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Immunosuppresants and ototoxicity

There is a wide range of immunosuppressant drugs ranging from calcineurin inhibitors (e.g. cyclosporine), anti-folic agents (e.g. methotrexate) to anti-TNF and monoclonal antibodies, many of which could be ototoxic. The authors performed a systematic review assessing ototoxicity secondary to immunosuppressant...

Compress to suppress the venous tinnitus

This interesting retrospective case series analyses the effectiveness of a modified surgical technique with retromastoid reconstruction of the sigmoid sinus by mechanical compression with Surgicel and bone wax packing under local anaesthesia for patients with venous pulsatile tinnitus related to...

Stapedotomy in osteogenesis imperfecta

Osteogenesis imperfecta (OI) is a rare connective tissue disease caused by a defect in collagen structure. Hearing loss is a characteristic feature of OI. It typically presents with conductive hearing loss initially, followed by a superimposed sensorineural component later in...

Is a hemithyroidectomy as effective as a total thyroidectomy for compressive symptoms?

The claim made in the title of this paper, that hemithyroidectomy is equally as successful as total thyroidectomy in alleviating compressive symptoms from goitres, is certainly intriguing. And with the inclusion of 45,539 subjects, it would at first glance seem...

Management of patients with advanced otosclerosis

This paper discusses the management options of advanced otosclerosis. There are several definitions for advanced otosclerosis in the literature but, more recently, the diagnosis of advanced otoscletosis has been reserved for patients who have less than 30% aided speech discrimination...

Suspect the unsuspecting in thyroid cancer

This article reminds readers of how often invasive thyroid disease can appear, as the symptomatology is minimal. Noticeable airway symptoms appear after 50% of the airway is involved and surgeons can often fall in the unsuspecting trap of discovering locally...

Nasal nitric oxide – an inflammatory marker in paediatric allergic rhinitis?

Nasal nitric oxide (nNO) is mainly produced in the paranasal sinus mucosa and was shown in some studies to have increased expression in allergic rhinitis (AR). Although it represents a potential non-invasive tool for AR measurement, there remains no consensus...

Adenoidal hypertrophy in children with allergic rhinitis

Nasal congestion in children with allergic rhinitis can be confounded by adenoidal hypertrophy. This retrospective Turkish study examines this association in more detail. The sample studied was 566 children (age 2-18) that were diagnosed (based on ARIA guidelines) and treated...

Cystic fibrosis – sinus surgery delays chronic Gram-negative lung infection

This prospective clinical follow-up study is of 106 patients with cystic fibrosis in Copenhagen. Morbidity and mortality in CF are significantly associated with pulmonary colonisation and infection, usually with Gram-negative bacteria. Initially this can be well treated with antibiotics until...

Differing types of pharyngeal pouch

This article raised an eyebrow on the grounds that apparently more than one type of pharyngeal pouch exists! They differ in terms of aetiology, site and approach to treatment, therefore awareness of them is advised to ensure the appropriate surgical...

Surgeons and swearing

We will all know colleagues who have raised the act of swearing to an art form; just as Malcolm Tucker in The Thick of It could cut a workmate in half with a well-placed swear word, surgeons can be equally...

Voice after posterior cordotomy: we think voice is bad, patients think it’s better!

Bilateral vocal fold immobility (BVFI) is a condition that can affect voice with an impact on quality of life (QOL). Surgical trauma from damage to bilateral recurrent laryngeal nerves, such as from previous thyroid, parathyroid, or mediastinal surgery are common...