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Should all patients with BPPV have an MRI?
This paper describes an interesting series of 500 patients over a 10-year period with posterior canal BPPV, who had been investigated with MRI. The female to male ratio was 1.6:1 with a mean age of 56. There was a right...
To monitor the nerves or not?
Whilst intraoperative nerve monitoring has become the standard of care for mastoid and parotid surgery, its benefit in thyroid surgery remains unclear. In the UK NICE was agnostic on the subject in 2008, stating that it was potentially helpful and...
What are the non-inflammatory causes of a conductive loss?
This retrospective study looked at patients with an intact tympanic membrane with non-inflammatory causes – i.e. otitis media and cholesteotoma. They document their findings based on exploratory tympanotomy. They operated depending on the findings with either a stapedectomy or a...
Robot controlled mastoid surgery!
This is a fascinating piece of work by a Korean team developing a human-robot collaborative control. Their model uses image guidance surgery to locate the drill tip’s position. Important structures can be highlighted – in this case the facial nerve....
Risk factors for post laryngectomy fistula
This is a meta-analysis looking at the postoperative pharyngocutaneous fistula rates following total laryngectomy. The authors ended up with 34 studies with about 2500 patients. The most striking finding was that preoperative radiotherapy was a significant risk factor as well...
What’s the risk of regrowth with partial (intracapsular) tonsillectomy
Partial (intracapsular) tonsillectomy is enjoying somewhat of a revival offering the potential for less postoperative pain and bleeding whilst relieving the obstructive element. The authors look at 303 patients, 82 of whom had partial tonsillectomy using coblation. They measured pre...The first compact auriscope: the 1865 speculum auris of Dr Brunton
Bringing light into darkness can also be a task for the physician. With the advent of endoscopy (initially by reflecting light into body cavities), new methods of diagnosis and treatment became available to the otologist. In 1865, the Scotsman John...
Do personal listening devices cause cochlear synaptopathy?
Cochlear synaptopathy is a condition in which noise interrupts the synaptic communication between sensory inner hair cells and low spontaneous rate cochlear nerve fibres. Since these nerve fibres are associated with signal coding in noisy backgrounds, their disruption leads to...
Prognostic value of vascular ultrasonographic findings in patients with idiopathic sudden sensorineural hearing loss
Sudden sensorineural hearing loss is often idiopathic. Although the aetiology of idiopathic sudden sensorineural hearing loss (ISSNHL) is unclear, vascular compromise is one of the frequently proposed hypotheses to explain its pathophysiology. Existing studies have shown an association between ISSNHL...
Role of intratympanic corticosteroid for treatment of Bell’s palsy and Ramsay Hunt syndrome
Acute peripheral facial palsy occurs annually in 30 in 1,000,000 individuals in the general population. Bell’s palsy and Ramsay Hunt syndrome account for about 70% of cases of peripheral facial palsy. They are believed to be caused by viral reactivation...
Pharmacological treatment of glue ear in children
Otitis media with effusion (OME), also known as glue ear, is a common cause of hearing loss in children. Most cases resolve spontaneously within three months. Early and proper management of OME can help avoid hearing and speech impairment that...
