Volume 6 Issue 3 - 2013

As we approach the end of the year no doubt many of you will be looking forward to a well deserved break over the Xmas period.

The Editorial Board and the administrative staff at RILA have been busy preparing for the ‘Update in ENT’ conference on the 5th of December at The Courthouse Hotel in London. We have some excellent speakers and the conference offers excellent value and I hope that you will be able to attend. Some of our more senior readers may remember the excellent one day conferences in the past that were organised by Professors Narula and Dhillon which were a great success and we hope to keep the meeting to the same high standard.

I went through the process of revalidation this summer and realised the importance of keeping good records of CPD activity, as it is now really compulsory to have evidence of participating in such activity. I hope you find ‘The Otorhinolaryngologist’ provides a good vehicle for your CPD and would welcome any feedback you may have on this aspect of the journal.

Please send me any comments as usual by e mail to This email address is being protected from spambots. You need JavaScript enabled to view it. With best wishes for Xmas and The New Year,

Best wishes,

Sanjai Sood

There has been fierce debate regarding the optimal surgical technique for the management of cholesteatoma for over 50 years. Choice of technique depends on factors relating to the surgeon, the patient and the disease process. Much literature has been devoted to the benefits and pitfalls of canal wall up and canal wall down techniques and their respective effects on measures such as number of operations required for disease eradication, adequate surgical access, complications, residual/recurrent cholesteatoma, hearing outcomes and long-term follow up. This article aims to review the pros and cons of canal wall up versus canal wall down surgery for cholesteatoma.

Acute Otitis Media (AOM) is a very common condition in children. Complications of acute otitis media have reduced with the introduction of antibiotics. However, intratemporal and intracranial complications still arise, particularly if there is acute mastoiditis. We discuss the intracranial complications of acute otitis media in children together with evidence-based management.

Chronic otitis media is the major reason for middle ear surgery. Epidemiological studies have revealed high heritability of persistent or recurrent middle ear inflammation. The genetic basis of chronic otitis media is complex, but a number of methods can be used to interrogate this complexity. The most promising method is the identification of genetic mutant mouse models, which may highlight genes to test for association with human disease, and enable pathobiology to be explored. Such an approach has suggested that the gene FBXO11 is associated with susceptibility to otitis media in man, and has also suggested that hypoxia signaling is an important component of the chronically inflamed middle ear. We discuss future research strategies in this field.

Ageing in humans refers to a multidimensional process of physical, psychological, and social change. These changes are interpreted and accepted in different ways for every different human. The face is the most distinguished part of the human body and is the conveyor of the effects of ageing to the observer. Accepting the new look of ageing differs from individual to individual and the longing of the ageing person to return to a younger place is what propels facial rejuvenation surgery. As the baby boomers age the demand for the naturally young face continues to increase and surgeons continue to strive to produce this look and previously accepted surgeries are changing everyday.

To be able to produce the natural facial ideal of youth the facial plastic surgeon must have op-timal knowledge of facial anatomy and the effects of ageing on the face.

This review article gives an overview of the current implantable hearing aid devices which are available in clinical practice for children. Although hearing aids remain the frontline option for children with hearing loss, there are now other alternatives to rehabilitate hearing in children where hearing aids are not applicable. This article summarises current views on cochlear implants, bone anchored hearing aids, middle ear implants and auditory brainstem implants in the paediatric population.

Abstract

Introduction: If auricular perichondritis is left untreated or sub optimally managed the development of a subperiosteal abscess with potential cartilage loss and gross cosmetic defect may ensue.

A preauricular sinus is a common congenital anomaly commonly found anterior to the ascending limb of the helix, resulting from incomplete fusion of the first and second hillocks of His. It presents as a discharging or infected lesion that is managed by surgical excision. We present a previously unreported case of an auricular sinus, located on the margin of the helix adjacent to the antitragus, resulting from incomplete fusion of the fifth and sixth hillocks of His. Whilst different surgical techniques may be used when excising such lesions, the age of the patient, the position and direction of the sinus tract and the potential deformity that can arise in the developing pinna must be taken into consideration.

Abstract

Introduction: The UK uses primary care physicians as “gatekeepers” to specialist services. In 2000 a referral pathway was implemented for patients with suspected Head & Neck cancer ensuring assessment by a specialist within 2-weeks of referral. Our aim was to assess the cancer detection rate for 2-week wait referrals and determine whether a one-stop clinic would be an appropriate use of resources in a 2-week wait referral clinic. Materials and Methods: A retrospective audit of all 2-week referrals from July 2009 to July 2010.

This is a laryngoscopic picture from a 55-year-old man presenting to ORL outpatients with frequent breaks in the voice. He underwent total hip replacement six weeks ago.

NOEORL at North of England Otolaryngology Society Spring Meeting, March 2013

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