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How effective and safe is audiologist-led screening of acoustic neuroma in patients with asymmetrical hearing loss and unilateral tinnitus?

About two out of 100 patients presenting with asymmetric hearing and unilateral tinnitus have acoustic neuroma. The traditional method in which these patients first attend a clinician and then undergo screening through an MRI, can be expensive and prolong the...

Diagnostic performance of non-echo-planar diffusion weighted MRI in detection of suspected cholesteatoma

Even though a ‘second look’ remains a gold standard for detection of residual cholesteatoma after intact canal wall techniques, non-echo-planar diffusion weighted MRI is considered a reasonable alternative to avoid further surgery. However, to establish or exclude a cholesteatoma de...

Rationales to explore the neck in penetrating injuries

Penetrating neck injuries in the UK are more commonly associated with low velocity objects such as knives and blades as opposed to gunshots. To explore the neck requires careful consideration of the need to do so in line with Burgess...

Associated findings in MRI used for detecting acoustic neuroma

Presently, gadolinium enhanced magnetic resonance imaging is the ‘gold standard’ for investigating acoustic neuroma. There are often ‘incidental’ findings that may or may not be significant. In this study of 109 scans, the authors noted an uptake of 0.9% for...

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...

Treatment of internal carotid artery blowout with embolisation and bypass grafting (nasopharyngeal carcinoma)

Carotid artery blowout syndrome (CBS) occurs when there is rupture of the carotid artery causing massive epistaxis and bleeding through the oral cavity caused by tumour invasion, surgery, radiotherapy, or infection. This article proposes a revascularisation strategy for internal carotid...

Complications associated with intra-tympanic steroid injections for sudden sensorineural hearing loss

Around 15,000 people in the UK experience a sudden sensorineural hearing loss (SSNHL) each year, and in the majority of cases the cause is unknown. Treatment options for idiopathic SSNHL include various modalities of steroid treatments which have known limitations...

Biologics for deafness

Cochlear implants and hearing aids are inherently limited in their ability to restore ‘natural’ hearing. Biological therapy to treat inner ear pathology still is evolving rapidly with several ongoing clinical trials, though none are available for clinical practice to date....

Prophylactic gastrostomy tubes in advance of chemoradiotherapy for advanced head and neck malignancies – are they worthwhile?

It is well recognised that radical chemoradiotherapy (CRT) for head and neck cancers can significantly affect swallowing, especially if radiotherapy is delivered to the hypopharynx and/or both sides of the neck. As such, prophylactic gastrostomy tubes are often advocated in...