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Stepwise approach to manage palatal myoclonus successfully
Palatal myoclonic tinnitus (PMT) is a rare condition caused by rhythmic voluntary or involuntary movements of the soft palate, mainly the tensor veli palatini and levator veli palatine muscles. Patients usually present with a ‘clicky’ noise in the ear. Oral...
Lingual tonsils and obstrucive sleep apnoea syndrome (OSAS)
Obstructive sleep apnoea can be due to narrowing of the retrolingual space by hypertrophic lingual tonsils. The authors studied 11 patients (five males and six females with a mean age of 44.3 years and a mean BMI of 28.6). All...
What about the older adults?
The authors of this paper propose that significant changes in the delivery of services, including speech and language therapy management of swallowing difficulties, may be required. Among the most common causes of dysphagia in older adults are stroke, progressive neurological...
Paediatric vestibular dysfunction
This Malaysian study looked at the awareness amongst otorhinolaryngologists in the investigation and management of paediatric vestibular dysfunction. The authors noted that, although paediatric vestibular dysfunction is a common problem, there seems to be limited literature in assessing the proficiency...
When to treat a fractured mandible?
This is a prospective study from Brisbane of 215 patients with a total of 359 fractures of the mandible. Nine outcome variables were analysed with a further 19 included to adjust for potential confounding. Treatment delay was found not to...
How best to manage single-sided deafness?
Nowadays there is a plethora of options for patients with single-sided deafness (SSD) including: Bluetooth contralateral routing of signal (CROS) aids; in-the-ear bone conduction hearing aids (TransEar); intra-oral bone conduction aids (SoundBite) and bone-anchored technologies (BAHA). Unilateral cochlear implantation is...
Mindfulness meditation versus relaxation therapy for tinnitus
Tinnitus, defined by McFadden as “a conscious experience of sound that originates in the head of its owner, without an external acoustic source”, has a high prevalence and variable psychological impact. It results from maladaptation of the brain to a...
Scoring system to predict hearing impairment following hemifacial spasm surgical treatment
The authors analysed brain stem auditory evoked potentials prospectively in 100 patients undergoing endoscopic microvascular decompression for management of hemifacial spasm over a period of two years. They then developed a scoring system based on electrophysiological events to predict the...
Precision medicine in allergic rhinitis and chronic rhinosinusitis
Precision medicine (PM) with its ‘four Ps’ (personalised, predictive, preventive and participatory) is about appreciating differences between individuals when offering management options for health problems. Multiple groups interested in rhinology such as EPOS and ARIA supported a review of the...
Neck dissection in adenoid cystic carcinoma is a risk worth taking?
This paper from Stanford University presents impressive figures to guide the debate on the extent of surgical management in adenoid cystic disease. Adenoid cystic carcinomas present a particular problem in that they can recur even after 20 years. They have...
Balloon dilatation is an effective adjunct
This is a good study design, sufficiently powered, comparing medical management to balloon sinus dilatation. All patients had failed medical management and were thoroughly assessed preoperatively with Lund-Mackay score confirming abnormal CT findings, SNOT 20 index score, chronic sinusitis score...
