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Round window niche drilling with intratympanic for ISSHL. A new option for salvage?

This paper from China compares the technique of widening the round window via a posterior tympanotomy approach and steroid-soaked gelatin sponge with intratympanic steroids alone for salvage therapy in severe idiopathic sensorineural hearing loss. Salvage therapy was defined as patients...

Endoscopic arytenoid abduction lateropexy for bilateral vocal cord paralysis in neonates

We are delighted to publish a further update on the use of the technique for vocal fold lateralisation in neonates from Laszlo Rovo and Shahram Madani, who have previously informed us of this new technique [1]. These cases are rare...

Aetiology, investigation and acute management of sudden sensorineural hearing loss

The cause of a single sided sensorineural hearing loss has a wide variety of aetiologies. This review, by Edwin Halliday, looks specifically at the differential diagnostic causes of a sudden sensorineural hearing loss, the relevant investigations and the management should...

The common frontal sinusotomy (Lothrop) and chronic rhinosinusitis

As our understanding of the pathophysiology of CRS evolves, so do our treatment strategies. It is accepted that in many cases, the main role of surgery is to allow better penetration of topical therapies to the sinus cavities. What, then,...

Is there a role for hyperbaric treatment in sudden hearing loss?

Sudden sensorineural hearing loss is a common presentation to ENT departments with a significant difference in management both at a local and regional level. The authors seek to clarify the role of hyperbaric oxygen therapy in combination with oral and...

Should we routinely perform steroid injections following microlaryngeal excision of benign lesions?

This retrospective cohort study assessed a single surgeon’s outcomes before and after the routine administration of intralesional triamcinolone following microsurgical removal of benign vocal fold lesions (polyps, nodules and cysts). A total of 211 patients were recruited for the study....

A more comprehensive management for eosinophilic chronic rhinosinusitis after FESS

In recent years there has been increasing recognition of eosinophilic chronic rhinosinusitis which, in particular, results in persistent symptoms and recurrence of nasal polyps, even after FESS surgery. It therefore calls for measures adjuvant to FESS to stop persistence of...

Use of topical steroids and antibiotics, compared to systemic antibiotics in the treatment of acute rhinusinusitis

Acute rhinusinusitis is mainly initiated by viral infections. Bacterial infection is usually superadded. The inflammatory cascade upregulates the pro-inflammatory mediators resulting in pain, nasal obstruction and nasal discharge. Local application of steroids and antibiotics could provide a higher concentration of...

Should intratympanic steroids be the first line treatment for sudden sensorineural hearing loss?

This article looked at whether intratympanic steroids (ITS) provide more benefits over systemic steroid therapy (SST) as initial therapy in patients with idiopathic sudden sensorineural hearing loss (ISSHL). This meta-analysis study, based on published RCTs, concluded that ITS treatment exhibited...

Monitoring the mouth in ALS

Amyotrophic lateral sclerosis (ALS; or motor neurone disease) is characterised by gradual loss of function in the speech muscles resulting in a progressive deterioration in a person’s ability to communicate. The aim of this study was to investigate the use...

Does salvage treatment in sudden sensorineural hearing loss work?

Many treatment strategies for sudden sensorineural hearing loss (SSNHL) have been discussed, but the high spontaneous recovery rate (32-65%) of idiopathic SSNHL and differing treatment guidelines make comparing outcomes difficult. Systemic steroids are the most common first-line therapy with significant...

Roshna Rose Paul: interview between trainee and senior surgeon

Professor Paul has been heavily involved with training and educating multiple cohorts of ENT trainees over the years, since 2010. In this article, Mr Reid (a current ENT registrar from the West Midlands) picks her brains. Prof Roshna Rose Paul....