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High dose betahistine as effective as, but slower acting compared to intratympanic dexamethasone in intractable Meniere’s disease

The management of intractable Meniere’s disease poses a complex conundrum to otolaryngologists. The focus of treatment is decreasing the severity and frequency of vertigo and tinnitus whilst trying to preserve hearing. Betahistine has been used for many years in the...

Low-frequency air-bone gaps appear to be a true audiological finding in Ménière’s disease

There is a lack of established objective tests in Ménière’s disease (MD) that can provide information about the disease process. The appearance of low-frequency air-bone gaps (LFABGs) in MD is a recognised but unexplored phenomenon. Two theories have been suggested...

Patients with auto-immune Meniere’s disease more likely to respond to intratympanic steroids

The authors retrospectively reviewed the duration of symptom control after intratympanic dexamethasone (IT) injections in 27 patients with Meniere’s disease (MD) over a six-year period. The patients received two IT injections of 3.3mg/ml of dexamethasone one-to-two weeks apart. Eleven patients...

The association of frontal recess anatomy and mucosal disease on the presence of chronic frontal sinusitis: a computed tomographic analysis

Ostial obstruction is a primary pathophysiological mechanism contributing to sinusitis, which can be caused by anatomical variations, mucosal inflammation or both. This retrospective case series aimed to identify anatomical factors and inflammatory areas relating to chronic frontal sinusitis on nasal...

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...

Is endoscopic approach more precise in addressing failed ventilation system in chronic mucosal ear disease?

Chronic mucosal disease, as opposed to cholesteatoma, is more directly related to failure of the ventilation system involving three channels. Isthmus anticus and isthmus posticus are channels in front and behind the long process of the incus and there is...

Does turbinoplasty outcome vary in the presence of allergic disease?

This well organised study from Australia looks at inferior turbinoplasty outcomes in patients with allergy and non-allergic rhinitis who have become refractory to medical treatment. There were 190 patients undergoing turbinoplasty with or without septoplasty assessed in this case-control study...

Head injury and prolonged bed rest, but not inner ear disease, predict poorer outcome after Epley manoeuvre in posterior semicircular canal benign paroxysmal positional vertgo (P-BPPV)

This Japanese study included 197 patients with P-BPPV treated over a two and a half year period. The vast majority had idiopathic BPPV (n=157). The remaining 40 had secondary BPPV, eight following head trauma, 14 due to prolonged bed rest...

Fungal rhinosinusitis

Allergic fungal rhinosinusitis (AFRS) has been defined by the following characteristics: presence of nasal discharge, nasal obstruction, decreased sense of smell or facial pressure for 12 weeks, mucin within the sinus cavity containing fungal hyphae and degranulating eosinophils, endoscopic evidence...