold standard’ for investigating acoustic neuroma. There are often ‘incidental’ findings that may or may not be significant. In this study of 109 scans, the authors noted an uptake of 0.9% for...