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Health related quality of life measures as outcome parameters in middle ear diseases

Surely the only outcome needed for post-surgical ears is a better PTA? Marcus Neudert argues there should be more to it than that. To draw a comprehensive picture of the disease-associated restrictions in patients with chronic otitis media, audiometric outcome...

To scan or not to scan?

This comprehensive review article seeks to establish how useful is MRI in the evaluation of patients with a history of smell loss or distortion. Interestingly, while some studies found the imaging unhelpful, one paper described found a 25% rate of...

To scan or not to scan, otosclerosis

Otosclerosis can co-exist with other ear pathologies such as superior semicircular canal dehiscence (SSCD). Stapedectomy in this situation can lead to development of SSCD symptoms. Authors conducted an email-based survey involving active members of the American Neurotologic Society (ANS) and...

Algorithm for malignant otitis externa

Timely detection and effective management of this potentially fatal condition cannot be overemphasised. This study presents 16 cases over 12 months in a tertiary referral centre. Most patients had diabetes and others were immunocompromised due to radiotherapy, immunosuppressive medication or...

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...

Parathyroid surgery in day care

Targeted parathyroid adenoma excision via preoperative ultrasound and radionuclide scanning techniques allow accurate localisation of the affected gland, allowing a minimally invasive surgical approach. The authors reviewed 144 cases undergoing surgery for primary hyperparathyroidism. Of these 67 were eligible for...

Best timing for post-treatment PET-CT scans in head and neck cancer

Unfortunately we know that the recurrence rate for head and neck cancer can be high, up to 30-50% in some series. These recurrences tend to occur within the first two years following treatment. Optimal surveillance strategies to detect recurrences early...

Short-term risk of falling after cochlear implantation

This paper examined the effect of cochlear implantation on balance function in 16 adult patients. The authors assessed balance pre- and (two weeks) post-operatively by timing how long each patient was able to stand on a foam pad with their...

Developing outcome measures for research

There are challenges in developing outcomes measures; Professor Hall presents five top pointers for making rapid progress in developing outcome measures for research purposes. Anyone who has worked clinically with hearing loss will appreciate that every patient’s experience is personal....

Anaesthesia for sleep nasendoscopy and snoring / obstructive sleep apnoea surgery

Surgery for sleep disordered breathing inevitably requires surgeon and anaesthetist to share the airway. Here, Edward Bick gives us the anaesthetic viewpoint, reiterating that communication is the key. A specific note is made of the anaesthetic technique for sleep nasendoscopy,...

Technology at the right time in the right place for people with communication difficulties

The ‘just-in-time’ (JIT) construct was developed as a business strategy for a major Japanese car company in the 1970s. It has now been applied to many other business models throughout the world. The JIT concept is where something is provided,...

Malignant lesions and reconstruction of the pinna

External ear reconstruction can be challenging. Baskaran Ranganathan and Amr Abdelhamid describe how careful assessment, planning and surgery following the subunit principles and reconstructive ladder will ultimately lead to good aesthetic outcomes with restored form and function. The external ear,...