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Choosing instrumental assessments of swallowing for children
Swallowing disorders in children are increasingly common due to advances in medical care allowing them to survive prematurity or complex health conditions. Careful assessment of eating and drinking is necessary to ensure that children are managed both safely and with...
The sleep nasendoscopy learning curve
There seems to be no accepted way of surgically assessing patients with sleep disordered breathing (SDB). Because of this, clinicians fall roughly into three camps: those who just use one operation for all patients, those who have given up surgery...
Vestibular paroxysmia, diagnostic controversy clarified?
Historically, the cause of vestibular paroxysmia (VP) had been attributed to neurovascular compression of the eighth cranial despite the observation that such compression is very common in asymptomatic subjects. This paper, part of International Classification of Vestibular Disorders (ICVD) by...
Hearing provides cues for the maintenance of balance
It is well known that balance relies on the integration of vestibular, visual and proprioceptive cues. However not much mention or attention has been given to the importance of auditory cues for balance maintenance. The authors set up experiments to...
Personal music systems are causing hearing loss
Sitting next to a teenager on a train with their iPod turned up loud enough for the entire carriage to hear is annoying, most will agree. Perhaps I might educate them about the risks of ‘music’ (if you can call...
Do certain chronic medications increase dysphagia in older people?
Oropharyngeal dysphagia is known to affect a high number of older people in the community, in care homes and in acute geriatric admissions to hospital. The authors of this study have recognised that many older people take drugs for chronic...
The video head impulse test: an aid to the diagnosis of spinocerebellar ataxias
Spinocerebellar and Friedreich ataxias (SCA and FA) by their nature present in neuro-otology clinics. The diagnosis is ultimately genetic but the authors investigated the characteristics of the VOR using the video head impulse test (vHIT) in order to distinguish between...
Marshmallows for swallowing assessments!
The complaint of ‘food sticking in my throat’ is one many of us will have heard several times in clinical practice. The authors of this study report the prevalence of this symptom to be between 5-8% in the general population...
Posturography in persistent postural-perceptual dizziness (PPPD)
Those in neuro-otology practice will be familiar with PPPD now appearing in the forthcoming beta edition of ICD-11. This condition combines the symptoms of phobic postural vertigo and chronic subjective dizziness in which anxiety plays a part. The underlying hypothesis...
When you regret an implant!
Cochlear implants (CIs) offer a solution to hearing loss not helped by conventional hearing aids. CIs help in improving speech recognition scores. While significant, it is not sufficient to provide satisfaction in some implantees. Alignment between expectations and realistic outcomes...
A systematic review of adjunctive probiotic therapy in the management of chronic rhinosinusitis
It is generally understood that administering substances containing live microbiologically active micro-organisms (probiotics) enhances the treatment of chronic rhinosinusitis. Probiotics manipulate and rebalance the alterations occurring in the local microbiome in chronic rhinosinusitis patients. This results in propagation of healthy...
