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Leadership challenges in the world 
of AQP and accreditation – learning from experience

The words ‘choice and competition’, ‘any qualified provider (AQP)’ and ‘accreditation’ have irrevocably become part of audiology jargon in the last two years in England. Commissioners who chose ‘Adult Hearing Aid Services for age-related hearing loss’ have begun the process...

The Dilemma of Beethoven’s Deafness

Beethoven was one of the world’s greatest musicians, and his deafness is well known. Many details of his medical conditions are known, and various theories of his hearing loss have been proposed. Ludwig van Beethoven was born in 1770 in...

Lost and sound: exploring hyperbaric oxygen therapy for refractory SSNHL

Can hyperbaric oxygen therapy (HBOT) offer a breakthrough for patients with refractory sudden sensorineural hearing loss (SSNHL)? SSNHL is defined as acute hearing loss of ≥30 decibels in three consecutive frequencies within three days. Typically, it’s treated with two weeks...

N-acetylcysteine may have a role in the protection of cochlear hair cells

Gentamycin is an aminoglycoside antibiotic which is widely used throughout the world, despite its ototoxic potential. It therefore seems wise to continue the search for accessible otoprotective agents. The aim of this study was to clarify the potential protective role...

Unilateral vocal cord mobility impairment and laryngopulmonary physiology

The concept of iatrogenic recurrent laryngeal nerve injury following thyroid surgery is often considered with respect to voice change but its potential impact on airway physiology has thus far not been evaluated. A cross-sectional observational study reviewed 21 patients with...

Is benign intracranial hypertension underdiagnosed in patients with spontaneous CSF leaks?

In ENT practice we come across spontaneous CSF leaks. Patients present either as unilateral watery rhinorrhoea or otorrhoea, or sometimes as hearing loss with a watery middle ear effusion. Clinicians, after confirming the diagnosis of CSF leak with beta 2...

Otoacoustic emissions in the diagnostic test battery for hearing loss

So, they are great for screening, but how can otoacoustic emissions be integrated into the diagnostic test battery? Beth Prieve examines the role of diagnostic OAEs by asking three simple questions. Audiologists and otolaryngologists are familiar with otoacoustic emissions (OAEs)...

Development of an ENT undergraduate curriculum

With over a third of medical schools not including any clinical attachment in the subject, this is a laudable attempt to confront the deficiencies in undergraduate ENT teaching within the UK. The Delphi process is an established method of developing...

To drain or not to drain

These two separate papers neatly tie together the same ideas. The first, a retrospective study of 107 patients and 116 procedures over a 10-year period who underwent a CSF leak repair, 82.2% without a lumbar drain and 17.8% with. The...

Outpatient closure of CSF leaks: a good idea or a step too far?

After day-case septoplasty, day case thyroidectomy, now day case CSF leak repair – has the pendulum moved too far? The authors put forward a convincing case for what, only 10 years ago, would have sounded like a provocation. They quote...

When should we decompress the facial nerve in Bell’s Palsy?

It has been over three decades since Fisch popularised facial nerve (FN) decompression for Bell’s Palsy. Studies further exploring this have been few since, partly due to the major complications that can occur following this type of surgery. The current...

Pharmacological treatment of glue ear in children

Otitis media with effusion (OME), also known as glue ear, is a common cause of hearing loss in children. Most cases resolve spontaneously within three months. Early and proper management of OME can help avoid hearing and speech impairment that...