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In search of courage; transition 
into Army

In search of courage. Well, that is how it all started. I was fairly advanced in surgical training not to mention age, when I decided to join the Territorial Army (TA). My peers, on hearing this couldn’t decide whether I...

Multidisciplinary approach to managing individuals with trisomy 21

Michelle Chung and Narad Mathura outline the Down syndrome one-stop clinic; a multidisciplinary clinic introduced at the Children & Young Persons Audiology Centre (CYPAC) at Guys and St Thomas’ NHS Foundation Trust for children and young people with Down syndrome....

Vicarious (nasal) menstruation

Hippocrates himself is known to have said that when a woman’s menses are due, but instead of the usual vaginal menstrual flow, she has a haemorrhage from the nose, then this is a sure sign of pregnancy [1]. Artist’s impression...

Role of interventional neuroradiology in otorhinolarygological pathology 
– a brief review

Introduction Since its advent in 1964 when Dotter percutaneously dilated a stenosed femoral artery [1], interventional radiology has undergone tremendous advancement in both imaging and devices that have enabled the operator (interventional radiologist) to access very distal small vasculature and...

Surgical management of sleep disordered breathing

Snoring and sleep-disordered breathing are often described as multi-level problems, and different surgical procedures are required to treat the various sites of airway narrowing and/or collapse. Jonathan Hobson gives us an eloquent run-through the various options available to the ENT...

Superior semicircular canal dehiscence syndrome

In this article, Hannah North and Simon Lloyd give us an overview of the complex condition of superior semicircular canal dehiscence (SSCD) syndrome, including diagnosis, treatment and management. Superior semicircular canal dehiscence (SSCD) is a bony defect of the otic...

Timing of surgery in chronic rhinosinusitis: does it matter?

While many patients with chronic rhinosinusitis respond to medical treatment, some do not. The next step for these patients is surgery, but how soon should this be offered? Sooner rather than later seems to be the answer, as Claire Hopkins...

Thyroid cancer – the last decade

Professor Ashok Shaha describes the evolution in the treatment of thyroid cancer that he has witnessed over the last decade and the invaluable progress made by himself and others, from their contributions to staging systems and guidelines. Nuances and paradigm...

Laryngotracheal stenosis

Airway stenosis has been an enormous challenge to laryngologists since the dawn of the sub-specialty. Careful evaluation is essential, as this will determine the best treatment. We hear more from one of the UK’s leading airway centres. Until the advent...

Olfaction in CRS

Conventional teaching tells us that hyposmia in chronic rhinosinusitis is due to mechanical obstruction of the olfactory cleft. But it might be that the story is slightly more complicated than that. Olfactory dysfunction is a common feature of chronic rhinosinusitis...

Mindfulness based approaches to tinnitus management: meditations on a new approach

Psychological approaches to tinnitus There is now widespread agreement that an individual’s interpretation of tinnitus can determine how distressing they find it. If tinnitus is regarded as non-threatening then habituation normally follows. If, however, tinnitus is interpreted as threatening, habituation...