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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...

Should we be doing earlier MRIs in sudden sensorineural hearing loss?

There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....

Diagnosis and management of acute sensorineural hearing loss: a Japanese perspective

In this paper, the authors set out the clinical guidelines to standardise diagnosis and treatment of acute sensorineural hearing loss in Japan. They categorised acute sensorineural hearing loss into five disorders: idiopathic sudden sensorineural hearing loss (iSSNHL), acute low-tone sensorineural...

How rare is vocal fold paralysis after spinal and epidural anaesthesia – should we be more concerned?

The authors present an unusual case of right vocal fold paralysis. Their patient was a 38-year-old woman who experienced new onset dysphonia following neuraxial anaesthesia (NA) for a caesarean section. Flexible nasendoscopy showed a right VFP with fixation in the...

Olfaction in CRS

Conventional teaching tells us that hyposmia in chronic rhinosinusitis is due to mechanical obstruction of the olfactory cleft. But it might be that the story is slightly more complicated than that. Olfactory dysfunction is a common feature of chronic rhinosinusitis...

Ear, nose and throat surgery in children – where will it be in 15 and 50 years?

Michael Kuo, David Albert and Mike Saunders have put their collective heads together to predict the future of ENT surgery in children; will there be a rise in workload due to increasing survival of children with complex medical problems? Or...

The ENT operating theatre viewed down the retrospectoscope

We learn much of our future by looking at our past; Douglas MacMillan provides us with a fascinating glimpse into his years as a junior doctor. The operating theatre was a somewhat alien environment in the late 1960s: theatre sisters...

Endolymphatic sac surgery: controversial procedure for the treatment of Ménière’s disease

Landmark Paper: Thomsen J, Bretlau P, Tos M, Johnsen NJ. Ménière’s disease: endolymphatic sac decompression compared with sham (placebo) decompression. Ann N Y Acad Sci 1981;374:820-30. Of all of the chapters in the Landmark Papers book, the chapter that discussed...

When to operate on a patient without chronic disease?

As ENT surgeons, we spend a lot of time managing chronic rhinosinusitis, so a review and update on the management of the acute disease is always helpful. The standard medical treatment of antibiotics, nasal steroids and nasal decongestants are reported...

Is there evidence to support early discharge of patients with tonsillitis, quinsy and epistaxis?

The COVID-19 pandemic, with its unprecedented pressures on the NHS, demands changes in the management of common ENT emergencies. In this review article, information has been gleaned from 22 relevant articles on how this can be done. The Portsmouth tonsillitis...

Possible correlation of ABR changes with prognosis in sudden sensorineural hearing loss

A sensorineural hearing loss (SNHL) of 30dB or more affecting at least three frequencies and occurring over less than three days is classified as ‘sudden’ SNHL (SSNHL). Treatment is urgently undertaken with systemic and/or intra-tympanic steroids, and ijn some cases...