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The challenge of disrupting the hearing care market in the USA

Barry Freeman, an Audiology Consultant of extensive global experience, examines the business model of hearing care service delivery in America. He discusses the challenges the profession has faced, and proposes some food for thought on learning from other health care...

Surgical challenges in advanced or recurrent thyroid malignancy

The management of thyroid malignancy and extent of surgery is controversial, especially considering the limitations of preoperative diagnosis. Neil Tolley provides guidance and reminds us of our responsibility not to over-treat. In the UK, 16% of thyroidectomies are performed for...

Global health missions – not just for consultants. A guide for trainees.

Lulu Ritchie is a courageous and driven trainee in London, inspired by humanitarian missions but conscious of the usual requests for consultant level doctors. Lulu didn’t let that hold her back. She found a way and has kindly summarised her...

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...

Should we do oesophagoscopy during panendoscopy?

Panendoscopy entails a complete evaluation of the upper aerodigestive tract, and consists of oral inspection, direct laryngoscopy, bronchoscopy, oesophagoscopy, or some combination of these procedures. Despite many advances in imaging over the years, a skilled surgeon’s eyes remain superior in...

Smoking and immunotherapy – does it worsen outcome?

This interesting study aimed to address the issue of smoking in patients who had their allergic rhinits treated by sublingual immunotherapy (SLIT). Assessment was with validated quality of life questionnaires. There were 163 patients recruited in Greece who had completed...

The workplace environment and doctors’ health (ENT)

It is well established that doctors have higher levels of stress, depression and suicide than the general population [1] and most other professional groups (Figure 1 illustrates the factors that can make us ill). In addition they have high levels...

An idiot’s guide to the Ministry of Health

Neville Chamberlain on an ill-judged charm offensive. Now I like to consider myself a well brought up sort of chap, and was always taught never to bring up religion, politics or (heaven forfend!) a lady’s name at the dinner table....

Cochlear implantation following radiotherapy treatment of vestibular schwannomas

The authors presented a case report and systematic review assessing the outcomes of patients from cochlear implantation (CI) following radiotherapy treatment for vestibular schwannoma (VS). Outcomes of cochlear implantation in these patients are uncertain due to the combination of both...

Secondary Rhinoplasty by the Global Masters

This well-written, beautifully illustrated two-volume book, along with its accompanying ebook version and videos, provides a comprehensive guide to the approach and techniques in secondary rhinoplasty. It builds on the knowledge and concepts in the world-renowned Dallas Rhinoplasty: Nasal Surgery...

What’s new in implantable devices? New indications in cochlear implantation

For over 40 years, cochlear implant procedures have steadily increased. Outcomes for patients are improving as a result of modified surgical techniques, a wider portfolio of electrode arrays, advances in programming strategies, access to improved technology and a better understanding...

Peripheral nerve stimulation for chronic refractory pain

Peripheral nerve stimulation (PNS) plays an important role in treating chronic refractory pain syndromes that manifest in limited distributions and overlap with areas of neurologic innervation. The process is generally thought to capitalise on the inhibition and activation of pain-related...